Towards Conversational Diagnostic AI

Fuente: arXiv
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Auteurs principaux: Tu, Tao, Palepu, Anil, Schaekermann, Mike, Saab, Khaled, Freyberg, Jan, Tanno, Ryutaro, Wang, Amy, Li, Brenna, Amin, Mohamed, Tomasev, Nenad, Azizi, Shekoofeh, Singhal, Karan, Cheng, Yong, Hou, Le, Webson, Albert, Kulkarni, Kavita, Mahdavi, S Sara, Semturs, Christopher, Gottweis, Juraj, Barral, Joelle, Chou, Katherine, Corrado, Greg S, Matias, Yossi, Karthikesalingam, Alan, Natarajan, Vivek
Format: Preprint
Publié: 2024
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author Tu, Tao
Palepu, Anil
Schaekermann, Mike
Saab, Khaled
Freyberg, Jan
Tanno, Ryutaro
Wang, Amy
Li, Brenna
Amin, Mohamed
Tomasev, Nenad
Azizi, Shekoofeh
Singhal, Karan
Cheng, Yong
Hou, Le
Webson, Albert
Kulkarni, Kavita
Mahdavi, S Sara
Semturs, Christopher
Gottweis, Juraj
Barral, Joelle
Chou, Katherine
Corrado, Greg S
Matias, Yossi
Karthikesalingam, Alan
Natarajan, Vivek
author_facet Tu, Tao
Palepu, Anil
Schaekermann, Mike
Saab, Khaled
Freyberg, Jan
Tanno, Ryutaro
Wang, Amy
Li, Brenna
Amin, Mohamed
Tomasev, Nenad
Azizi, Shekoofeh
Singhal, Karan
Cheng, Yong
Hou, Le
Webson, Albert
Kulkarni, Kavita
Mahdavi, S Sara
Semturs, Christopher
Gottweis, Juraj
Barral, Joelle
Chou, Katherine
Corrado, Greg S
Matias, Yossi
Karthikesalingam, Alan
Natarajan, Vivek
contents At the heart of medicine lies the physician-patient dialogue, where skillful history-taking paves the way for accurate diagnosis, effective management, and enduring trust. Artificial Intelligence (AI) systems capable of diagnostic dialogue could increase accessibility, consistency, and quality of care. However, approximating clinicians' expertise is an outstanding grand challenge. Here, we introduce AMIE (Articulate Medical Intelligence Explorer), a Large Language Model (LLM) based AI system optimized for diagnostic dialogue. AMIE uses a novel self-play based simulated environment with automated feedback mechanisms for scaling learning across diverse disease conditions, specialties, and contexts. We designed a framework for evaluating clinically-meaningful axes of performance including history-taking, diagnostic accuracy, management reasoning, communication skills, and empathy. We compared AMIE's performance to that of primary care physicians (PCPs) in a randomized, double-blind crossover study of text-based consultations with validated patient actors in the style of an Objective Structured Clinical Examination (OSCE). The study included 149 case scenarios from clinical providers in Canada, the UK, and India, 20 PCPs for comparison with AMIE, and evaluations by specialist physicians and patient actors. AMIE demonstrated greater diagnostic accuracy and superior performance on 28 of 32 axes according to specialist physicians and 24 of 26 axes according to patient actors. Our research has several limitations and should be interpreted with appropriate caution. Clinicians were limited to unfamiliar synchronous text-chat which permits large-scale LLM-patient interactions but is not representative of usual clinical practice. While further research is required before AMIE could be translated to real-world settings, the results represent a milestone towards conversational diagnostic AI.
format Preprint
id arxiv_https___arxiv_org_abs_2401_05654
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Towards Conversational Diagnostic AI
Tu, Tao
Palepu, Anil
Schaekermann, Mike
Saab, Khaled
Freyberg, Jan
Tanno, Ryutaro
Wang, Amy
Li, Brenna
Amin, Mohamed
Tomasev, Nenad
Azizi, Shekoofeh
Singhal, Karan
Cheng, Yong
Hou, Le
Webson, Albert
Kulkarni, Kavita
Mahdavi, S Sara
Semturs, Christopher
Gottweis, Juraj
Barral, Joelle
Chou, Katherine
Corrado, Greg S
Matias, Yossi
Karthikesalingam, Alan
Natarajan, Vivek
Artificial Intelligence
Computation and Language
Machine Learning
At the heart of medicine lies the physician-patient dialogue, where skillful history-taking paves the way for accurate diagnosis, effective management, and enduring trust. Artificial Intelligence (AI) systems capable of diagnostic dialogue could increase accessibility, consistency, and quality of care. However, approximating clinicians' expertise is an outstanding grand challenge. Here, we introduce AMIE (Articulate Medical Intelligence Explorer), a Large Language Model (LLM) based AI system optimized for diagnostic dialogue. AMIE uses a novel self-play based simulated environment with automated feedback mechanisms for scaling learning across diverse disease conditions, specialties, and contexts. We designed a framework for evaluating clinically-meaningful axes of performance including history-taking, diagnostic accuracy, management reasoning, communication skills, and empathy. We compared AMIE's performance to that of primary care physicians (PCPs) in a randomized, double-blind crossover study of text-based consultations with validated patient actors in the style of an Objective Structured Clinical Examination (OSCE). The study included 149 case scenarios from clinical providers in Canada, the UK, and India, 20 PCPs for comparison with AMIE, and evaluations by specialist physicians and patient actors. AMIE demonstrated greater diagnostic accuracy and superior performance on 28 of 32 axes according to specialist physicians and 24 of 26 axes according to patient actors. Our research has several limitations and should be interpreted with appropriate caution. Clinicians were limited to unfamiliar synchronous text-chat which permits large-scale LLM-patient interactions but is not representative of usual clinical practice. While further research is required before AMIE could be translated to real-world settings, the results represent a milestone towards conversational diagnostic AI.
title Towards Conversational Diagnostic AI
topic Artificial Intelligence
Computation and Language
Machine Learning
url https://arxiv.org/abs/2401.05654