Medical education with large language models in ophthalmology: custom instructions and enhanced retrieval capabilities
Bibliographic record
Abstract
Foundation models are the next generation of artificial intelligence that has the potential to provide novel use cases for healthcare. Large language models (LLMs), a type of foundation model, are capable of language comprehension and the ability to generate human-like text. Researchers and developers have been tuning LLMs to optimise their performance in specific tasks, such as medical challenge problems. Until recently, tuning required technical programming expertise, but the release of custom generative pre-trained transformers (GPTs) by OpenAI has allowed users to tune their own GPTs with natural language. This has the potential to democratise access to high-quality bespoke LLMs globally. In this review, we provide an overview of LLMs, how they are tuned and how custom GPTs work. We provide three use cases of custom GPTs in ophthalmology to demonstrate the versatility and effectiveness of these tools. First, we present 'EyeTeacher', an educational aid that generates questions from clinical guidelines to facilitate learning. Second, we built 'EyeAssistant', a clinical support tool that is tuned with clinical guidelines to respond to various physician queries. Lastly, we design 'The GPT for GA', which offers clinicians a comprehensive summary of emerging management strategies for geographic atrophy by analysing peer-reviewed documents. The review underscores the significance of custom instructions and information retrieval in tuning GPTs for specific tasks in ophthalmology. We also discuss the evaluation of LLM responses and address critical aspects such as privacy and accountability in their clinical application. Finally, we discuss their potential in ophthalmic education and clinical practice.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".