Jinekolojik Onkolojide Cerrahi Karar Verme Sürecinde Yapay Zekânın Rolünün Araştırılması: Bir Fizibilite Çalışması

Öz

Giriş: Tıp pratiğinde yapay zekâ (YZ) uygulamalarının kullanımı hızla artmaktadır. İlgili veriler girildiğinde, YZ sistemleri triyaj, tanı, yönetim ve cerrahi planlama konularında sağlık profesyonellerine destek sağlayabilmektedir. Amaç: Bu çalışmanın amacı, jinekolojik kanserli hastalarda ChatGPT-4o’nun cerrahi öneriler oluşturmadaki klinik geçerliliğini ve uygulanabilirliğini değerlendirmek; modelin çıktılarının deneyimli jinekolojik onkoloji uzmanlarının kararlarıyla uyumunu incelemektir. Yöntem: Bu fizibilite çalışmasında, 5 endometrium kanseri (EK), 5 adneksiyel kitle (AK) ve 5 serviks kanseri (SK) vakası olmak üzere toplam 15 kurgusal olgu senaryosu oluşturuldu. Bu senaryolar, jinekolojik onkoloji cerrahisinde en az beş yıllık deneyime sahip iki uzman tarafından uygunluk açısından gözden geçirildi. Olgular önce ChatGPT-4o tarafından analiz edilerek cerrahi yönetim önerileri oluşturuldu. Daha sonra aynı senaryolar, Avrupa Jinekolojik Onkoloji Derneği (ESGO) akreditasyonuna sahip bir merkezde görev yapan iki uzman ve iki asistan tarafından değerlendirildi. YZ tarafından oluşturulan öneriler Global Quality Score (GQS) sistemi kullanılarak değerlendirildi ve uzman kararlarıyla karşılaştırıldı. Bulgular: ChatGPT-4o tarafından sunulan cerrahi öneriler, hekimlerin kararlarıyla yüksek düzeyde uyum göstermiştir. En yüksek tutarlılık EK vakalarında gözlenmiştir. Özellikle klinik rehberlerde yönetim algoritmaları net olarak tanımlanmış olgularda, YZ modeli doğru ve kılavuza uygun öneriler sunmuştur. Ancak daha karmaşık olgularda sınırlı klinik öngörü yeteneği dikkati çekmiştir. Sonuç: Bu fizibilite çalışması, ChatGPT-4o’nun jinekolojik kanserli hastalarda klinik olarak anlamlı ve kılavuz uyumlu cerrahi öneriler sunabildiğini göstermektedir. YZ destekli cerrahi karar verme süreçlerinin etkinliğini değerlendiren ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• jinekolojik kanserler
• yapay zeka
• chatGPT
• cerrahi karar

Exploring the Role of Artificial Intelligence in Surgical Decision-Making in Gynecologic Oncology: A Feasibility Study

Öz

Introduction: The use of artificial intelligence (AI) applications in medical practice is rapidly increasing. When relevant data are entered, AI systems can assist healthcare professionals by providing information on triage, diagnosis, management, and surgical planning. Objective: This study aimed to evaluate the clinical relevance and feasibility of ChatGPT-4o in generating surgical recommendations for patients with gynecologic cancers, by comparing its outputs with the decisions made by experienced gynecologic oncology specialists. Methods: In this feasibility study, a total of 15 fictional case scenarios were created, including 5 cases each of endometrial cancer (EC), adnexal masses (AM), and cervical cancer (CC). These scenarios were first reviewed for appropriateness by two specialists with at least five years of experience in gynecologic oncology surgery. The cases were initially analyzed by ChatGPT-4o, which provided surgical management recommendations. Subsequently, the same scenarios were evaluated by two specialists and two fellows working at a European Society of Gynaecological Oncology (ESGO)-accredited center. The AI-generated recommendations were assessed using the Global Quality Score (GQS) system and compared with expert evaluations. Results: The surgical recommendations provided by ChatGPT-4o showed a high degree of concordance with the physicians’ decisions. The highest consistency was observed in the EC cases. Particularly in cases where management pathways were clearly defined by clinical guidelines, the AI model provided accurate suggestions. However, limited clinical insight was noted in more complex scenarios. Conclusion: This feasibility study demonstrates that ChatGPT-4o is capable of providing clinically meaningful and guideline-compliant surgical recommendations for patients with gynecologic cancers. Further studies assessing the effectiveness of AI-assisted surgical decision-making processes are warranted to better establish the clinical applicability of this model.

Anahtar Kelimeler

• Artificial İntelligence
• ChatGPT
• Gynecologic Oncology
• Surgical Desicion

Kaynakça

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