RESUMEN
OBJECTIVES: Artificial intelligence (AI)-based chatbots have demonstrated accuracy in a variety of fields, including medicine, but research has yet to substantiate their accuracy and clinical relevance. We evaluated an AI chatbot's answers to questions posed during a treatment planning conference. METHODS: Pathology residents, pathology faculty, and an AI chatbot (OpenAI ChatGPT [January 30, 2023, release]) answered a questionnaire curated from a genitourinary subspecialty treatment planning conference. Results were evaluated by 2 blinded adjudicators: a clinician expert and a pathology expert. Scores were based on accuracy and clinical relevance. RESULTS: Overall, faculty scored highest (4.75), followed by the AI chatbot (4.10), research-prepared residents (3.50), and unprepared residents (2.87). The AI chatbot scored statistically significantly better than unprepared residents (P = .03) but not statistically significantly different from research-prepared residents (P = .33) or faculty (P = .30). Residents did not statistically significantly improve after research (P = .39), and faculty performed statistically significantly better than both resident categories (unprepared, P < .01; research prepared, P = .01). CONCLUSIONS: The AI chatbot gave answers to medical questions that were comparable in accuracy and clinical relevance to pathology faculty, suggesting promise for further development. Serious concerns remain, however, that without the ability to provide support with references, AI will face legitimate scrutiny as to how it can be integrated into medical decision-making.
RESUMEN
Background: Hyperhemolysis syndrome (HS) is a severe hemolytic transfusion reaction that can cause hemoglobin and hematocrit levels to drop below pretransfusion levels, leading to severe anemia. HS most commonly occurs in patients with a pre-existing hemoglobinopathy such as sickle cell disease (SCD) or beta-thalassemia. Methods: We report a case of HS, occurring in the absence of hemoglobinopathy, making the diagnosis challenging. The patient reported was also affected by a CIC-rearranged sarcoma. As part of the workup, the patient received a bone marrow biopsy for suspected hemophagocytic lymphohistiocytosis. Results: This provided a rare biopsy specimen to correlate reticulocytopenia with marked erythroid hyperplasia in the marrow, supporting the hypothesis of reticulocyte destruction as a contributing cause of anemia in these patients. This patient had demonstrable alloantibodies to the Jk(a) and P1 antigens as potential triggers for HS. Conclusions: It is vital that a diagnosis of HS be correctly made in these patients with severe anemia, as blood transfusions generally lead to worsening of their conditions.
