
==== Front
Int J Surg
Int J Surg
JS9
International Journal of Surgery (London, England)
1743-9191
1743-9159
Lippincott Williams & Wilkins Hagerstown, MD

38874486
IJS-D-24-02526
10.1097/JS9.0000000000001825
00143
3
Correspondence
Re: ChatGPT encounters multiple opportunities and challenges in neurosurgery
Zhang Hongyu MM a434442775@qq.com

Wang Xuefeng MD awxf1973@139.com

Su Shu PhD shusu@hospital.cqmu.edu.cn
b*
a Department of Neurosurgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin
b Department of Epidemiology and Biostatistics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
* Corresponding author. Address: Department of Epidemiology and Biostatistics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, People’s Republic of China. Tel.: +86 13696460826. E-mail: shusu@hospital.cqmu.edu.cn (S. Su).
9 2024
14 6 2024
110 9 60306031
1 6 2024
3 6 2024
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/

OPEN-ACCESSTRUE
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pmc Dear Editor,

We read with great interest the editorial entitled ‘ChatGPT encounters multiple opportunities and challenges in neurosurgery’ by Kuang et al.1 recently published in the International Journal of Surgery. The authors comprehensively discussed the potential applications, opportunities, and limitations of ChatGPT in the field of neurosurgery. As an artificial intelligence (AI)-powered chatbot, ChatGPT has demonstrated impressive natural language processing capabilities and human-like conversational skills, providing valuable insights into how it could assist patients, medical students/residents, and neurosurgeons in various aspects.

Firstly, while the authors highlighted the potential of ChatGPT in patient education, preoperative planning, intraoperative management, and postoperative rehabilitation, it is important to recognize that ChatGPT cannot replace the expertise and judgment of neurosurgeons. The authors rightfully pointed out that ChatGPT lacks the ability to perform physical examinations, diagnose conditions, or carry out surgical procedures. Moreover, neurosurgery often involves complex decision-making based on individual patient characteristics and real-time intraoperative findings, which may be beyond the capabilities of language models like ChatGPT.

Secondly, the editorial also raised valid concerns regarding the accuracy and reliability of information generated by ChatGPT. As the authors mentioned, the chatbot’s responses are based on patterns learned from its training data, which may not always reflect the most up-to-date or evidence-based medical knowledge. Additionally, ChatGPT may struggle with understanding subtle language nuances, leading to potential misinterpretations. Therefore, any information provided by ChatGPT should be critically appraised and verified by qualified medical professionals before being applied in clinical practice.

Thirdly, the authors correctly emphasize the need for careful consideration of legal and ethical issues when implementing AI technologies like ChatGPT in healthcare. Privacy, confidentiality, and liability are major concerns that need to be addressed. Clear guidelines and regulations should be established to ensure the responsible and transparent use of AI in medical decision-making2. Moreover, the potential biases in ChatGPT’s training data and algorithms must be recognized and mitigated to prevent any discriminatory or unfair outcomes.

Despite these limitations, we agree with the authors that ChatGPT holds great promise in advancing neurosurgical education, research, and patient care. With the rapid evolution from ChatGPT-4 to ChatGPT-4o, several conjectures on innovative applications are worth exploring. For instance, ChatGPT-4o’s integration with Brain–Computer Interfaces (BCIs) could offer groundbreaking advancements in enhancing communication abilities for patients with severe neurological dysfunction3. Additionally, ChatGPT-4o’s advanced data processing capabilities could revolutionize neuro-monitoring technologies by providing real-time insights and alerts, aiding early intervention and improving patient outcomes. Moreover, the integration of ChatGPT-4o with neurosurgical navigation systems and multimodal imaging techniques could potentially enhance surgical precision and diagnostic accuracy4.

However, it is essential to note that these applications are still conjectures and have yet to be realized in practice. The current versions of ChatGPT in medicine and neurosurgery come with significant limitations and areas needing improvement, such as accuracy and privacy concerns1,5. It is crucial to address these issues through continued research and rigorous regulatory frameworks to fully unlock the potential of ChatGPT in clinical settings.

In conclusion, the editorial by Kuang et al.1 provides a timely and insightful discussion on the potential applications and challenges of ChatGPT in neurosurgery. While recognizing its impressive capabilities, we must remain aware of its current limitations and the need for further validation and refinement. As the field of AI continues to evolve, close collaboration between clinicians, researchers, and technology developers will be crucial in harnessing its full potential to improve patient outcomes and advance neurosurgical care.

Ethical approval

No need for this study.

Consent

Not applicable.

Source of funding

Natural Science Foundation of Chongqing (CSTB2023NSCQ-MSX0198).

Author contribution

H.Z. and X.W.: writing – original draft; S.S.: project administration, resources, supervision, and writing – review and editing. All authors finalized the manuscript, refined the article, contributed to the final manuscript, and approved it for publication.

Conflicts of interest disclosure

The authors declare no conflicts of interest.

Research registration unique identifying number (UIN)

Not applicable.

Guarantor

Xuefeng Wang.

Data availability statement

Data sharing is not applicable to this article. All the data from the current study are publicly available.

Provenance and peer review

This manuscript is not invited for submission.

Hongyu Zhang and Xuefeng Wang contributed equally to this work.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Published online 14 June 2024
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References

1 Kuang Y-R Zou M-X Niu H-Q . ChatGPT encounters multiple opportunities and challenges in neurosurgery. Int J Surg 2023;109 :2886–2891.37352529
2 Wang C Liu S Yang H . Ethical considerations of using ChatGPT in health care. J Med Internet Res 2023;25 :e48009.37566454
3 Friehs GM Zerris VA Ojakangas CL . Brain–machine and brain–computer interfaces. Stroke 2004;35 :2702–2705.15486335
4 Lim ZW Pushpanathan K Yew SME . Benchmarking large language models’ performances for myopia care: a comparative analysis of ChatGPT-3.5, ChatGPT-4.0, and Google Bard. eBioMedicine 2023;95 :104770.37625267
5 Tan S Xin X Wu D . ChatGPT in medicine: prospects and challenges: a review article. Int J Surg 2024;110 :3701–3706.38502861
