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arXiv 2602.05381cs.AI
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医学基于大语言模型聊天机器人在眼科患者查询中的临床验证与基于LLM的评估

Clinical Validation of Medical-based Large Language Model Chatbots on Ophthalmic Patient Queries with LLM-based Evaluation

Singapore National Eye Centre(新加坡国家眼科中心);Singapore Eye Research Institute(新加坡眼科研究所);Singapore Health Services(新加坡保健服务集团);Medical University of Vienna(维也纳医科大学);The Hospital at Maayo(马约医院);Duke-NUS Medical School(杜克-新加坡国立大学医学院);London School of Hygiene and Tropical Medicine(伦敦卫生与热带医学院);Chang Gung Memorial Hospital(长庚纪念医院);Taipei Medical University(台北医学大学);National Health Research Institutes(国家卫生研究院);Nanyang Technological University(南洋理工大学)
Ting Fang Tan, Kabilan Elangovan, Andreas Pollreisz, Kevin Bryan Dy, Wei Yan Ng, Joy Le Yi Wong, Jin Liyuan, Chrystie Quek Wan Ning, Ashley Shuen Ying Hong, Aru… 展开作者

Ting Fang Tan, Kabilan Elangovan, Andreas Pollreisz, Kevin Bryan Dy, Wei Yan Ng, Joy Le Yi Wong, Jin Liyuan, Chrystie Quek Wan Ning, Ashley Shuen Ying Hong, Arun James Thirunavukarasu, Shelley Yin-His Chang, Jie Yao, Dylan Hong, Wang Zhaoran, Amrita Gupta, Daniel SW Ting

AI总结:

本研究评估了四个医疗LLM在回答眼科患者问题中的表现,发现Meerkat-7B表现最佳,而MedLLaMA3-v20存在大量误导内容,GPT-4-Turbo评分与临床评分一致,表明基于LLM的评估在大规模基准测试中的可行性。

摘要:

领域特定的大语言模型越来越多地用于支持眼科患者教育、分诊和临床决策,因此需要严格评估以确保安全性和准确性。本研究评估了四个小型医疗LLM:Meerkat-7B、BioMistral-7B、OpenBioLLM-8B和MedLLaMA3-v20,在回答眼科相关患者查询方面的表现,并评估了基于LLM的评估在临床评分中的可行性。在横断面研究中,每个模型回答了180个眼科患者查询,生成了2160个响应。模型选择参数小于100亿以实现资源高效的部署。响应由三位不同资历的眼科医生和GPT-4-Turbo使用S.C.O.R.E.框架评估,该框架评估安全性、共识和上下文、客观性、可重复性和可解释性,评分采用五点利克特量表。LLM与临床评分的一致性通过斯皮尔曼等级相关性、肯德尔塔统计和核密度估计分析评估。Meerkat-7B在Senior Consultants、Consultants和Residents的评分中分别达到3.44、4.08和4.18的平均分。MedLLaMA3-v20表现最差,25.5%的响应包含幻觉或临床误导性内容,包括虚构术语。GPT-4-Turbo评分与临床评估总体一致,斯皮尔曼rho为0.80,肯德尔塔为0.67,尽管Senior Consultants评分更为保守。总体而言,医疗LLM在安全的眼科问题回答方面显示出潜力,但临床深度和共识仍存在差距,支持基于LLM的评估在大规模基准测试中的可行性,并强调需要混合自动和临床审查框架以指导安全的临床部署。

英文摘要:

Domain specific large language models are increasingly used to support patient education, triage, and clinical decision making in ophthalmology, making rigorous evaluation essential to ensure safety and accuracy. This study evaluated four small medical LLMs Meerkat-7B, BioMistral-7B, OpenBioLLM-8B, and MedLLaMA3-v20 in answering ophthalmology related patient queries and assessed the feasibility of LLM based evaluation against clinician grading. In this cross sectional study, 180 ophthalmology patient queries were answered by each model, generating 2160 responses. Models were selected for parameter sizes under 10 billion to enable resource efficient deployment. Responses were evaluated by three ophthalmologists of differing seniority and by GPT-4-Turbo using the S.C.O.R.E. framework assessing safety, consensus and context, objectivity, reproducibility, and explainability, with ratings assigned on a five point Likert scale. Agreement between LLM and clinician grading was assessed using Spearman rank correlation, Kendall tau statistics, and kernel density estimate analyses. Meerkat-7B achieved the highest performance with mean scores of 3.44 from Senior Consultants, 4.08 from Consultants, and 4.18 from Residents. MedLLaMA3-v20 performed poorest, with 25.5 percent of responses containing hallucinations or clinically misleading content, including fabricated terminology. GPT-4-Turbo grading showed strong alignment with clinician assessments overall, with Spearman rho of 0.80 and Kendall tau of 0.67, though Senior Consultants graded more conservatively. Overall, medical LLMs demonstrated potential for safe ophthalmic question answering, but gaps remained in clinical depth and consensus, supporting the feasibility of LLM based evaluation for large scale benchmarking and the need for hybrid automated and clinician review frameworks to guide safe clinical deployment.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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