Artificial Intelligence-Powered Hand Surgery Consultation: GPT-4 as an Assistant in a Hand Surgery Outpatient Clinic

The Journal Of Hand Surgery, vol. 49, pp. 1078–1088

Abstract

PURPOSE: Exploring the integration of artificial intelligence in clinical settings, this study examined the feasibility of using Generative Pretrained Transformer 4 (GPT-4), a large language model, as a consultation assistant in a hand surgery outpatient clinic. METHODS: The study involved 10 simulated patient scenarios with common hand conditions, where GPT-4, enhanced through specific prompt engineering techniques, conducted medical history interviews, and assisted in diagnostic processes. A panel of expert hand surgeons, each board-certified in hand surgery, evaluated GPT-4's responses using a Likert Scale across five criteria with scores ranging from 1 (lowest) to 5 (highest). RESULTS: Generative Pretrained Transformer 4 achieved an average score of 4.6, reflecting good performance in documenting a medical history, as evaluated by the hand surgeons. CONCLUSIONS: These findings suggest that GPT-4 can effectively document medical histories to meet the standards of hand surgeons in a simulated environment. The findings indicate potential for future application in patient care, but the actual performance of GPT-4 in real clinical settings remains to be investigated. CLINICAL RELEVANCE: This study provides a preliminary indication that GPT-4 could be a useful consultation assistant in a hand surgery outpatient clinic, but further research is required to explore its reliability and practicality in actual practice.

Authors 4

1. Tim Leypold corresponding Aachen Department of Plastic Surgery Hand Surgery—Burn Center

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Plastic Surgery, Hand Surgery-Burn Center, University Hospital Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Aachen, Germany. Electronic address: tleypold@ukaachen.de

2. Benedikt Schäfer Aachen Department of Plastic Surgery Hand Surgery—Burn Center

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Plastic Surgery, Hand Surgery-Burn Center, University Hospital Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Aachen, Germany

3. Anja Miriam Boos Aachen Department of Plastic Surgery Hand Surgery—Burn Center

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Plastic Surgery, Hand Surgery-Burn Center, University Hospital Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Aachen, Germany

4. Justus P. Beier Aachen Department of Plastic Surgery Hand Surgery—Burn Center

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Plastic Surgery, Hand Surgery-Burn Center, University Hospital Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Aachen, Germany