导 读

人工智能（AI）与医疗领域的交叉已成为备受关注的话题。ChatGPT是由OpenAI开发的先进的聊天机器人程序，它利用自然语言处理和人工智能来促进用户和计算机之间的交互对话。本文深入探讨了由OpenAI开发的前沿AI程序ChatGPT，是如何融入医疗保健领域，并从多方面提升医疗实践的水平。ChatGPT在彻底改变患者的医疗体验、医学教育和医生临床决策方面具有变革性潜力。然而，本研究也以批判的眼光审视了在医学等敏感和复杂领域采用此类AI技术所面临的挑战和限制。本研究的重要性在于对AI在医疗保健中的作用持中立态度，既认可其具有令人印象深刻的潜力，同时也警示了其所带来的风险和伦理困境。对于了解像ChatGPT这样的AI如何在确保患者安全和维护伦理标准的前提下推动医学领域发展至关重要。

图1 图文摘要

将OpenAI开发的ChatGPT融入医疗领域，标志着科技与医学融合迈出的重要一步。本文讨论了在医疗领域使用ChatGPT的潜在益处和挑战。

医疗文书工作通常是耗时且容易发生人为错误的任务。ChatGPT有望通过自动化文档处理来简化这些流程，降低医疗保健专业人员的工作负担和错误发生的概率，使他们能够更多地投入到患者护理中，从而提高患者的医疗质量。ChatGPT通过在不同数据集上广泛训练，积累了大量医学知识，对于需要迅速获取医疗信息的临床工作者尤其有益。它能够通过提供最新的医学研究和见解，有助于解决复杂病例的诊断问题。此外，ChatGPT还能为医学生和医疗专业人员提供获取信息的平台，以辅助医学教育。然而，AI系统的表现取决于它们接受训练的数据，信息准确性有待加强，医学研究的不断发展也意味着需要定期更新ChatGPT的知识库，以确保信息的时效性。此外，ChatGPT还具备使用自然语言进行互动的能力，以易于理解的方式向患者解释医疗状况和治疗方案，有助于揭开医学术语的复杂性，使普通人更容易理解医疗信息，从而能够做出更为明智的健康决策，但也可能会削弱医患关系中至关重要的人文关怀。

ChatGPT可能只在某些情况下与当下精准医学的需求相一致。AI算法主要基于广泛的数据集进行训练，可能无法解读每位患者独特的细微遗传和分子差异。因此或许有必要将更个性化的数据整合到ChatGPT的培训中，以确保其建议更加符合精准医学的原则。ChatGPT提供的信息的可靠性是其临床医疗应用中的关键问题，ChatGPT的训练数据可能并不总是准确或最新的。错误的信息可能导致误诊或不适当的治疗方案，因此需要严格的验证程序，并使用同行评审的循证医学信息持续更新其数据库。此外，ChatGPT对敏感患者数据的处理需要采取严格的数据保护措施，以防止侵犯个人隐私。关于基于ChatGPT建议做出的决策的问责性，也存在伦理困境。建立明确的指南和监管机制对于解决这些问题和确保AI在医疗卫生领域的合规使用至关重要。

尽管ChatGPT具有上述功能，但仍需要人类的监督。ChatGPT应被视为一种辅助工具，旨在增强而不是取代医疗工作者的专业知识。为了将ChatGPT优化用于医疗用途，需要不仅进行技术改进，还需要深入理解医疗保健领域所面临的独特挑战。专业技术人员、临床医生和政策制定者之间的紧密合作对于开发既有效又符合伦理的AI至关重要。综上所述，将ChatGPT整合到医疗保健领域具有巨大的潜力，可以改善患者护理和医疗管理的各个方面，但也伴随着重大挑战，必须以谨慎的态度应对。

总结与展望

ChatGPT是一种高级语言模型，能够生成类似于人类的自然语言响应。它在医学和医疗保健领域具有多种潜在应用，包括但不限于识别潜在的研究主题并生成相关文献摘要，为专业人员提供准确的信息，以辅助临床和实验室诊断，同时也有助于医学生、医生、护士和其他医疗保健从业者了解领域的最新进展。此外，它还可以开发虚拟助手，以协助患者管理健康，例如追踪药物剂量、提醒用药时间，以及回答患者的问题。然而，ChatGPT在医学领域也面临一些挑战和限制。因此，虽然在医疗保健领域具有广泛的应用前景，但仍需要进一步的研究和开发，以克服当前的局限性，提升性能和实用性。

责任编辑

盛剑鹏    浙江大学

易宗毕    武汉大学中南医院

本文内容来自

The Innovation姊妹刊

The Innovation Medicine第1卷第3期以Commentary发表的“ChatGPT: The doctor's assistant?” (投稿: 2023-08-30；接收: 2023-11-07；在线刊出: 2023-11-13)。

DOI: https://doi.org/10.59717/j.xinn-med.2023.100034

引用格式：Yin C., Zheng J., Liu J., et al., (2023). ChatGPT: The doctor's assistant? The Innovation Medicine 1(3), 100034.

作者简介

张剑宁，专业技术少将主任医师、教授，博士生导师，现任解放军总医院神经外科医学部主任，中国医促会神经损伤学分会主任委员、全军神经外科专业委员会副主任委员、中华医学会神经外科分会全国委员、中国医师协会神经外科分会全国委员、全军战创伤学专业委员会常委。先后获国家科技进步二等奖1项，中华医学科技一等将1项，军队科技进步二等奖1项，军队医疗成果二等奖6项，军队科技进步三等奖2项，陕西省科技进步三等奖1项，陕西省医药卫生科技成果一等奖1项。2014年荣获王忠诚中国神经外科医师学术成就奖。以第一作者发表学术论文180余篇。对颅脑战创伤救治、脑肿瘤基础与诊治等研究深入，承担全军重大科研课题、国家自然科学基金、863课题及省部级课题10余项。

刘佳雨，医学博士、博士后，解放军总医院神经外科医学部专业技术上尉主治医师。在国内外期刊发表学术论文34篇，以第一作者身份发表SCI论文22篇，累计影响因子102.046分。参编《神经外科学》，参译《神经外科手术技巧》、《功能神经外科与神经调控》等著作3部。参与国家自然科学基金面上项目1项和国家科技部重点专项1项。同时担任包括Aging、Pain Practice、 Cancer Medicine、Scientific Reports、World Neurosurgery等多个国内外期刊的编委和审稿人职务。多次在中华医学会、中国医师协会、中国医药协会等学术会议上进行发言和壁报展示。

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(min-width:1024px){body:not(.pages_skin_pc) .wx-root,body:not(.pages_skin_pc) body{--appmsgExtra-BG: #F7F7F7}}@media screen and (min-width:1024px){body:not(.pages_skin_pc) .wx-root[data-weui-theme=dark],body:not(.pages_skin_pc) body[data-weui-theme=dark]{--weui-BG-0: #111;--weui-BG-1: #1e1e1e;--weui-BG-2: #191919;--weui-BG-3: #202020;--weui-BG-4: #404040;--weui-BG-5: #2c2c2c;--weui-FG-0: rgba(255, 255, 255, .8);--weui-FG-HALF: rgba(255, 255, 255, .6);--weui-FG-1: rgba(255, 255, 255, .5);--weui-FG-2: rgba(255, 255, 255, .3);--weui-FG-3: rgba(255, 255, 255, .1);--weui-FG-4: rgba(255, 255, 255, .15);--weui-FG-5: rgba(255, 255, 255, .1);--weui-RED: #fa5151;--weui-ORANGERED: #ff6146;--weui-ORANGE: #c87d2f;--weui-YELLOW: #cc9c00;--weui-GREEN: #74a800;--weui-LIGHTGREEN: #3eb575;--weui-BRAND: #07c160;--weui-BLUE: #10aeff;--weui-INDIGO: #1196ff;--weui-PURPLE: #8183ff;--weui-WHITE: rgba(255, 255, 255, .8);--weui-LINK: #7d90a9;--weui-TEXTGREEN: #259c5c;--weui-FG: #fff;--weui-BG: 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