Using ChatGPT for Patient’s Q&A. What Could Go Wrong?

In a field where precision is everything, new work from the Hospital for Special Surgery (HSS) in New York dives into the details of using artificial intelligence driven chatbots like ChatGPT to answer patient’s questions. Accuracy, it seems, is still a work-in-progress.

The study, “Using Artificial Intelligence to Answer Common Patient-Focused Questions in Minimally Invasive Spine Surgery,” appears in the May 29, 2023, edition of The Journal of Bone and Joint Surgery.

Co-author Sheeraz Qureshi, M.D., M.B.A., the Patty and Jay Baker Chair in Minimally Invasive Spine Surgery at HSS, told OTW, “The recent advancements in artificial intelligence (AI), such as chatbots, have brought about a new way our patients may potentially utilize these technologies by posing questions to gain insight into their own conditions.”

“One of our primary concerns is that patients review inaccurate information which can hinder proper medical care. Therefore, it was crucial to us to critically evaluate and test the accuracy and ability of these technologies and to understand their value and limitations. This allows us to counsel patients who may have referenced chatbots appropriately.”

In this study, the authors employed ChatGPT to answer questions often posed by patients. According to Dr. Qureshi, “We drew on the experiences of the attending surgeons regarding common questions they get asked in clinic from patients. We utilized many of those same questions in this study.”

The team secured a variety of prompts and responses, beginning with ChatGPT introducing itself. Patient questions included, “I have back pain radiating down my leg. What should I do and what type of doctor should I see?” and “Do I need spine surgery?” Other topics broached were alternatives to surgery, specific types of surgery, and postoperative recovery.

OTW asked Dr. Qureshi about his concerns regarding this technology and he said, “The primary concern for artificial intelligence technology, like chatbots, pertains to its ability to present inaccurate information in a highly believable style that is difficult for the average person to evaluate. Of course, we understand the great value for this technology to benefit our patients it is important to understand its limitations and view the technology accordingly.”

“As a chatbot, there is no limit to the number of questions we could have asked. In this initial evaluation, we considered asking questions that our team felt patients would most likely ask if they used this resource. Given that this technology remains freely accessible and available, we will continue to evaluate its capacity in the field of orthopedics.”

OTW also asked Dr. Qureshi about the speed with which these kinds of AI-based technologies are moving into the “average” orthopedic and spine practice.

In Dr. Qureshi’s view, “Artificial intelligence technologies have exponentially increased in their utilization across all industries. The adoption of AI technologies by orthopedic surgeons will significantly vary based on the specific use case. In our paper we explored its usage for patient education. However, usage for radiographic analysis, augmented reality, and robotic solutions have all been reported. The field is so broad and incredibly valuable so we believe that widespread adoption of AI by orthopedic surgeons is already beginning and as we see well-designed systems which are able to integrate their utility, we can expect to see further adoption.”