In medicine, the accuracy and efficiency of information processing can be lifesaving. Medical large language models (LLMs) are designed to assist with this. They take on tasks like interpreting electronic health records (EHR), which helps clinicians spot important patterns and deliver better patient care. By analyzing EHRs, LLMs help create more personalized treatment plans and improve the quality of patient engagement without increasing the workload on healthcare providers.
The history of LLMs shows us big steps forward in how computers understand language and learn. Better designs for neural networks, lots of data, and more powerful computers have all helped make LLMs better.
The introduction of multimodal AI in healthcare, which combines text with other data types like images and sounds, is a leap forward. This approach can lead to more comprehensive care solutions. For instance, a medical LLM can process spoken language from doctor-patient interactions, turning these conversations into actionable data that can be referenced later.
How LLMs Can Affect Healthcare
LLMs are starting to change healthcare like stethoscopes and X-rays did before. These models can learn, change, and manage complex tasks, which may lead to better and more efficient healthcare. Several ways LLMs can affect healthcare:
- Organizing health data: These models can quickly and correctly sort health information into structured forms, identifying important terms and linking them to clinical categories. This could greatly improve how we record health data.
- Finding lost data: They can find missing information in patients’ records, such as in hospital discharge notes. The study showed a model found 31% of missing data, like height and weight, which helps analyze patient outcomes more fairly.
- Protecting patient information: Models can be trained to detect and hide sensitive health information, possibly doing a better job than old methods while keeping important data.
- Selecting patients for studies: These models can find patients for research studies by matching their details with study requirements. They can also help doctors suggest who might be right for a study.
- Answering patient questions: Models can assist doctors by responding to common questions from patients about health or medicines.
Legal and Ethical Perspectives
When including LLMs in healthcare, they will become as essential as drugs and medical devices. They need the same strict regulation and oversight. The Food and Drug Administration (FDA) is in a good position to regulate these models, much like it does with drugs and medical devices. The models should undergo thorough testing, just like new medicines do, to ensure they are safe and work well.
Although these models have great potential, integrating them into healthcare will take time and care. For example, a study from 2019 found that many doctors are skeptical about the benefits of artificial intelligence. We should introduce these models gradually, avoiding too much disruption to existing clinical workflows. Doctors will need training and support to use them well.
Despite the promise, these technologies come with challenges. The accuracy of LLMs in medicine must be impeccable, as mistakes can have serious consequences. Furthermore, LLMs need to be fine-tuned to recognize the delicateness of different medical specialties. There’s also the ethical side of AI, where biases in training data must be addressed to prevent unequal treatment recommendations.
The WHO advocates for the secure and ethical use of AI in healthcare
The World Health Organization (WHO) has issued a warning about the use of AI, particularly LLMs, in the health sector. The organization emphasizes the importance of using these tools responsibly to safeguard human well-being and public health. However, WHO insists on a cautious approach to leveraging LLMs to improve access to health information, assist in clinical decisions, or improve diagnoses in regions with fewer resources. The aim is to protect health and address health disparities. WHO points out several concerns for strict monitoring to ensure the safe, effective, and ethical use of these technologies:
- Training data for AI might be biased, leading to false or inaccurate outputs that can harm health and equity.
- LLMs can produce answers that seem credible but may be wrong or contain severe mistakes, particularly in health-related areas.
- LLMs might be using data without proper consent and may not safeguard sensitive information provided by users.
- LLMs have the potential to be exploited to create and spread convincing false information in text, audio, or video, which the public may struggle to identify as unreliable.
- While WHO is dedicated to using new technologies like AI to advance health, it advises policymakers to prioritize patient safety and protection as tech companies commercialize LLMs.
Exploring Healthcare Language Models
OpenAI recently checked how well their latest model, GPT-4, did on tests that doctors take and on different healthcare-related questions. GPT-4 isn’t made just for medical stuff, but it still did a great job. In the tests, which included the MultiMedQA and some real test questions from the US Medical License Exam, GPT-4 scored more than 20 points above the passing level. It even did better than the older GPT-3.5 and some other AI trained specifically for medical questions. Plus, GPT-4 was better at knowing when its answers might be right or wrong, which is a big step up from before.
John Snow Labs has created advanced LLMs for medical purposes that have made great strides in healthcare natural language processing (NLP). These models perform better than many other language models specialized in healthcare. They can summarize clinical notes with 30% more accuracy than models like BART, Flan-T5, and Pegasus. This means they are good at picking out the key information from complex medical notes, making it easier for healthcare workers to understand them. When pulling out medical codes used for diagnosis and procedures, John Snow Labs’ models get it right 76% of the time. GPT-3.5 and GPT-4 have lower success rates, at 26% and 36%, showing John Snow Labs’ models are better at this task, based on the study.
Doctors need to actively shape and create the LLMs in medicine. The researchers from Stanford University highlighted that doctors should compromise about making common datasets that show how to give instructions like “summarize a patient’s past specialist visits.” Instead of paying for services like GPT-4, healthcare systems could make their own free, shared models using their data. In addition, healthcare institutions should ask tech companies if their models were trained with medical data and if the training methods fit the model’s final use.
Shah, Entwistle, and Pfeffer from Stanford University point out that right now, they’re not sure how much LLMs help in clinics because they haven’t figured out the best way to test them. There are issues with how to check their skills, like if the test data was already used in training or if it’s fair to use human tests for machines. It’s like checking if a car is safe to drive or if a person can drive. The car is tested in making, not with a driving test meant for people. Saying an LLM can give medical advice because it passed a medical test is like giving a car a driving test. It doesn’t make sense, according to them. What benefits of LLMs could be brought and then tested to see if they’re real? Only after that can it be confirmed that an LLM helped in a particular job. These tests are needed to understand the legal risks and how to handle wrong answers LLMs might give, which can sound right but need to be revised. Testing LLMs in real situations, like on-the-road tests for cars, is important before any doctor relies on them too much. If we want to use them to help doctors, not replace them, this kind of testing is the key. Otherwise, we might use them for things we already do well without asking how they could help us do even better.
Doctors can’t ignore LLMs as powerful tools. They need to lead the way in using them in everyday practice by picking the right training data and checking if LLMs really deliver the promised benefits.
The future of healthcare LLMs is bright. They’re not only refining the current practices but also paving the way for new types of healthcare solutions that are more accessible, efficient, and personalized. As we continue to develop and integrate LLMs into healthcare systems, we are witnessing a new chapter in medical history, one where data and care converge to create unprecedented patient support.