Clinical and Surgical Applications of Large Language Models: A Systematic Review

Abstract

Background: Large language models (LLMs) represent a recent advancement in artificial intelligence with medical applications across various healthcare domains. The objective of this review is to highlight how LLMs can be utilized by clinicians and surgeons in their everyday practice. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six databases were searched to identify relevant articles. Eligibility criteria emphasized articles focused primarily on clinical and surgical applications of LLMs. Results: The literature search yielded 333 results, with 34 meeting eligibility criteria. All articles were from 2023. There were 14 original research articles, four letters, one interview, and 15 review articles. These articles covered a wide variety of medical specialties, including various surgical subspecialties. Conclusions: LLMs have the potential to enhance healthcare delivery. In clinical settings, LLMs can assist in diagnosis, treatment guidance, patient triage, physician knowledge augmentation, and administrative tasks. In surgical settings, LLMs can assist surgeons with documentation, surgical planning, and intraoperative guidance. However, addressing their limitations and concerns, particularly those related to accuracy and biases, is crucial. LLMs should be viewed as tools to complement, not replace, the expertise of healthcare professionals.

Keywords: ChatGPT; artificial intelligence (AI); deep learning; diagnosis; machine learning; management; surgical specialties.

Figure 1

Relationships between AI technologies, including LLMs.

Figure 2

Modified 2020 PRISMA flow diagram outlining the article identification and eligibility assessment process for this systematic review.

Figure 3

Applications of LLMs within clinical practice. Created with BioRender.com.

Figure 4

Applications of LLMs within surgical practice. Created with BioRender.com.