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NEJM AI Grand Rounds

From Clinical Notes to GPT-4: Dr. Emily Alsentzer on Natural Language Processing in Medicine

Feb 19, 2025
Dr. Emily Alsentzer, an assistant professor at Stanford University and an expert in natural language processing, takes listeners on a journey from medicine to AI. She discusses her evolution from a pre-med background to specializing in clinical AI. The conversation dives into the biases present in AI healthcare diagnostics, particularly with GPT-4, highlighting the disparities in diagnostic accuracy across demographics. Emily also emphasizes the need for collaboration between clinicians and computer scientists, addressing the future of AI in medical research.
55:06

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Quick takeaways

  • The evolution of NLP in medicine illustrates the importance of addressing biases in AI systems to ensure accurate diagnosis across diverse patient demographics.
  • Dr. Emily Alsentzer's interdisciplinary approach combines clinical expertise with AI, advocating for tools that enhance decision-making grounded in real-world applications.

Deep dives

Impact of Demographics on AI Diagnosis

Changing the demographics of patient cases significantly impacts AI models' diagnostic accuracy, as demonstrated in a study where swapping race or gender in medical scenarios affected correct diagnoses in 37% of evaluated cases. A striking example arose from a case of pharyngitis in sexually active teenagers; while AI correctly diagnosed mono in 100% of white patients, it only achieved a 64 to 84% accuracy in minority patients, often leading to misdiagnoses related to STDs. This highlighted the reliance of AI systems on historical biases present in their training data, ultimately affecting their performance on diverse populations. Such disparities suggest a pressing need to address how AI tools are trained and utilized, particularly in sensitive healthcare contexts where accuracy is critical for proper care.

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