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Łaszkiewicz J, Krajewski W, Tomczak W, Chorbińska J, Nowak Ł, Chełmoński A, Krajewski P, Sójka A, Małkiewicz B, Szydełko T. Performance of ChatGPT in providing patient information about upper tract urothelial carcinoma. Contemp Oncol (Pozn) 2024; 28:172-181. [PMID: 39421706 PMCID: PMC11480910 DOI: 10.5114/wo.2024.141567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 05/14/2024] [Indexed: 10/19/2024] Open
Abstract
Introduction The aim was to evaluate ChatGPT generated responses to patient-important questions regarding upper tract urothelial carcinoma (UTUC). Material and methods Fifteen common inquiries asked by patients regarding UTUC were assigned to 4 categories: general information; symptoms and diagnosis; treatment; and prognosis. These questions were entered into ChatGPT and its responses were recorded. In every answer 5 criteria (adequate length, comprehensible language, precision in addressing the question, compliance with European Association of Urology guidelines and safety of the response for the patient) were assessed by the urologists using a numerical scale of 1-5 (a score of 5 being the best). Results Sixteen questionnaires were included. A score of five was assigned 336 times (28.0%); 4 - 527 times, (43.9%); 3 - 268 times (22.3%); 2 - 53 ti- mes (4.4%); and 1 - 16 times (1.3%). The average overall score was 3.93. Responses to each question received average scores within the range 3.34-4.18. Answers regarding "general information" were graded the highest - mean score 4.14. Artificial intelligence scored the lowest in the "treatment" category - mean score 3.68. A mean score of 4.02 was given for the safety of the response. However, a few urologists considered several answers as unsafe for the patient, by grading them 1 or 2 in this criterion. Conclusions ChatGPT does not provide fully adequate information on UTUC, and inquiries regarding treatment can be misleading for the patients. In particular cases, patients might receive potentially unsafe answers. However, ChatGPT can be used with caution to provide basic information regarding epidemiology and risk factors of UTUC.
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Affiliation(s)
- Jan Łaszkiewicz
- University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Wojciech Krajewski
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Wojciech Tomczak
- University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Joanna Chorbińska
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Łukasz Nowak
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Adam Chełmoński
- University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Piotr Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wrocław, Poland
| | - Aleksandra Sójka
- University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Bartosz Małkiewicz
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Tomasz Szydełko
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
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Klemm J, Bekku K, Abufaraj M, Laukhtina E, Matsukawa A, Parizi MK, Karakiewicz PI, Shariat SF. Upper Tract Urothelial Carcinoma: A Narrative Review of Current Surveillance Strategies for Non-Metastatic Disease. Cancers (Basel) 2023; 16:44. [PMID: 38201472 PMCID: PMC10777993 DOI: 10.3390/cancers16010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Non-metastatic upper urinary tract carcinoma (UTUC) is a comparatively rare condition, typically managed with either kidney-sparing surgery (KSS) or radical nephroureterectomy (RNU). Irrespective of the chosen therapeutic modality, patients with UTUC remain at risk of recurrence in the bladder; in patients treated with KSS, the risk of recurrence is high in the remnant ipsilateral upper tract system but there is a low but existent risk in the contralateral system as well as in the chest and in the abdomen/pelvis. For patients treated with RNU for high-risk UTUC, the risk of recurrence in the chest, abdomen, and pelvis, as well as the contralateral UT, depends on the tumor stage, grade, and nodal status. Hence, implementing a risk-stratified, location-specific follow-up is indicated to ensure timely detection of cancer recurrence. However, there are no data on the type and frequency/schedule of follow-up or on the impact of the recurrence type and site on outcomes; indeed, it is not well known whether imaging-detected asymptomatic recurrences confer a better outcome than recurrences detected due to symptoms/signs. Novel imaging techniques and more precise risk stratification methods based on time-dependent probabilistic events hold significant promise for making a cost-efficient individualized, patient-centered, outcomes-oriented follow-up strategy possible. We show and discuss the follow-up protocols of the major urologic societies.
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Affiliation(s)
- Jakob Klemm
- Department of Urology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria; (K.B.); (M.A.); (E.L.); (A.M.); (M.K.P.); (S.F.S.)
| | - Kensuke Bekku
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria; (K.B.); (M.A.); (E.L.); (A.M.); (M.K.P.); (S.F.S.)
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8525, Japan
| | - Mohammad Abufaraj
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria; (K.B.); (M.A.); (E.L.); (A.M.); (M.K.P.); (S.F.S.)
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman 11733, Jordan
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria; (K.B.); (M.A.); (E.L.); (A.M.); (M.K.P.); (S.F.S.)
- Institute for Urology and Reproductive Health, Sechenov University, 119991 Moscow, Russia
| | - Akihiro Matsukawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria; (K.B.); (M.A.); (E.L.); (A.M.); (M.K.P.); (S.F.S.)
- Department of Urology, Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Mehdi Kardoust Parizi
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria; (K.B.); (M.A.); (E.L.); (A.M.); (M.K.P.); (S.F.S.)
| | - Pierre I. Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC H2X 3E4, Canada;
| | - Shahrokh F. Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria; (K.B.); (M.A.); (E.L.); (A.M.); (M.K.P.); (S.F.S.)
- Institute for Urology and Reproductive Health, Sechenov University, 119991 Moscow, Russia
- Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman 11942, Jordan
- Karl Landsteiner Institute of Urology and Andrology, 1090 Vienna, Austria
- Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Urology, Second Faculty of Medicine, Charles University, 252 50 Prague, Czech Republic
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