Potential for GPT Technology to Optimize Future Clinical Decision-Making Using Retrieval-Augmented Generation

ChatGPT and Beyond: An overview of the growing field of large language models and their use in ophthalmology

ChatGPT, an artificial intelligence (AI) chatbot built on large language models (LLMs), has rapidly gained popularity. The benefits and limitations of this transformative technology have been discussed across various fields, including medicine. The widespread availability of ChatGPT has enabled clinicians to study how these tools could be used for a variety of tasks such as generating differential diagnosis lists, organizing patient notes, and synthesizing literature for scientific research. LLMs have shown promising capabilities in ophthalmology by performing well on the Ophthalmic Knowledge Assessment Program, providing fairly accurate responses to questions about retinal diseases, and in generating differential diagnoses list. There are current limitations to this technology, including the propensity of LLMs to "hallucinate", or confidently generate false information; their potential role in perpetuating biases in medicine; and the challenges in incorporating LLMs into research without allowing "AI-plagiarism" or publication of false information. In this paper, we provide a balanced overview of what LLMs are and introduce some of the LLMs that have been generated in the past few years. We discuss recent literature evaluating the role of these language models in medicine with a focus on ChatGPT. The field of AI is fast-paced, and new applications based on LLMs are being generated rapidly; therefore, it is important for ophthalmologists to be aware of how this technology works and how it may impact patient care. Here, we discuss the benefits, limitations, and future advancements of LLMs in patient care and research.

Large language models as decision aids in neuro-oncology: a review of shared decision-making applications

Shared decision-making (SDM) is crucial in neuro-oncology, fostering collaborations between patients and healthcare professionals to navigate treatment options. However, the complexity of neuro-oncological conditions and the cognitive and emotional burdens on patients present significant barriers to achieving effective SDM. This discussion explores the potential of large language models (LLMs) such as OpenAI's ChatGPT and Google's Bard to overcome these barriers, offering a means to enhance patient understanding and engagement in their care. LLMs, by providing accessible, personalized information, could support but not supplant the critical insights of healthcare professionals. The hypothesis suggests that patients, better informed through LLMs, may participate more actively in their treatment choices. Integrating LLMs into neuro-oncology requires navigating ethical considerations, including safeguarding patient data and ensuring informed consent, alongside the judicious use of AI technologies. Future efforts should focus on establishing ethical guidelines, adapting healthcare workflows, promoting patient-oriented research, and developing training programs for clinicians on the use of LLMs. Continuous evaluation of LLM applications will be vital to maintain their effectiveness and alignment with patient needs. Ultimately, this exploration contends that the thoughtful integration of LLMs into SDM processes could significantly enhance patient involvement and strengthen the patient-physician relationship in neuro-oncology care.