Large Language Models (LLMs) like ChatGPT hold potential for healthcare innovation and transformation, but they also carry inherent risks. For example, when ChatGPT is asked to evaluate symptoms, its analyses can vary between sessions and become broadly generic. In worst-case scenarios, it may invent or hallucinate answers and portions of answers. One strategy for addressing those risks is to provide the LLM with patient-specific information (age, weight, height, activity level, etc.), summary health history, and quantitative physiological data; monitoring data are particularly useful because they capture trends.
For this Use Case, we provided ChatGPT with the patient's personal information and health history, plus a set of Ambulatory Blood Pressure Monitoring (ABPM) measurements (96 over 24 hours) that included Cardiac Output (CO) and Systemic Vascular Resistance (SVR). CO and SVR measurements were made possible by Biobeat’s FDA-listed, noninvasive, disposable physiological sensor, which was introduced about three years ago. I engineered a set of prompts that directed ChatGPT and its sibling, Data Analyst, to evaluate the data, diagnose the patient, and offer recommendations. ChatGPT’s outputs are shown below.
ChatGPT Analysis and Diagnosis
To provide a thoughtful evaluation and potential diagnosis for the patient based on the health data from the spreadsheet and the additional personal information provided, I'll follow a systematic approach that includes analyzing the data, considering the patient's lifestyle, and incorporating medical guidelines and research findings.
Analytical Process:
Data Analysis:
Blood Pressure (BP) Control: Given the patient's BP readings are being treated and under control, we'll compare the reported BP measurements (SBP and DBP) from the spreadsheet against recommended levels for hypertension management in older adults.
Heart Rate (HR) and Cardiac Output (CO): Analyze these parameters to assess cardiovascular efficiency, especially in the context of the patient's active lifestyle.
Systemic Vascular Resistance (SVR): Evaluate if the SVR readings fall within normal ranges, as abnormal values could indicate issues with blood flow resistance.
Oxygen Saturation (SPO2): Verify that SPO2 levels are within a healthy range, indicating effective oxygenation of the blood.
Physical Activity and Health Impact: Assess how the patient's physical activity level influences cardiovascular health and diabetes risk, given his pre-diabetic status.
Medical Guidelines and Research:
American Diabetes Association guidelines on managing pre-diabetes through lifestyle modification.
American Heart Association (AHA) guidelines for BP control in older adults, considering the patient's age and hypertension treatment.
Research on Physical Activity's Impact on Cardiovascular Health: Studies showing the benefits of regular physical activity on heart health and diabetes management.
Evaluation and Preliminary Diagnosis:
Considering the provided health data and personal information:
The patient's active lifestyle, including walking, aerobics, weightlifting, and dancing, is highly beneficial for managing pre-diabetes and maintaining cardiovascular health. Regular physical activity is known to improve glucose control and reduce cardiovascular risk factors.
The BP readings, if consistently within the control range as per AHA guidelines for individuals under hypertension treatment, suggest effective management of his condition.
His HR, CO, and SPO2 readings need to be compared to standard ranges to assess cardiovascular function and oxygenation levels. Typically, a resting HR between 60-100 bpm, CO within 4-8 liters per minute, and SPO2 above 95% are considered within normal ranges for adults.
Considering the patient's age, weight, and A1C results, he is at an increased risk for developing type 2 diabetes and cardiovascular diseases. However, his active lifestyle plays a crucial role in mitigating some of these risks.
Recommendations:
Continue Physical Activity: Maintain or slightly increase the level of physical activity, as it's beneficial for both cardiovascular health and glucose control.
Dietary Modifications: Consult with a dietitian to fine-tune dietary habits, focusing on reducing glycemic load and managing weight, crucial for pre-diabetes management.
Regular Monitoring: Continue regular monitoring of BP, glucose levels, and cardiovascular health markers, adjusting treatment and lifestyle modifications as needed.
Consult Healthcare Providers: An annual or bi-annual comprehensive review with healthcare providers to assess the efficacy of the current management plan and make adjustments.
References:
American Diabetes Association. (2023). Standards of Medical Care in Diabetes—2023.
American Heart Association. (2023). Guidelines for the Management of Hypertension in Adults.
Pescatello, L.S., et al. (2014). Physical Activity and Hypertension. Human Kinetics.
Colberg, S.R., et al. (2010). Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care.
Whelton, P.K., et al. (2018). 2018 ACC/AHA Guideline for the Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.
This evaluation incorporates general medical knowledge and does not substitute for professional medical advice. Individual health conditions are unique, and treatment or recommendations should always be personalized and conducted under the guidance of healthcare professionals.
End ChatGPT