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作 者:Xintian Yang Tongxin Li Qin Su Yaling Liu Chenxi Kang Yong Lyu Lina Zhao Yongzhan Nie Yanglin Pan
机构地区:[1]State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases,Xijing Hospital of Digestive Diseases,Fourth Military Medical University,Xi’an,Shaanxi 710032,China [2]Department of Radiotherapy,Xijing Hospital,Fourth Military Medical University,Xi’an,Shaanxi 710032,China
出 处:《Chinese Medical Journal》2025年第2期130-142,共13页中华医学杂志(英文版)
基 金:supported by grants from the National Key Research&Development Program of China(No.2022YFC2505100);the National Natural Science Foundation of China(No.81970557).
摘 要:Large language models(LLMs)such as ChatGPT,Claude,Llama,and Qwen are emerging as transformative technologies for the diagnosis and treatment of various diseases.With their exceptional long-context reasoning capabilities,LLMs are proficient in clinically relevant tasks,particularly in medical text analysis and interactive dialogue.They can enhance diagnostic accuracy by processing vast amounts of patient data and medical literature and have demonstrated their utility in diagnosing common diseases and facilitating the identification of rare diseases by recognizing subtle patterns in symptoms and test results.Building on their image-recognition abilities,multimodal LLMs(MLLMs)show promising potential for diagnosis based on radiography,chest computed tomography(CT),electrocardiography(ECG),and common pathological images.These models can also assist in treatment planning by suggesting evidence-based interventions and improving clinical decision support systems through integrated analysis of patient records.Despite these promising developments,significant challenges persist regarding the use of LLMs in medicine,including concerns regarding algorithmic bias,the potential for hallucinations,and the need for rigorous clinical validation.Ethical considerations also underscore the importance of maintaining the function of supervision in clinical practice.This paper highlights the rapid advancements in research on the diagnostic and therapeutic applications of LLMs across different medical disciplines and emphasizes the importance of policymaking,ethical supervision,and multidisciplinary collaboration in promoting more effective and safer clinical applications of LLMs.Future directions include the integration of proprietary clinical knowledge,the investigation of open-source and customized models,and the evaluation of real-time effects in clinical diagnosis and treatment practices.
关 键 词:Large language models Artificial intelligence DIAGNOSIS Treatment planning Clinical decision support
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