Technology has transformed the
way people learn. Since the
birth of the internet, people
have taken to search engines
to seek information on a wide
range of subjects. When it
comes to finding out more about a disease, its
symptoms and treatments, one usually has to
sift through pages of unverified information.
Today, with user-friendly interfaces and
simple-to-understand conversational language,
free artificial intelligence (AI)-powered tools
like Chat Generative Pretrained Transformer
(ChatGPT) are shaking things up.
In Singapore, medical collaborations
with natural-language AI models are taking
off. A National Heart Centre Singapore
(NHCS) research team — whose members
include Dr Samuel Koh (above), Senior Resident,
and Clinical Associate Professor Jonathan
Yap, Consultant, Department of Cardiology
(below,) — decided to evaluate how well
ChatGPT can provide adequate explanations to patients on common procedures and
conditions. In an article entitled ‘Leveraging
ChatGPT to aid patient education on
coronary angiogram’ published last July in
Annals of the Academy of Medicine Singapore,
Dr Koh and his team suggested that heart
disease patients may seek information
through the large language model regarding
their condition. Dr Koh said: “ChatGPT is the
next game changer through its interactive
and conversational style, summarising facts in
simple language suitable for the layperson.”
Given the high rates of ischaemic heart
disease and heart failure in Singapore,
the research team focused on common
conditions and procedures such as coronary
angiography and heart failure. Among the
many benefits, they found that ChatGPT
provided jargon-free answers that a layperson
would find easy to understand. ChatGPT’s
responses to heart disease questions were also
presented in an organised, in-depth manner.
Despite this, the team was quick to
stress that ChatGPT, in its current form,
has its drawbacks. “The performance of
ChatGPT currently is insufficient to replace
the role of a healthcare provider in
delivering personalised health advice
and management,” said Dr Koh.
“Information taken from ChatGPT
needs to be verified with a healthcare
professional.” This is because
ChatGPT at times produced significant
factual inaccuracies. For instance, the
team noted that ChatGPT’s answers
regarding coronary angiogram incorrectly
listed the risks associated with angiography.
The team also noted that ChatGPT
omitted several recommendations that would
have been addressed in a consultation. For
example, it did not factor in non-cardiac
causes of chest pain and breathlessness when
asking about symptoms of heart disease and
the need for a coronary angiography.
Most importantly, ChatGPT lacked the
human touch of a physician. This was a
finding of a paper co-authored by Dr Koh
and Clinical Associate Professor David Sim,
Head and Senior Consultant, Department
of Cardiology, NHCS (‘Educating patient
with advanced heart failure through chat
generative pretrained transformer and
natural-language artificial intelligence: Is
now the time for it?’, published in Journal of
Palliative Medicine in July 2023). ChatGPT’s
responses were “generic” and “failed to take
into account the specific circumstances
of the individual”. End-of-life planning
calls for more empathetic and humanistic
approaches, but ChatGPT was unable to
manage the user’s emotional response and
acknowledged its own limitation by saying
that it had no intent to provide religious or
spiritual guidance involved in end-of-life
planning. Therefore, the team recommended
that patients discuss such topics with their
doctors and palliative care specialists.
ChatGPT, while somewhat useful, cannot
replace a qualified medical professional.
Despite ChatGPT’s current limitations, its
ease of access, user-friendly interface, and
quality of answers make it a potentially
helpful adjunct in the care and management
of patients.
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