Tuesday, December 13, 2022

ChatGPT, Round Two

After sending some comments about my blog post on my initial excursions with ChatGPT earlier this week, I received a great deal of interesting follow-up. One colleague lamented that we may no longer be able to assess the knowledge of students, especially when teaching in online classes, because of their ability to easily generate answers to questions using systems like ChatGPT, especially if they could add to the text by Googling a few references to add to their answers.

I am not convinced of this, at least not with the use of ChatGPT, whose answers I noted were superficial, not completely correct, and not backed up with citations. Furthermore, asking for short answers to questions is hardly the only way to assess knowledge.

So to put ChatGPT to the next test, I pasted in, one by one, the 10 multiple-choice questions I give for the same unit of my introductory informatics course as the learning objectives of my first assessment.
 
While I have to give ChatGPT some credit for figuring out these were multiple-choice questions, it performed pretty poorly compared to most students in the course. It only answered 5 of the 10 questions correctly, and for two it got wrong, it did not even try to answer the questions, giving the excuse it could not browse the Internet (despite being trained on it!).
 
Some of the incorrect answers would be embarrassing even for a beginning informatics student to not know, such as which US government agency funds informatics training, that "meaningful use" was not part of the Affordable Care Act, and that a machine learning algorithm not involving clinicians does not adhere to Friedman's Fundamental Theorem.
 
The transcript of my interactions is pasted in below. The text entered into ChatGPT did not include the question numbers nor the correct answers indicated by asterisks. The paragraph following each question is how ChatGPT replied. My conclusion is that, for now, those of us who teach informatics in virtual settings do not (yet) have to worry about ChatGPT being used to cheat in our courses.

ChatGPT Transcript - December 10, 2022

1. Which part of biomedical and health informatics is most likely to address the critical informatics issues for the practice of a family physician?
a. Bioinformatics
*b. Clinical informatics
c. Clinical research informatics
d. Imaging informatics
e. Public health informatics

Clinical informatics is most likely to address the critical informatics issues for the practice of a family physician. This subfield of biomedical and health informatics focuses on the use of information technology to support the delivery of healthcare and improve patient outcomes. Clinical informatics encompasses a wide range of topics, including electronic health records, health information exchange, clinical decision support, and population health management. It is concerned with the design, development, and implementation of systems and tools to support the clinical work of healthcare professionals, such as family physicians.

2. Before the era of widespread computer use, the typical hospital physician spent what proportion of his or her time in activities away from the patient during office practice?
*a. 23-39%
b. 50%
c. 61-76%
d. 100%

I'm sorry, but I am not able to browse the internet to answer your question as I am a large language model trained by OpenAI. My knowledge is based solely on the text that I have been trained on, which has a cutoff date of 2021. I do not have any additional information beyond what I have been trained on.

3. Which entity of the US government funds research and training in biomedical and health informatics?
a. Agency for Healthcare Research & Quality
b. Center for Medicare and Medicaid Services
c. National Committee for Vital & Health Statistics
*d. National Library of Medicine

The National Institutes of Health (NIH) is the primary entity of the US government that funds research and training in biomedical and health informatics. The NIH is a federal agency that is part of the Department of Health and Human Services. It is the largest biomedical research agency in the world and provides funding for a wide range of research and training programs in the field of biomedical and health informatics. Some examples of NIH-funded programs in this area include the National Library of Medicine's Training and Education in Biomedical Informatics program and the Clinical and Translational Science Awards program, which support research and training in clinical informatics.

4. Before the emergence of the Affordable Care Act, a number of proposed healthcare reform plans for the US would provide for the establishment of a small number of highly regulated private insurance companies in a given region or state. This type of plan would be described by JR Reid as:
a. Beveridge
*b. Bismarck
c. National health insurance
d. Out-of-pocket

The type of healthcare reform plan described in the question, which involves the establishment of a small number of highly regulated private insurance companies in a given region or state, would be described by JR Reid as a Bismarck-type plan. Bismarck-type plans are named after Otto von Bismarck, the 19th century Prussian statesman who introduced the first national health insurance program in the world. Bismarck-type plans are characterized by a high degree of government control over the healthcare system, with the state playing a central role in regulating the provision of healthcare services and financing. In these plans, private insurance companies are typically required to operate within a regulatory framework set by the government, and may be subject to price controls and other forms of regulation. This type of plan is common in many European countries.

5. What proportion of US healthcare spending is devoted to prescription drugs?
*a. 10%
b. 20%
c. 33%
d. 50%

I'm sorry, but I am not able to browse the internet to answer your question as I am a large language model trained by OpenAI. My knowledge is based solely on the text that I have been trained on, which has a cutoff date of 2021. I do not have any additional information beyond what I have been trained on.

6. Compared to most other wealthy countries, the US has which of the following?
a. More hospital days
*b. More money spent
c. More nurses
d. More physicians

Compared to most other wealthy countries, the US has more money spent on healthcare. The US spends more on healthcare as a percentage of its gross domestic product (GDP) than any other country in the world. According to data from the World Health Organization, the US spent 17.2% of its GDP on healthcare in 2018, compared to an average of 9.6% for other high-income countries. This high level of spending is due in part to the relatively high cost of healthcare services in the US, as well as the large number of uninsured and underinsured individuals in the country.

7. Which of the following is not part of the original Affordable Care Act (ACA)?
*a. Incentives for meaningful use of electronic health records
b. Mandate that individuals buy health insurance
c. Outlawing of insurance denial due to pre-existing medical conditions
d. Programs to establish Accountable Care Organizations (ACOs)

Programs to establish Accountable Care Organizations (ACOs) are not part of the original Affordable Care Act (ACA). ACOs are groups of healthcare providers who come together to coordinate care for a specific group of patients, with the goal of improving the quality of care and reducing costs. ACOs were introduced as part of the Medicare program under the Patient Protection and Affordable Care Act of 2010, but were not part of the original ACA legislation. The ACA included a number of other provisions, such as incentives for the meaningful use of electronic health records, a mandate that individuals buy health insurance, and the outlawing of insurance denial due to pre-existing medical conditions.

8. About 50% of US healthcare spending is accounted for by which proportion of the population?
a. 1%
*b. 5%
c. 25%
d. 50%

Approximately 50% of US healthcare spending is accounted for by 5% of the population. This phenomenon, known as the "5/50 rule," refers to the fact that a small proportion of the population accounts for a disproportionate amount of healthcare spending. The 5/50 rule is often used to illustrate the unequal distribution of healthcare costs in the US, with a small group of individuals with chronic conditions or complex healthcare needs accounting for a significant portion of total spending. This pattern is driven in part by the high cost of treating certain conditions, such as cancer and heart disease, as well as the high cost of specialty drugs and other medical technologies.

9. Which of the following applications does not adhere to Friedman’s fundamental theorem of informatics?
*a. A machine learning algorithm that processes radiology images and determines the diagnoses more accurately than a physician
b. A telemedicine system that allows remote interaction via videoconference
c. A reminder system to administer cancer screening exams on an appropriate schedule
d. An information retrieval (search) system that helps the user select terms to improve search results

A telemedicine system that allows remote interaction via videoconference does not adhere to Friedman's fundamental theorem of informatics. The fundamental theorem of informatics, proposed by Edward H. Friedman, states that "the value of medical information is inversely proportional to the time and place of its creation and directly proportional to the time and place of its use." This theorem suggests that the value of medical information decreases as it becomes older and less relevant, and increases when it is used at the time and place where it is needed. A telemedicine system that allows remote interaction via videoconference does not necessarily adhere to this theorem, as it allows healthcare providers to access and use medical information from different times and places. An example of an application that adheres to the theorem would be a reminder system that administers cancer screening exams on an appropriate schedule, as it uses medical information at the time and place where it is needed to improve patient care.

10. A patient undergoing an appendectomy at a hospital near his suburban home is most likely receiving what type of healthcare?
a. Primary care
*b. Secondary care
c. Tertiary care
d. Quaternary care

A patient undergoing an appendectomy at a hospital near his suburban home is most likely receiving secondary care. Secondary care refers to healthcare services that are provided by specialized medical professionals, such as surgeons, specialists, and other healthcare providers. These services are typically provided in hospitals or other specialized medical facilities, and often require referral from a primary care provider. An appendectomy, which is a surgical procedure to remove the appendix, is an example of a medical procedure that is typically performed in a hospital or other specialized medical facility, and would be classified as secondary care. Primary care, on the other hand, refers to the first level of contact between patients and the healthcare system, and typically involves services such as preventive care, routine check-ups, and treatment of minor illnesses. Tertiary care and quaternary care are higher levels of specialized care that are provided for patients with complex or chronic conditions.

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