Dr. Alex Vaccaro on ChatGPT's role in orthopedics

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ChatGPT has received a lot of buzz in 2023, but what role does it have in orthopedics? 

Alex Vaccaro, MD, a spine surgeon and president of Rothman Orthopaedic Institute in Philadelphia, connected with Becker's to answer, "What technology is slated to be the next big thing in orthopedics?"

Dr. Alex Vaccaro: Orthopedics, and the broader field of healthcare, is faced with a unique opportunity due to significant advances in machine learning and artificial intelligence in the past decade. The possible applications of ChatGPT have been shown in diverse fields, including programming, climate change and education. 

In the field of orthopedics and healthcare, it has been also shown to have potential benefits, especially in medical research and patient care. In academic research, ChatGPT can serve as a useful tool for researchers to increase research efficiency as well as improve their writing. As ChatGPT is trained on a database up to the year of 2022, it is able to summarize scientific information up to that point in time. By entering any scientific prompt, researchers can quickly assess an overview of the subject and better understand the pre-existing literature. ChatGPT is also able to analyze a written work and correct grammatical mistakes, check citations, as well as offer stylistic improvements. However, when using ChatGPT to generate text, care must be taken to ensure accuracy of the text as well as avoiding plagiarism. 

Although it cannot replace the role of an orthopedic surgeon, ChatGPT may provide patients with information on orthopedic diagnosis and management. When given a patient history of shoulder and elbow symptoms, ChatGPT chose the diagnosis made by a shoulder and elbow specialist in 93% of the patients and correctly managed 83% of the patients. 

ChatGPT may also be used for the purpose of providing information to patients regarding surgery, but this should be used with caution. In one study looking at ChatGPT's ability to answer questions regarding anterior cruciate ligament surgery, ChatGPT was found to give an answer that was fully or mostly correct 65% of the time and was completely inaccurate 15% of the time. The problems of inaccurate information persist, but there is significant potential for patients to have their questions answered and better understand their diagnosis. 

ChatGPT may also be able to help providers in the setting of clinical support. Recent studies have shown that ChatGPT is able to instantly generate discharge summaries and operative notes. However, several problems were noted in both of these categories. In discharge summaries, the text was generic with discharge instructions that were not tailored to the problem at hand while in operative notes, details were added that were not accurate in the specific case. 

In these cases, ChatGPT can be trained to fix its errors post hoc, but any text generated by ChatGPT will require confirmation for accuracy. Despite this, once appropriately trained, ChatGPT may be able to increase clerical efficiency and save providers significant time, especially in these tasks that require providers to summarize several days' worth of information.

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