Role of ChatGPT in Cardiovascular and Cerebrovascular Disease

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1		David-Dimitris Chlorogiannis	--	2281	2023-12-08 03:05:28

This entry is adapted from the peer-reviewed paper 10.3390/healthcare11212906

Cardiovascular and cerebrovascular disease incidence has risen mainly due to poor control of preventable risk factors and still constitutes a significant financial and health burden worldwide. ChatGPT is an artificial intelligence language-based model developed by OpenAI. Due to the model’s unique cognitive capabilities beyond data processing and the production of high-quality text, there has been a surge of research interest concerning its role in the scientific community and contemporary clinical practice.

cardiovascular disease cerebrovascular disease chatGPT language-based models diagnosis treatment stroke myocardial infarction

1. Introduction

Cardiovascular and cerebrovascular disease are still the leading cause of premature morbidity, mortality, and disease disability on a global scale ^[1]. Despite significant advancements in the standard of care, particularly in higher-income countries, the incidence of these diseases continues to rise ^[2]. This finding has been partially attributed to poorly controlled preventable risk factors such as hypertension, hyperlipidemia, smoking, diabetes, and obesity, the latter now being widely considered a pervasive epidemic of the 21st century, despite the significant development of newer pharmaceutic agents for primary and secondary prevention, improved invasive procedures, and better diagnostic tools ^[3].

In this era of rapid technological progress, artificial intelligence (AI) has emerged as a central pillar of the fourth industrial revolution. Artificial intelligence encompasses a field of computer science in which machines are trained to perform tasks that typically require human intelligence. AI has already gained ground in radiology, where it helps with more accurate image processing and interpretation ^[4]. The concept of digital symptom checking is not new and began in the early 2000s with WebMD, which provided a handful of risk calculators available to the public ^[5]^[6]. The days of the binary calculators have long past and ever since there has been a rapid development of more than ten artificial intelligence models, each demonstrating remarkable capabilities ^[7]. Since primary prevention and risk factor modification play a pivotal role in the management of cardiovascular and cerebrovascular disease, there has been a surge of interest in artificial intelligence’s role, especially for language-based models, in the advancement of cardiovascular and cerebrovascular disease management and financial burden reduction. One such language-based model, ChatGPT, is at the forefront of this artificial intelligence revolution ^[8].

ChatGPT is an artificial intelligence language-based model developed by OpenAI and was based on the Generative Pre-trained Transformer (GPT) architecture, specifically the GPT-4 version ^[8]. GPT-4 version is a subtype of machine learning algorithms and more specifically a neural network, trained on a vast amount of internet text, whose primary functions are to understand, generate human-like text, and perform a variety of natural language processing tasks, depending on the input provided. The input can be a word or text and then the model “breaks down” the input to smaller parts and analyzes it. Then, through statistical computations, it generates an output. These include text generation, language translation, text summarization, sentiment analysis, named entity recognition, and question answering. The model first launched on 30 November 2022, and quickly divided the scientific community with its capabilities ^[9]^[10], ranging from simple student essay generation to research articles, with submissions even including ChatGPT as a co-author ^[11].

2. ChatGPT for Diagnosis of Cardiovascular and Cerebrovascular Disease

Cardiovascular and cerebrovascular disease manifest from multifaceted complex pathophysiological etiologies, having been linked with multiple risk factors ^[12]. Given their extremely high impact on morbidity and mortality associated with their prevalence, particular emphasis is required on risk factor modification as a primary means of reducing their incidence. In this context, the researchers initiated a conversation with ChatGPT to explore its potential as a diagnostic tool. The response of the model elucidated several critical instances through which ChatGPT can enhance the diagnosis of these diseases:

ChatGPT can be used to advance the diagnosis of cardiovascular disease and stroke by analyzing patient data and providing personalized recommendations to healthcare providers, leveraging its natural language processing and machine learning capabilities. For this reason, the researchers asked the ChatGPT “how it can be used to improve the diagnosis of cardiovascular disease and cerebrovascular disease”:

Symptom analysis: ChatGPT can assist in analyzing patient-reported symptoms related to cardiovascular issues or stroke. Patients often describe their symptoms in plain language, and ChatGPT can understand and interpret these descriptions. For example, if a patient reports symptoms such as chest pain, shortness of breath, or sudden weakness on one side of the body, ChatGPT can analyze this information and provide insights to healthcare providers. This can help identify potential cardiovascular or stroke-related issues early in the diagnostic process.

Differential diagnosis: ChatGPT can aid healthcare providers in generating a comprehensive list of potential diagnoses based on a patient’s reported symptoms and medical history. By cross-referencing the patient’s information with a vast database of medical knowledge and guidelines, ChatGPT can help rule out non-cardiovascular or non-stroke-related conditions and provide a more accurate differential diagnosis. This supports healthcare professionals in making informed decisions about further diagnostic tests and evaluations.

Risk assessment: In addition to symptom analysis, ChatGPT can evaluate other risk factors associated with cardiovascular disease and stroke. It can consider a patient’s age, gender, family history, lifestyle factors (such as smoking and diet), and relevant medical history (such as diabetes or hypertension). ChatGPT can provide insights into a patient’s overall risk of developing cardiovascular disease or experiencing a stroke by assessing these risk factors. This information helps in risk stratification and informs the diagnostic process.

Real-time data collection: ChatGPT can collect and analyze patient data during interactions. For example, suppose a patient is experiencing acute symptoms, such as sudden chest pain or neurological deficits. In that case, ChatGPT can prompt the patient to provide additional information about the symptoms, their duration, and any associated factors. This real-time data collection can aid healthcare providers in making prompt and accurate diagnostic decisions, particularly in emergency situations.

Referral recommendations: Based on the analysis of symptoms and risk factors, ChatGPT can suggest appropriate referrals to other healthcare providers or specialists. For instance, if a patient’s symptoms indicate a potential heart condition, ChatGPT can recommend a cardiology consultation or additional cardiac tests. These referral recommendations help ensure that patients receive timely and appropriate care from the right specialists.

Education and Patient Empowerment: ChatGPT can educate patients about the importance of early diagnosis and seeking medical attention for symptoms related to cardiovascular disease or stroke. It can explain the significance of diagnostic tests, such as electrocardiograms (ECGs), echocardiograms, or brain imaging, and address any concerns or misconceptions patients may have. By empowering patients with knowledge, ChatGPT can encourage them to proactively engage in the diagnostic process.

Support for Telemedicine: In the era of telemedicine, ChatGPT can serve as a virtual assistant during remote consultations with healthcare providers. It can help patients describe their symptoms accurately and provide healthcare professionals with essential information for remote diagnosis. This enhances the accessibility of healthcare services, especially for patients in remote or underserved areas.

In summary, ChatGPT’s role in the advancement of the diagnosis of cardiovascular disease and stroke is multifaceted. It contributes to symptom analysis, supports differential diagnosis, assesses risk factors, collects real-time data, facilitates referral recommendations, educates patients, and enhances telemedicine interactions. By assisting healthcare providers in the diagnostic process, ChatGPT plays a valuable role in the early detection and management of these critical medical conditions, ultimately leading to better patient outcomes.

Regarding diagnosis for cardiovascular and cerebrovascular disease, its main strengths are the system’s capacity to offer instantaneous responses regarding symptom analysis, risk assessment, real-time data collection, differential diagnosis aid, referral recommendations, education and patient empowerment, and support for telemedicine. Indeed, language-based models with a simple chatbox-like interface can analyze the symptoms experienced by the patient or other inserted data as input and, after examining them, return a result based on the patient’s disease risk. Against this background, Rizwan and Sadiq explored the diagnostic accuracy and accessibility of ChatGPT in cardiovascular diseases compared to experts in clinical cardiology and imaging. Eight of the ten clinical scenarios processed by ChatGPT were perfectly diagnosed; however, the other two answers given by ChatGPT were partially incorrect since those diseases were associated with the actual diagnosis. Moreover, the therapeutic protocols that ChatGPT suggested in the same study were in accordance with the literature and current medical knowledge ^[13]

Furthermore, the ability to simplify difficult-to-understand pathophysiological concepts or procedures while also being readily accessible makes it a solid option for patient education armamentarium. In this context, Khan et al. explored the capacity of the model to hold conversations about diabetes in a casual manner. They found that its responses were scientifically sound and easy to interpret, signifying the potential to extrapolate this ability with other diseases ^[14]. Similarly, Haver et al. tested the appropriateness of the responses of the model for Breast Cancer prevention recommendations and found that the responses of the model were appropriate 22 out of 25 times ^[15]. In the cardiovascular setting, the model was tested in 25 questions concerning core preventive concepts, including risk factor counseling, test results, and medication information, based on guideline-based prevention topics.

3. ChatGPT as a Tool for Secondary Prevention and Management

Moreover, the promising future of ChatGPT in primary prevention strategies has also fueled the interest in its potential value as a cardiovascular and cerebrovascular disease management and prognostic tool (secondary prevention). The researchers began a second conversation with ChatGPT, asking if it “can be used to advance the management and prognosis of cardiovascular disease and stroke”. Its response was as follows:

Chat GPT can be used to advance the management and prognosis of cardiovascular disease and stroke in several ways, leveraging its natural language processing and machine learning capabilities. Here are some specific ways in which Chat GPT can help healthcare providers to manage and predict outcomes for patients with cardiovascular disease and stroke:

Risk stratification: ChatGPT can analyze patient data, including medical history, lifestyle factors, and diagnostic test results, to provide risk stratification for individuals with CVD or stroke. By assessing various risk factors such as age, gender, family history, smoking status, and cholesterol levels, ChatGPT can help healthcare providers identify patients who are at higher risk of adverse outcomes. This risk stratification enables healthcare teams to allocate resources more effectively and provide more intensive management for high-risk patients.

Treatment optimization: ChatGPT can assist healthcare providers in optimizing treatment plans for patients with CVD or stroke. It achieves this by analyzing patient data and generating personalized treatment recommendations. These recommendations take into account the patient’s medical history, comorbidities, and medication preferences. By tailoring treatment plans to individual patients, ChatGPT helps healthcare providers identify the most effective interventions, reducing the risk of adverse events and optimizing outcomes.

Medication management: Ensuring medication adherence is crucial in managing CVD and stroke. ChatGPT can play a vital role in helping patients manage their medication regimens effectively. It can provide patients with reminders for medication adherence, explain the importance of each medication, and address any concerns or questions patients may have about their prescribed medications. By improving medication adherence, ChatGPT contributes to better disease management and outcomes.

Symptom management: Patients with CVD or stroke often experience symptoms that require ongoing management. ChatGPT can assist healthcare providers in managing these symptoms by analyzing patient-reported data and providing personalized recommendations. For instance, if a patient reports symptoms like chest pain or shortness of breath, ChatGPT can offer guidance on symptom management strategies, helping patients improve their quality of life and reduce the risk of complications.

Predictive modeling: Chat GPT can help healthcare providers predict outcomes for cardiovascular or stroke patients. By analyzing patient data and identifying patterns, Chat GPT can help healthcare providers predict the likelihood of adverse effects and take proactive steps to prevent them.

Rehabilitation Support: Patients often require rehabilitation and lifestyle adjustments after experiencing a cardiovascular event like a heart attack or stroke. ChatGPT can assist in providing guidance on post-event rehabilitation programs, exercise routines, dietary changes, and lifestyle modifications. It can offer personalized recommendations to help patients recover and reduce the risk of future cardiovascular events.

Patient Education: Educating patients about their condition, treatment options, and lifestyle modifications is essential for effective disease management. ChatGPT can serve as a valuable educational resource, providing patients with clear and accessible information. It can explain complex medical concepts, clarify treatment plans, and address patient queries, empowering patients to actively participate in their care.

In summary, ChatGPT’s role in the management and prognosis of cardiovascular disease and stroke lies in its ability to provide personalized, data-driven insights and recommendations. By leveraging patient data and medical knowledge, ChatGPT enhances risk assessment, treatment optimization, medication management, symptom control, predictive modeling, rehabilitation support, and patient education. This comprehensive approach contributes to better patient outcomes, improved quality of care, and more effective management of these critical medical conditions.

For the management and prognosis of cardiovascular and cerebrovascular disease, the system’s value is, again, in providing instant and personalized questions after analyzing individualized data. The accelerated response time of the “heart or brain team” for reperfusion strategies can be lifesaving. At the same time, the model may also declare if the patient is eligible for inclusion in a trial and manage accordingly ^[16]. Moreover, since language-based models have already been considered a powerful tool in medical education ^[17], they may be replicated in patient education as well. Medication nonadherence has been linked with poor patient and caregiver communication ^[18]^[19]^[20], and language-based models, with their natural text, can provide knowledge regarding the benefits and reasoning behind treatment plans while also answering patients’ questions at any time, even providing symptomatic treatment recommendations during the rehabilitation period after the event. Lastly, the enhanced data processing may further aid in identifying patients’ unique clinical characteristics and thus suggest individualized treatment plans, facilitating the transition from evidence-based medicine to a more personalized one while also recognizing the increased likelihood for drug-to-drug interactions (DDIs) when proposing such a plan.

References

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Subjects: Health Care Sciences & Services

Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register :

David-Dimitris Chlorogiannis

Anastasios Apostolos

Anargyros Chlorogiannis

Leonidas Palaiodimos

George Giannakoulas

Sumant Pargaonkar

Sofia Xesfingi

Damianos G. Kokkinidis

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Update Date: 08 Dec 2023

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1. Introduction

2. ChatGPT for Diagnosis of Cardiovascular and Cerebrovascular Disease

3. ChatGPT as a Tool for Secondary Prevention and Management

References