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Efforts to apply artificial intelligence (AI) and machine learning in the medical field and specifically in neurosurgery are actively underway.1-7 Currently, imaging-based diagnosis, disease diagnosis, and methods of prediction using clinical data and genomic data are fields that receive the most attention.3-6,8-11 However, AI technologies associated with natural language processing are also being investigated.12 Conversational AI is an application of natural language processing that refers to AI technologies capable of communicating with people.13 These include chatbots or virtual agents using generative pretraining transformer (GPT) language models. These technologies are rapidly advancing and are poised to make a significant contribution to medical research and patient care. Multiple groups have already put various conversational AI platforms to use them foradvance patient care including taking down medical histories, assisting in psychotherapy, and improving care in chronic conditions.7,13-16 However, the conventional conversational AI platforms were limited with mostly structured rules of engagement. ChatGPT has new potential roles in both patient care and research including producing primary documents and assisting in research conceptualization/design. We gave a ChatGPT (OpenAI LLC) with the following prompt: Write me a research editorial for the journal: Neurosurgery about how we can incorporate chatbots into neurosurgical research and neurosurgical patient care and received an insightful and well-written correspondence completely generated by the software. We comment on how as a community we need to carefully embrace these powerful technologies to improve neurosurgical research and patient outcomes. “Integrating Chatbot Technology into Neurosurgical Research and Patient Care: A Research Editorial Over the past few years, chatbot technology has made significant strides in the field of health care, with chatbots being used to assist with tasks such as patient education, appointment scheduling, and symptom management. The use of chatbots in neurosurgery is a relatively new area of exploration, but it has the potential to revolutionize the way we conduct research and deliver care to patients with brain and nervous system conditions. One potential application of chatbot technology in neurosurgery is in the field of research. Chatbots can be used to gather data from large numbers of patients, streamlining the process of data collection and analysis. This can be particularly useful in longitudinal studies, where chatbots can be used to track patient outcomes over time. Chatbots can also be used to administer surveys or questionnaires to patients, allowing researchers to gather data on patient experiences and preferences. Another potential use of chatbot technology in neurosurgery is in the delivery of patient care. Chatbots can be used to provide patients with timely and accurate information about their care and treatment, helping to alleviate anxiety and confusion. Chatbots can also be used to triage patients with urgent issues, reducing the burden on emergency departments and allowing patients to receive care more quickly. In addition, chatbots can be used to facilitate communication between patients and their health care providers, allowing patients to receive care remotely and reducing the need for in-person visits. There are, of course, challenges to the integration of chatbot technology into neurosurgery. One concern is the potential for chatbots to misdiagnose or provide incorrect information, which could have serious consequences for patients. It is important for chatbots to be carefully designed and tested to ensure their accuracy and reliability. In addition, there may be privacy and security concerns surrounding the use of chatbots because sensitive patient information could be transmitted through chatbot conversations. These concerns will need to be carefully addressed as chatbot technology is developed and implemented in the field of neurosurgery. In conclusion, chatbot technology has the potential to revolutionize the way we conduct research and deliver care to patients with brain and nervous system conditions. Although there are challenges to be addressed, the potential benefits of chatbots in neurosurgery are significant, and it is important for researchers and health care providers to explore and invest in this promising area of technology.” (Text generated by OpenAI's Assistant AI:https://openai.com). As with anyone currently exploring ChatGPT technologies, we were impressed with the ease of use and abilities of the chatbot. However, because it becomes easier to write a manuscript than it is to read a manuscript or to have a chatbot respond to patient questions and triage medical necessity, the medical field and neurosurgery as its own community must begin thinking now about how to best integrate these advances into our profession. We must consider the ethics of using content generating AI. We must carefully navigate and control the dialog surrounding the most glaring controversies intrinsic to the use chatbot technology in medical care and scientific research, including Privacy concerns: Chatbot technology contains an intrinsic risk of compromising patient privacy. Chatbots may be used to collect and store sensitive health information, which could be vulnerable to breaches or misuse. Ethical concerns: In an academic setting, it is especially important to follow proper citation guidelines and to disclose the use of chatbot-generated content in works because failing to do so could be considered academic misconduct. Bias: There remains a serious risk of bias in using chatbot technology for recommendations or treatment plans and for compiling manuscripts. As chatbots are trained on available data, if that data are biased, it may perpetuate or amplify existing inequalities in published data. Legal liabilities: There are also concerns about legal liabilities when chatbot technology is used in medical care and research. For example, if a chatbot provides incorrect or harmful advice, who is responsible for the consequences? Validity: The content produced by a conversational AI platform must be validated, and its accuracy must be judged. Effectiveness: Finally, there is some debate about the effectiveness of chatbot technology in medical care and research. Although chatbots may be able to provide some basic information and assistance, they are at this time, likely unable to fully replace human health care providers in all cases. Incorporation of these technologies is poised to make significant contributions in medical research and patient care. Medicine as a whole must consider the use of chatbot/machine-generated content and ensure that it is appropriate for its intended purpose. It remains our human responsibility to verify machine content and ensure that it meets the moral and ethical standards and requirements of our fields and to recognize bias should it occur. Neurosurgery has always embraced innovation and should lead the way in introducing these AI technologies into the larger health care and academic environment. The future is now.
D’Amico et al. (Thu,) studied this question.