- 1. Xuzhou Clinical College, Xuzhou Medical University, Xuzhou 221004, P. R. China;
- 2. School of Management, Xuzhou Medical University, Xuzhou 221004, P. R. China;
- 3. The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, P. R. China;
TAN Zaixiang,
Email: tanzaixiang@126.com
As one of the hottest artificial intelligence technologies currently, ChatGPT, as one of the hottest artificial intelligence technologies today, plays a significant role in advancing the field of evidence-based medicine, particularly in expanding the sources of original evidence, enhancing the efficiency of evidence acquisition, aiding in shared decision-making between doctors and patients, and promoting education in evidence-based medicine and public science education. Presently, ChatGPT is in its "technological budding phase" and it is crucial to be wary of the risks it brings, such as "evidence contamination", algorithmic black boxes, security vulnerabilities, and the digital divide. To balance the positive effects and potential risks of ChatGPT in the realm of evidence-based medicine, we offer countermeasures and suggestions from the perspectives of ChatGPT's ethical standards, evidence sources, expert verification, and usage norms.
| 1. | 陆伟, 刘家伟, 马永强, 等. ChatGPT为代表的大模型对信息资源管理的影响. 图书情报知识, 2023, 40(2): 6-9,70. |
| 2. | 程思凡. ChatGPT知识生产框架、技术迷思与未来演进. 当代传播, 2023(6): 60-64. |
| 3. | Liu J, Wang C, Liu S. Utility of ChatGPT in clinical practice. J Med Internet Res, 2023, 25: e48568. |
| 4. | Liu S, Wright AP, Patterson BL, et al. Using AI-generated suggestions from ChatGPT to optimize clinical decision support. J Am Med Inform Assoc, 2023, 30(7): 1237-1245. |
| 5. | Hirosawa T, Kawamura R, Harada Y, et al. ChatGPT-generated differential diagnosis lists for complex case-derived clinical vignettes: diagnostic accuracy evaluation. JMIR Med Inform, 2023, 11: e48808. |
| 6. | Hirosawa T, Harada Y, Yokose M, et al. Diagnostic accuracy of differential-diagnosis lists generated by generative pretrained transformer 3 chatbot for clinical vignettes with common chief complaints: a pilot study. Int J Environ Res Public Health, 2023, 20(4): 3378. |
| 7. | Rao A, Kim J, Kamineni M, et al. Evaluating ChatGPT as an adjunct for radiologic decision-making. medRxiv, 2023, 2023: 2023.02. 02.23285399. |
| 8. | Rao A, Pang M, Kim J, et al. Assessing the utility of ChatGPT throughout the entire clinical workflow: development and usability study. J Med Internet Res, 2023, 25: e48659. |
| 9. | Kao HJ, Chien TW, Wang WC, et al. Assessing ChatGPT's capacity for clinical decision support in pediatrics: A comparative study with pediatricians using KIDMAP of Rasch analysis. Medicine (Baltimore), 2023, 102(25): e34068. |
| 10. | Levartovsky A, Ben-Horin S, Kopylov U, et al. Towards AI-augmented clinical decision-making: an examination of ChatGPT's utility in acute ulcerative colitis presentations. Am J Gastroenterol, 2023, 118(12): 2283-2289. |
| 11. | 张智雄, 于改红, 刘熠, 等. ChatGPT对文献情报工作的影响. 数据分析与知识发现, 2023, 7(3): 36-42. |
| 12. | 王建磊, 曹卉萌. ChatGPT的传播特质、逻辑、范式. 深圳大学学报(人文社会科学版), 2023, 40(2): 144-152. |
| 13. | Lin Z. Why and how to embrace AI such as ChatGPT in your academic life. R Soc Open Sci, 2023, 10(8): 230658. |
| 14. | Salvagno M, Taccone FS, Gerli AG. Can artificial intelligence help for scientific writing. Crit Care, 2023, 27(1): 75. |
| 15. | 陆瑶, 刘佳宁, 王冕, 等. 人工智能在医患共同决策中的应用. 协和医学杂志, 2023. |
| 16. | Abbasgholizadeh Rahimi S, Cwintal M, Huang Y, et al. Application of artificial intelligence in shared decision making: scoping review. JMIR Med Inform, 2022, 10(8): e36199. |
| 17. | 张锦英, 张洪江. 循证医学与人性化医疗: 实践现状、问题与原因分析. 医学与哲学, 2019, 40(23): 11-14,35. |
| 18. | 赵羚谷, 许卫卫, 王颖, 等. 我国临床实践中的医患共同决策流程设计和挑战. 医学与哲学, 2019, 40(18): 1-6,22. |
| 19. | Ayoub NF, Lee YJ, Grimm D, et al. Head-to-head comparison of ChatGPT versus google search for medical knowledge acquisition. Otolaryngol Head Neck Surg, 2023. |
| 20. | Jeblick K, Schachtner B, Dexl J, et al. ChatGPT makes medicine easy to swallow: an exploratory case study on simplified radiology reports. Eur Radiol, 2023. |
| 21. | Cascella M, Montomoli J, Bellini V, et al. Evaluating the feasibility of ChatGPT in healthcare: an analysis of multiple clinical and research scenarios. J Med Syst, 2023, 47(1): 33. |
| 22. | Chintagunta B, Katariya N, Amatriain X, et al. Medically aware GPT-3 as a data generator for medical dialogue summarization. Proceedings of the Second Workshop on Natural Language Processing for Medical Conversations, Association for Computational Linguistics, 2021. |
| 23. | 王云云, 靳英辉, 郭毅, 等. 新时代背景下循证医学助力新型医学人才培养的思考. 中国循证心血管医学杂志, 2021, 13(12): 1434-1437. |
| 24. | 余淳, 卢军, 张瑞琦, 等. 四川大学华西医院构建基于全生命周期的继续医学教育体系实践. 中国循证医学杂志, 2021, 21(10): 1219-1221. |
| 25. | 中华人民共和国中央人民政府. 新一代人工智能发展规划的通知. 2017. |
| 26. | 樊景春, 李金娟, 靳利梅, 等. 如何在医学生《循证医学》课程中开展案例教学. 教育教学论坛, 2017(47): 181-184. |
| 27. | Mousavi MA, Amini M, Delavari S, et al. Using team-based learning to teach evidence-based medicine to first-year residents. Acta Fac Medicae Nai, 2019, 36(1): 60-68. |
| 28. | 吴军其, 吴飞燕, 文思娇, 等. ChatGPT赋能教师专业发展: 机遇、挑战和路径. 中国电化教育, 2023(5): 15-23,33. |
| 29. | Lee H. The rise of ChatGPT: Exploring its potential in medical education. Anat Sci Educ, 2023. |
| 30. | Hou FQ, Wang Y, LI J, et al. Management of acute diarrhea in adults in China: a cross-sectional survey. BMC Public Health, 2013, 13: 41. |
| 31. | Wu T, He S, Liu J, et al. A brief overview of ChatGPT: the history, status quo and potential future development. IEEE/CAA J Autom Sinica, 2023, 10(5): 1122-1136. |
| 32. | De Angelis L, Baglivo F, Arzilli G, et al. ChatGPT and the rise of large language models: the new AI-driven infodemic threat in public health. Front Public Health, 2023, 11: 1166120. |
| 33. | 鞠宏磊, 申欣雨. 生成式人工智能产品的内容安全风险及监管路径. 经济问题, 2023(12): 16-19,27. |
| 34. | Lonnie LH. Experts say that soon, almost the entire internet could be generated by AI. 2022. |
| 35. | Dunn AG, Shih I, Ayre J, et al. What generative AI means for trust in health communications. J Commun Healthc, 2023, 16(4): 385-388. |
| 36. | Liu Y, Han T, Ma S, et al. Summary of ChatGPT-Related research and perspective towards the future of large language models. Meta-Radiology, 2023, 1(2): 100017. |
| 37. | Rudin C. Stop explaining black box machine learning models for high stakes decisions and use interpretable models instead. Nat Mach Intell, 2019, 1(5): 206-215. |
| 38. | Tools such as ChatGPT threaten transparent science; here are our ground rules for their use. Nature, 2023, 613(7945): 612-612. |
| 39. | van Dis EAM, Bollen J, Zuidema W, et al. ChatGPT: five priorities for research. Nature, 2023, 614(7947): 224-226. |
| 40. | Temsah MH, Aljamaan F, Malki KH, et al. ChatGPT and the future of digital health: a study on healthcare workers' perceptions and expectations. Healthcare (Basel), 2023, 11(13): 1812. |
| 41. | Praveen SV, Vajrobol V. Can ChatGPT be trusted for consulting. Uncovering doctor's perceptions using deep learning techniques. Ann Biomed Eng, 2023, 51(10): 2116-2119. |
| 42. | Goodman RS, Patrinely JR, Osterman T, et al. On the cusp: considering the impact of artificial intelligence language models in healthcare. Med, 2023, 4(3): 139-140. |
| 43. | Macnish K. Unblinking eyes: the ethics of automating surveillance. Ethics Inf Technol, 2012, 14(2): 151-167. |
| 44. | 付翔, 魏晓伟, 张浩, 等. 数字安全角度下审视和剖析ChatGPT. 航空兵器, 2023, 30(6): 1-7. |
| 45. | 意大利宣布禁用ChatGPT. 2023. |
| 46. | ChatGPT服务中断, 还泄露对话记录?OpenAI回应. 2023. |
| 47. | 李佩芳, 陈佳丽, 宁宁, 等. ChatGPT在医学领域的应用进展及思考. 华西医学, 2023, 38(10): 1456-1460. |
| 48. | Introducing ChatGPT. 2022. |
| 49. | Money will kill ChatGPT’s magic. 2022. |
| 50. | Liebrenz M, Schleifer R, Buadze A, et al. Generating scholarly content with ChatGPT: ethical challenges for medical publishing. Lancet Digit Health, 2023, 5(3): e105-e106. |
| 51. | 刘淼. 数字鸿沟: 定义域的扩展与实践场景的分析. 湖南师范大学社会科学学报, 2023, 52(4): 135-142. |
| 52. | 瞿星, 杨金铭, 陈滔, 等. ChatGPT对医学教育模式改变的思考. 四川大学学报(医学版), 2023, 54(5): 937-940. |
| 53. | Wang C, Liu S, Yang H, et al. Ethical considerations of using ChatGPT in health care. J Med Internet Res, 2023, 25: e48009. |
| 54. | 李雨, 张崇凡, 刘瀚旻, 等. 基于现代思想理解现代医学困境和循证医学实践. 中国循证儿科杂志, 2021, 16(5): 398-401. |
| 55. | McDougall RJ. Computer knows best. The need for value-flexibility in medical AI. J Med Ethics, 2019, 45(3): 156-160. |
| 56. | Karabacak M, Margetis K. Embracing large language models for medical applications: opportunities and challenges. Cureus, 2023, 15(5): e39305. |
| 57. | 李晓洁, 刘瑞爽, 丛亚丽. ChatGPT在医疗健康领域应用的伦理挑战及治理建议. 中华医学信息导报, 2023, 38(8): 5. |
| 58. | Luo X, Estill J, Chen Y. The use of ChatGPT in medical research: do we need a reporting guideline. Int J Surg, 2023, 109(12): 3750-3751. |
| 59. | Khlaif ZN, Mousa A, Hattab MK, et al. The potential and concerns of using AI in scientific research: ChatGPT performance evaluation. JMIR Med Educ, 2023, 9: e47049. |
- 1. 陆伟, 刘家伟, 马永强, 等. ChatGPT为代表的大模型对信息资源管理的影响. 图书情报知识, 2023, 40(2): 6-9,70.
- 2. 程思凡. ChatGPT知识生产框架、技术迷思与未来演进. 当代传播, 2023(6): 60-64.
- 3. Liu J, Wang C, Liu S. Utility of ChatGPT in clinical practice. J Med Internet Res, 2023, 25: e48568.
- 4. Liu S, Wright AP, Patterson BL, et al. Using AI-generated suggestions from ChatGPT to optimize clinical decision support. J Am Med Inform Assoc, 2023, 30(7): 1237-1245.
- 5. Hirosawa T, Kawamura R, Harada Y, et al. ChatGPT-generated differential diagnosis lists for complex case-derived clinical vignettes: diagnostic accuracy evaluation. JMIR Med Inform, 2023, 11: e48808.
- 6. Hirosawa T, Harada Y, Yokose M, et al. Diagnostic accuracy of differential-diagnosis lists generated by generative pretrained transformer 3 chatbot for clinical vignettes with common chief complaints: a pilot study. Int J Environ Res Public Health, 2023, 20(4): 3378.
- 7. Rao A, Kim J, Kamineni M, et al. Evaluating ChatGPT as an adjunct for radiologic decision-making. medRxiv, 2023, 2023: 2023.02. 02.23285399.
- 8. Rao A, Pang M, Kim J, et al. Assessing the utility of ChatGPT throughout the entire clinical workflow: development and usability study. J Med Internet Res, 2023, 25: e48659.
- 9. Kao HJ, Chien TW, Wang WC, et al. Assessing ChatGPT's capacity for clinical decision support in pediatrics: A comparative study with pediatricians using KIDMAP of Rasch analysis. Medicine (Baltimore), 2023, 102(25): e34068.
- 10. Levartovsky A, Ben-Horin S, Kopylov U, et al. Towards AI-augmented clinical decision-making: an examination of ChatGPT's utility in acute ulcerative colitis presentations. Am J Gastroenterol, 2023, 118(12): 2283-2289.
- 11. 张智雄, 于改红, 刘熠, 等. ChatGPT对文献情报工作的影响. 数据分析与知识发现, 2023, 7(3): 36-42.
- 12. 王建磊, 曹卉萌. ChatGPT的传播特质、逻辑、范式. 深圳大学学报(人文社会科学版), 2023, 40(2): 144-152.
- 13. Lin Z. Why and how to embrace AI such as ChatGPT in your academic life. R Soc Open Sci, 2023, 10(8): 230658.
- 14. Salvagno M, Taccone FS, Gerli AG. Can artificial intelligence help for scientific writing. Crit Care, 2023, 27(1): 75.
- 15. 陆瑶, 刘佳宁, 王冕, 等. 人工智能在医患共同决策中的应用. 协和医学杂志, 2023.
- 16. Abbasgholizadeh Rahimi S, Cwintal M, Huang Y, et al. Application of artificial intelligence in shared decision making: scoping review. JMIR Med Inform, 2022, 10(8): e36199.
- 17. 张锦英, 张洪江. 循证医学与人性化医疗: 实践现状、问题与原因分析. 医学与哲学, 2019, 40(23): 11-14,35.
- 18. 赵羚谷, 许卫卫, 王颖, 等. 我国临床实践中的医患共同决策流程设计和挑战. 医学与哲学, 2019, 40(18): 1-6,22.
- 19. Ayoub NF, Lee YJ, Grimm D, et al. Head-to-head comparison of ChatGPT versus google search for medical knowledge acquisition. Otolaryngol Head Neck Surg, 2023.
- 20. Jeblick K, Schachtner B, Dexl J, et al. ChatGPT makes medicine easy to swallow: an exploratory case study on simplified radiology reports. Eur Radiol, 2023.
- 21. Cascella M, Montomoli J, Bellini V, et al. Evaluating the feasibility of ChatGPT in healthcare: an analysis of multiple clinical and research scenarios. J Med Syst, 2023, 47(1): 33.
- 22. Chintagunta B, Katariya N, Amatriain X, et al. Medically aware GPT-3 as a data generator for medical dialogue summarization. Proceedings of the Second Workshop on Natural Language Processing for Medical Conversations, Association for Computational Linguistics, 2021.
- 23. 王云云, 靳英辉, 郭毅, 等. 新时代背景下循证医学助力新型医学人才培养的思考. 中国循证心血管医学杂志, 2021, 13(12): 1434-1437.
- 24. 余淳, 卢军, 张瑞琦, 等. 四川大学华西医院构建基于全生命周期的继续医学教育体系实践. 中国循证医学杂志, 2021, 21(10): 1219-1221.
- 25. 中华人民共和国中央人民政府. 新一代人工智能发展规划的通知. 2017.
- 26. 樊景春, 李金娟, 靳利梅, 等. 如何在医学生《循证医学》课程中开展案例教学. 教育教学论坛, 2017(47): 181-184.
- 27. Mousavi MA, Amini M, Delavari S, et al. Using team-based learning to teach evidence-based medicine to first-year residents. Acta Fac Medicae Nai, 2019, 36(1): 60-68.
- 28. 吴军其, 吴飞燕, 文思娇, 等. ChatGPT赋能教师专业发展: 机遇、挑战和路径. 中国电化教育, 2023(5): 15-23,33.
- 29. Lee H. The rise of ChatGPT: Exploring its potential in medical education. Anat Sci Educ, 2023.
- 30. Hou FQ, Wang Y, LI J, et al. Management of acute diarrhea in adults in China: a cross-sectional survey. BMC Public Health, 2013, 13: 41.
- 31. Wu T, He S, Liu J, et al. A brief overview of ChatGPT: the history, status quo and potential future development. IEEE/CAA J Autom Sinica, 2023, 10(5): 1122-1136.
- 32. De Angelis L, Baglivo F, Arzilli G, et al. ChatGPT and the rise of large language models: the new AI-driven infodemic threat in public health. Front Public Health, 2023, 11: 1166120.
- 33. 鞠宏磊, 申欣雨. 生成式人工智能产品的内容安全风险及监管路径. 经济问题, 2023(12): 16-19,27.
- 34. Lonnie LH. Experts say that soon, almost the entire internet could be generated by AI. 2022.
- 35. Dunn AG, Shih I, Ayre J, et al. What generative AI means for trust in health communications. J Commun Healthc, 2023, 16(4): 385-388.
- 36. Liu Y, Han T, Ma S, et al. Summary of ChatGPT-Related research and perspective towards the future of large language models. Meta-Radiology, 2023, 1(2): 100017.
- 37. Rudin C. Stop explaining black box machine learning models for high stakes decisions and use interpretable models instead. Nat Mach Intell, 2019, 1(5): 206-215.
- 38. Tools such as ChatGPT threaten transparent science; here are our ground rules for their use. Nature, 2023, 613(7945): 612-612.
- 39. van Dis EAM, Bollen J, Zuidema W, et al. ChatGPT: five priorities for research. Nature, 2023, 614(7947): 224-226.
- 40. Temsah MH, Aljamaan F, Malki KH, et al. ChatGPT and the future of digital health: a study on healthcare workers' perceptions and expectations. Healthcare (Basel), 2023, 11(13): 1812.
- 41. Praveen SV, Vajrobol V. Can ChatGPT be trusted for consulting. Uncovering doctor's perceptions using deep learning techniques. Ann Biomed Eng, 2023, 51(10): 2116-2119.
- 42. Goodman RS, Patrinely JR, Osterman T, et al. On the cusp: considering the impact of artificial intelligence language models in healthcare. Med, 2023, 4(3): 139-140.
- 43. Macnish K. Unblinking eyes: the ethics of automating surveillance. Ethics Inf Technol, 2012, 14(2): 151-167.
- 44. 付翔, 魏晓伟, 张浩, 等. 数字安全角度下审视和剖析ChatGPT. 航空兵器, 2023, 30(6): 1-7.
- 45. 意大利宣布禁用ChatGPT. 2023.
- 46. ChatGPT服务中断, 还泄露对话记录?OpenAI回应. 2023.
- 47. 李佩芳, 陈佳丽, 宁宁, 等. ChatGPT在医学领域的应用进展及思考. 华西医学, 2023, 38(10): 1456-1460.
- 48. Introducing ChatGPT. 2022.
- 49. Money will kill ChatGPT’s magic. 2022.
- 50. Liebrenz M, Schleifer R, Buadze A, et al. Generating scholarly content with ChatGPT: ethical challenges for medical publishing. Lancet Digit Health, 2023, 5(3): e105-e106.
- 51. 刘淼. 数字鸿沟: 定义域的扩展与实践场景的分析. 湖南师范大学社会科学学报, 2023, 52(4): 135-142.
- 52. 瞿星, 杨金铭, 陈滔, 等. ChatGPT对医学教育模式改变的思考. 四川大学学报(医学版), 2023, 54(5): 937-940.
- 53. Wang C, Liu S, Yang H, et al. Ethical considerations of using ChatGPT in health care. J Med Internet Res, 2023, 25: e48009.
- 54. 李雨, 张崇凡, 刘瀚旻, 等. 基于现代思想理解现代医学困境和循证医学实践. 中国循证儿科杂志, 2021, 16(5): 398-401.
- 55. McDougall RJ. Computer knows best. The need for value-flexibility in medical AI. J Med Ethics, 2019, 45(3): 156-160.
- 56. Karabacak M, Margetis K. Embracing large language models for medical applications: opportunities and challenges. Cureus, 2023, 15(5): e39305.
- 57. 李晓洁, 刘瑞爽, 丛亚丽. ChatGPT在医疗健康领域应用的伦理挑战及治理建议. 中华医学信息导报, 2023, 38(8): 5.
- 58. Luo X, Estill J, Chen Y. The use of ChatGPT in medical research: do we need a reporting guideline. Int J Surg, 2023, 109(12): 3750-3751.
- 59. Khlaif ZN, Mousa A, Hattab MK, et al. The potential and concerns of using AI in scientific research: ChatGPT performance evaluation. JMIR Med Educ, 2023, 9: e47049.