OBJECTIVE: To evaluate the accuracy of Chat Generative Pretrained Transformer (ChatGPT)-4.0 by comparing its appropriateness scores for acute hip fractures with the American Academy of Orthopaedic Surgeons (AAOS) Appropriate Use Criteria given 30 patient scenarios. \"Appropriateness\" indicates the unexpected health benefits of treatment exceed the expected negative consequences by a wide margin.
METHODS: Using the AAOS Appropriate Use Criteria as the benchmark, numerical scores from 1 to 9 assessed appropriateness. For each patient scenario, ChatGPT-4.0 was asked to assign an appropriate score for six treatments to manage acute hip fractures.
RESULTS: Thirty patient scenarios were evaluated for 180 paired scores. Comparing ChatGPT-4.0 with AAOS scores, there was a positive correlation for multiple cannulated screw fixation, total hip arthroplasty, hemiarthroplasty, and long cephalomedullary nails. Statistically significant differences were observed only between scores for long cephalomedullary nails.
CONCLUSIONS: ChatGPT-4.0 scores were not concordant with AAOS scores, overestimating the appropriateness of total hip arthroplasty, hemiarthroplasty, and long cephalomedullary nails, and underestimating the other three. ChatGPT-4.0 was inadequate in selecting an appropriate treatment deemed acceptable, most reasonable, and most likely to improve patient outcomes.
目的:通过将聊天生成式预训练变压器(ChatGPT)-4.0的急性髋部骨折的适当性评分与美国骨科医师学会(AAOS)的适当使用标准进行比较,以评估30例患者的情况。“适当性”表示治疗的意外健康益处远远超过预期的负面后果。
方法:使用AAOS适当使用标准作为基准,从1到9的数字分数评估适当性。对于每种患者情况,ChatGPT-4.0被要求为六种治疗急性髋部骨折的治疗分配适当的评分。
结果:对30例患者情景进行180个配对评分评估。比较ChatGPT-4.0与AAOS评分,多个空心螺钉固定呈正相关,全髋关节置换术,半髋关节置换术,和长的头髓内钉.仅在长头髓内钉的评分之间观察到统计学上的显着差异。
结论:ChatGPT-4.0评分与AAOS评分不一致,高估全髋关节置换术的适当性,半髋关节置换术,和长的头髓内钉,低估了其他三个。ChatGPT-4.0不足以选择被认为可接受的适当治疗,最合理的,最有可能改善患者预后。