Letter to the Editor
Reply to Letter to the Director: “Artificial Intelligence and new language models in Ophthalmology: Complications of the use of silicone oil in vitreoretinal surgery”
Respuesta a Carta al Director: «Integrando la Inteligencia Artificial y los nuevos modelos de lenguaje en Oftalmología: complicaciones del uso del aceite de silicona en cirugía vítreo-retiniana»
F.J. Valentín-Bravoa,
, E. Mateos-Álvarezb, R. Usategui-Martínc, C. Andrés-Iglesiasc, J.C. Pastor-Jimenoc,d, S. Pastor-Idoatec,e
Corresponding author
a The Retina Clinic London, London, United Kingdom
b Escuela de doctorado de la Universidad de Valladolid, Valladolid, Spain
c Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
d Red de Cooperación en la Investigación en Oftalmología (Oftared), Instituto de Salud Carlos III, Madrid, Spain
e Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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"apellidos" => "Pastor-Idoate" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "The Retina Clinic London, London, United Kingdom" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Escuela de doctorado de la Universidad de Valladolid, Valladolid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Red de Cooperación en la Investigación en Oftalmología (Oftared), Instituto de Salud Carlos III, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Hospital Clínico Universitario de Valladolid, Valladolid, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta a Carta al Director: «Integrando la Inteligencia Artificial y los nuevos modelos de lenguaje en Oftalmología: complicaciones del uso del aceite de silicona en cirugía vítreo-retiniana»" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have carefully read your letter to the editor on the article "Integrating Artificial Intelligence and new language models in Ophthalmology: Complications of the use of silicone oil in vitreoretinal surgery".</p><p id="par0010" class="elsevierStylePara elsevierViewall">In it, the author expresses his concern and disagreement with the use of Artificial Intelligence (AI) and language models, such as ChatGPT. We welcome your comments, understand your concerns and would like to address the points you have raised.</p><p id="par0015" class="elsevierStylePara elsevierViewall">First of all, we want to clarify that the authors do not consider this language model as "their equal" or a substitute but as a complementary tool that can be useful in daily clinical practice as well as in the academic environment. However, human reasoning is essential for its interpretation.</p><p id="par0020" class="elsevierStylePara elsevierViewall">AI and language models are generating considerable interest not only in the field of medicine. Therefore, the article is not intended to generate "excitement", but rather to raise awareness of these tools in relation to our speciality. Likewise, no attempt has been made to compare ChatGPT's personal skills.</p><p id="par0025" class="elsevierStylePara elsevierViewall">We share his perspective that AI and ChatGPT have multiple limitations,<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> such as those mentioned, i.e., "the ability to understand the complexity of human language and conversation, soft skills, etc.". These models are designed to generate text based on specific inputs, without having a deep understanding of the meaning of the words. Therefore, it is to be expected that the tool does not possess these intrinsic human skills.</p><p id="par0030" class="elsevierStylePara elsevierViewall">We understand your concern about ChatGPT's possible "imagination or invention". However, just as it lacks those "soft and complex skills" that allow it, among other tasks, to evaluate works, it also lacks the capacity for invention.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In fact, we wanted to check your example of assessing the diagnostic criteria generated by ChatGPT for the invented ophthalmological condition called "Inherited Visual Malingering". Using the same terminology, the model responds as follows: <span class="elsevierStyleItalic">"Unfortunately, I cannot provide specific information on the "diagnostic criteria for Inherited Visual Malingering", as there is no recognised medical condition or term by that name in my knowledge base as of my cut-off date in September 2021. It is possible that "Inherited Visual Malingering" is a specific term used in a limited context or a rare condition that has not been widely documented or recognised by the medical community at large. It is also possible that there has been a typographical error or confusion with the correct term.</span></p><p id="par0040" class="elsevierStylePara elsevierViewall">As can be seen, the model acknowledges the lack of specific information on this condition and suggests possible explanations for its absence.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Finally, we would like to thank you for your reflection on this currently relevant topic, as it is undeniable that ChatGPT and other similar tools are here to stay. However, we recognise that scientific accuracy and reliability are still insufficient.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> Therefore, any professional using these tools must engage in critical thinking, be aware of their limitations and actively verify the information generated with reliable sources.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a></p><span id="sec1030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect1065">Conflict of interest</span><p id="par1065" class="elsevierStylePara elsevierViewall">No Conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec1030" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Integrando la Inteligencia Artificial y los nuevos modelos de lenguaje en Oftalmología: Complicaciones del uso del aceite de silicona en cirugía vítreo-retiniana" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F.J. Valentín-Bravo" 1 => "E. Mateos-Álvarez" 2 => "R. Usategui-Martín" 3 => "C. Andrés-Iglesias" 4 => "J.C. Pastor-Jimeno" 5 => "S. Pastor-Idoate" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.oftale.2023.04.011" "Revista" => array:6 [ "tituloSerie" => "Arch Soc Esp Oftalmol" "fecha" => "2023" "volumen" => "98" "paginaInicial" => "298" "paginaFinal" => "303" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37094759" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of artificial intelligence and language models in medicine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F.J. Valentín Bravo" 1 => "E. Mateos Álvarez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.oftale.2023.04.003" "Revista" => array:6 [ "tituloSerie" => "Arch Soc Esp Oftalmol (Engl Ed)" "fecha" => "2023" "volumen" => "98" "paginaInicial" => "305" "paginaFinal" => "306" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37031735" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessing the accuracy and reliability of AI-generated medical responses: An evaluation of the chat-GPT model" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Johnson" 1 => "R. Goodman" 2 => "J. Patrinely" 3 => "C. Stone" 4 => "E. Zimmerman" 5 => "R. 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