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Li B, Beaton D, Lee DS, Aljabri B, Al-Omran L, Wijeysundera DN, Hussain MA, Rotstein OD, de Mestral C, Mamdani M, Al-Omran M. Comprehensive review of virtual assistants in vascular surgery. Semin Vasc Surg 2024; 37:342-349. [PMID: 39277351 DOI: 10.1053/j.semvascsurg.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/15/2024] [Accepted: 07/02/2024] [Indexed: 09/17/2024]
Abstract
Virtual assistants, broadly defined as digital services designed to simulate human conversation and provide personalized responses based on user input, have the potential to improve health care by supporting clinicians and patients in terms of diagnosing and managing disease, performing administrative tasks, and supporting medical research and education. These tasks are particularly helpful in vascular surgery, where the clinical and administrative burden is high due to the rising incidence of vascular disease, the medical complexity of the patients, and the potential for innovation and care advancement. The rapid development of artificial intelligence, machine learning, and natural language processing techniques have facilitated the training of large language models, such as GPT-4 (OpenAI), which can support the development of increasingly powerful virtual assistants. These tools may support holistic, multidisciplinary, and high-quality vascular care delivery throughout the pre-, intra-, and postoperative stages. Importantly, it is critical to consider the design, safety, and challenges related to virtual assistants, including data security, ethical, and equity concerns. By combining the perspectives of patients, clinicians, data scientists, and other stakeholders when developing, implementing, and monitoring virtual assistants, there is potential to harness the power of this technology to care for vascular surgery patients more effectively. In this comprehensive review article, we introduce the concept of virtual assistants, describe potential applications of virtual assistants in vascular surgery for clinicians and patients, highlight the benefits and drawbacks of large language models, such as GPT-4, and discuss considerations around the design, safety, and challenges associated with virtual assistants in vascular surgery.
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Affiliation(s)
- Ben Li
- Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of Vascular Surgery, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Suite 7-074, Bond Wing, Toronto, ON, Canada, M5B 1W8; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Temerty Centre for Artificial Intelligence Research and Education in Medicine, University of Toronto, Toronto, ON, Canada
| | - Derek Beaton
- Data Science and Advanced Analytics, Unity Health Toronto, University of Toronto, Toronto, ON, Canada
| | - Douglas S Lee
- Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, ON, Canada
| | - Badr Aljabri
- Department of Surgery, King Saud University, Saudi Arabia
| | - Leen Al-Omran
- School of Medicine, Alfaisal University, Saudi Arabia
| | - Duminda N Wijeysundera
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, ON, Canada; Department of Anesthesia, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Mohamad A Hussain
- Division of Vascular and Endovascular Surgery and the Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Ori D Rotstein
- Department of Surgery, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Division of General Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Charles de Mestral
- Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of Vascular Surgery, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Suite 7-074, Bond Wing, Toronto, ON, Canada, M5B 1W8; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Muhammad Mamdani
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Temerty Centre for Artificial Intelligence Research and Education in Medicine, University of Toronto, Toronto, ON, Canada; Data Science and Advanced Analytics, Unity Health Toronto, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Mohammed Al-Omran
- Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of Vascular Surgery, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Suite 7-074, Bond Wing, Toronto, ON, Canada, M5B 1W8; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Temerty Centre for Artificial Intelligence Research and Education in Medicine, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Surgery, King Faisal Specialist Hospital and Research Center, Saudi Arabia.
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Lareyre F, Nasr B, Poggi E, Lorenzo GD, Ballaith A, Sliti I, Chaudhuri A, Raffort J. Large language models and artificial intelligence chatbots in vascular surgery. Semin Vasc Surg 2024; 37:314-320. [PMID: 39277347 DOI: 10.1053/j.semvascsurg.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/12/2024] [Accepted: 06/14/2024] [Indexed: 09/17/2024]
Abstract
Natural language processing is a subfield of artificial intelligence that aims to analyze human oral or written language. The development of large language models has brought innovative perspectives in medicine, including the potential use of chatbots and virtual assistants. Nevertheless, the benefits and pitfalls of such technology need to be carefully evaluated before their use in health care. The aim of this narrative review was to provide an overview of potential applications of large language models and artificial intelligence chatbots in the field of vascular surgery, including clinical practice, research, and education. In light of the results, we discuss current limits and future directions.
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Affiliation(s)
- Fabien Lareyre
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, France; Université Côte d'Azur, Centre National de la Recherche Scientifique (CNRS), UMR7370, Laboratoire de Physiomédecine Moléculaire (LP2M), Nice, France; Fédération Hospitalo-Universitaire FHU Plan & Go, Nice, France
| | - Bahaa Nasr
- University of Brest, Institut National de la Santé et de la Recherche Médicale (INSERM), IMT-Atlantique, UMR 1011 LaTIM, Vascular and Endovascular Surgery Department, CHU Cavale Blanche, Brest, France
| | - Elise Poggi
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, France
| | - Gilles Di Lorenzo
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, France
| | - Ali Ballaith
- Department of Cardiovascular Surgery, Zayed Military Hospital, Abu Dhabi, United Arab Emirates
| | - Imen Sliti
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, France
| | - Arindam Chaudhuri
- Bedfordshire - Milton Keynes Vascular Centre, Bedfordshire Hospitals, National Health Service Foundation Trust, Bedford, UK
| | - Juliette Raffort
- Université Côte d'Azur, Centre National de la Recherche Scientifique (CNRS), UMR7370, Laboratoire de Physiomédecine Moléculaire (LP2M), Nice, France; Fédération Hospitalo-Universitaire FHU Plan & Go, Nice, France; Clinical Chemistry Laboratory, University Hospital of Nice, France; Institute 3IA Côte d'Azur, Université Côte d'Azur, France; Department of Clinical Biochemistry, Hôpital Pasteur, Pavillon J, 30, Avenue de la Voie Romaine, 06001 Nice cedex 1, France.
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Lareyre F, Nasr B, Chaudhuri A, Di Lorenzo G, Carlier M, Raffort J. Comprehensive Review of Natural Language Processing (NLP) in Vascular Surgery. EJVES Vasc Forum 2023; 60:57-63. [PMID: 37822918 PMCID: PMC10562666 DOI: 10.1016/j.ejvsvf.2023.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/13/2023] [Accepted: 09/08/2023] [Indexed: 10/13/2023] Open
Abstract
Objective The use of Natural Language Processing (NLP) has attracted increased interest in healthcare with various potential applications including identification and extraction of health information, development of chatbots and virtual assistants. The aim of this comprehensive literature review was to provide an overview of NLP applications in vascular surgery, identify current limitations, and discuss future perspectives in the field. Data sources The MEDLINE database was searched on April 2023. Review methods The database was searched using a combination of keywords to identify studies reporting the use of NLP and chatbots in three main vascular diseases. Keywords used included Natural Language Processing, chatbot, chatGPT, aortic disease, carotid, peripheral artery disease, vascular, and vascular surgery. Results Given the heterogeneity of study design, techniques, and aims, a comprehensive literature review was performed to provide an overview of NLP applications in vascular surgery. By enabling identification and extraction of information on patients with vascular diseases, such technology could help to analyse data from healthcare information systems to provide feedback on current practice and help in optimising patient care. In addition, chatbots and NLP driven techniques have the potential to be used as virtual assistants for both health professionals and patients. Conclusion While Artificial Intelligence and NLP technology could be used to enhance care for patients with vascular diseases, many challenges remain including the need to define guidelines and clear consensus on how to evaluate and validate these innovations before their implementation into clinical practice.
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Affiliation(s)
- Fabien Lareyre
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, France
- Université Côte d'Azur, Inserm, U1065, C3M, Nice, France
| | - Bahaa Nasr
- Department of Vascular and Endovascular Surgery, Brest University Hospital, Brest, France
- INSERM, UMR 1101, LaTIM, Brest, France
| | - Arindam Chaudhuri
- Bedfordshire - Milton Keynes Vascular Centre, Bedfordshire Hospitals, NHS Foundation Trust, Bedford, UK
| | - Gilles Di Lorenzo
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, France
| | - Mathieu Carlier
- Department of Urology, University Hospital of Nice, Nice, France
| | - Juliette Raffort
- Université Côte d'Azur, Inserm, U1065, C3M, Nice, France
- Institute 3IA Côte d’Azur, Université Côte d’Azur, France
- Clinical Chemistry Laboratory, University Hospital of Nice, France
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Lareyre F, Lê CD, Ballaith A, Adam C, Carrier M, Amrani S, Caradu C, Raffort J. Applications of Artificial Intelligence in Non-cardiac Vascular Diseases: A Bibliographic Analysis. Angiology 2022; 73:606-614. [DOI: 10.1177/00033197211062280] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Research output related to artificial intelligence (AI) in vascular diseases has been poorly investigated. The aim of this study was to evaluate scientific publications on AI in non-cardiac vascular diseases. A systematic literature search was conducted using the PubMed database and a combination of keywords and focused on three main vascular diseases (carotid, aortic and peripheral artery diseases). Original articles written in English and published between January 1995 and December 2020 were included. Data extracted included the date of publication, the journal, the identity, number, affiliated country of authors, the topics of research, and the fields of AI. Among 171 articles included, the three most productive countries were USA, China, and United Kingdom. The fields developed within AI included: machine learning (n = 90; 45.0%), vision (n = 45; 22.5%), robotics (n = 42; 21.0%), expert system (n = 15; 7.5%), and natural language processing (n = 8; 4.0%). The applications were mainly new tools for: the treatment (n = 52; 29.1%), prognosis (n = 45; 25.1%), the diagnosis and classification of vascular diseases (n = 38; 21.2%), and imaging segmentation (n = 38; 21.2%). By identifying the main techniques and applications, this study also pointed to the current limitations and may help to better foresee future applications for clinical practice.
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Affiliation(s)
- Fabien Lareyre
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, Nice, France
- Université Côte d’Azur, Inserm U1065, C3M, Nice, France
- AI Institute 3IA Côte D’Azur, Université Côte D’Azur, Nice, Nice, France
| | - Cong Duy Lê
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, Nice, France
- AI Institute 3IA Côte D’Azur, Université Côte D’Azur, Nice, Nice, France
| | - Ali Ballaith
- Department of Vascular Surgery, University Hospital of Nice, Nice, France
| | - Cédric Adam
- Laboratory of Applied Mathematics and Computer Science (MICS), CentraleSupélec, Paris, France
| | - Marion Carrier
- Laboratory of Applied Mathematics and Computer Science (MICS), CentraleSupélec, Paris, France
| | - Samantha Amrani
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, Nice, France
| | - Caroline Caradu
- Vascular and General Surgery Department, Bordeaux University Hospital, Bordeaux, France
| | - Juliette Raffort
- Université Côte d’Azur, Inserm U1065, C3M, Nice, France
- AI Institute 3IA Côte D’Azur, Université Côte D’Azur, Nice, Nice, France
- Clinical Chemistry Laboratory, University Hospital of Nice, Nice, France
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