Are Generative Pretrained Transformer 4 Responses to Developmental Dysplasia of the Hip Clinical Scenarios Universal? An International Review.

Autor:	Luo S; Department of Pediatric Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning., Canavese F; Department of Orthopaedic Surgery, School of Medicine, Stanford University, Palo Alto, CA., Aroojis A; Department of Orthopaedic Surgery, School of Medicine, Stanford University, Palo Alto, CA., Andreacchio A; Department of Orthopaedic Surgery, School of Medicine, Stanford University, Palo Alto, CA., Anticevic D; Pediatric Orthopedics Clinic of Pediatric Surgery and Orthopedics, Pediatric Institute of Southern Switzerland (IPSI), Via Athos Gallino, Bellinzona, Switzerland., Bouchard M; Ufuk University Faculty of Medicine, Ankara, Turkey., Castaneda P; Department of Orthopaedic Surgery, School of Medicine, Stanford University, Palo Alto, CA., De Rosa V; Pediatric Orthopedics Clinic of Pediatric Surgery and Orthopedics, Pediatric Institute of Southern Switzerland (IPSI), Via Athos Gallino, Bellinzona, Switzerland., Fiogbe MA; Ufuk University Faculty of Medicine, Ankara, Turkey., Frick SL; Department of Orthopaedic Surgery, School of Medicine, Stanford University, Palo Alto, CA., Hui JH; Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan., Johari AN; Pediatric Orthopedics Clinic of Pediatric Surgery and Orthopedics, Pediatric Institute of Southern Switzerland (IPSI), Via Athos Gallino, Bellinzona, Switzerland., Loro A; Ufuk University Faculty of Medicine, Ankara, Turkey., Lyu X; Department of Orthopaedic Surgery, School of Medicine, Stanford University, Palo Alto, CA., Matsushita M; Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan., Omeroglu H; Ufuk University Faculty of Medicine, Ankara, Turkey., Roye DP; Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan., Shah MM; Ufuk University Faculty of Medicine, Ankara, Turkey., Yong B; Department of Pediatric Orthopaedics, Beit CURE Children's Hospital of Malawi, Chichiri Blantyre, Malawi., Li L; Department of Pediatric Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning.
Jazyk:	angličtina
Zdroj:	Journal of pediatric orthopedics [J Pediatr Orthop] 2024 Jul 01; Vol. 44 (6), pp. e504-e511. Date of Electronic Publication: 2024 Apr 09.
DOI:	10.1097/BPO.0000000000002682
Abstrakt:	Objective: There is increasing interest in applying artificial intelligence chatbots like generative pretrained transformer 4 (GPT-4) in the medical field. This study aimed to explore the universality of GPT-4 responses to simulated clinical scenarios of developmental dysplasia of the hip (DDH) across diverse global settings. Methods: Seventeen international experts with more than 15 years of experience in pediatric orthopaedics were selected for the evaluation panel. Eight simulated DDH clinical scenarios were created, covering 4 key areas: (1) initial evaluation and diagnosis, (2) initial examination and treatment, (3) nursing care and follow-up, and (4) prognosis and rehabilitation planning. Each scenario was completed independently in a new GPT-4 session. Interrater reliability was assessed using Fleiss kappa, and the quality, relevance, and applicability of GPT-4 responses were analyzed using median scores and interquartile ranges. Following scoring, experts met in ZOOM sessions to generate Regional Consensus Assessment Scores, which were intended to represent a consistent regional assessment of the use of the GPT-4 in pediatric orthopaedic care. Results: GPT-4's responses to the 8 clinical DDH scenarios received performance scores ranging from 44.3% to 98.9% of the 88-point maximum. The Fleiss kappa statistic of 0.113 ( P = 0.001) indicated low agreement among experts in their ratings. When assessing the responses' quality, relevance, and applicability, the median scores were 3, with interquartile ranges of 3 to 4, 3 to 4, and 2 to 3, respectively. Significant differences were noted in the prognosis and rehabilitation domain scores ( P < 0.05 for all). Regional consensus scores were 75 for Africa, 74 for Asia, 73 for India, 80 for Europe, and 65 for North America, with the Kruskal-Wallis test highlighting significant disparities between these regions ( P = 0.034). Conclusions: This study demonstrates the promise of GPT-4 in pediatric orthopaedic care, particularly in supporting preliminary DDH assessments and guiding treatment strategies for specialist care. However, effective integration of GPT-4 into clinical practice will require adaptation to specific regional health care contexts, highlighting the importance of a nuanced approach to health technology adaptation. Level of Evidence: Level IV. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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