Validation of automated paper screening for esophagectomy systematic review using large language models
Bibliographic record
Abstract
Background: Large language models (LLMs) offer a potential solution to the labor-intensive nature of systematic reviews. This study evaluated the ability of the GPT model to identify articles that discuss perioperative risk factors for esophagectomy complications. To test the performance of the model, we tested GPT-4 on narrower inclusion criterion and by assessing its ability to discriminate relevant articles that solely identified preoperative risk factors for esophagectomy. Methods: = 1,967) discussing risk factors to esophagectomy complications. The articles underwent title and abstract screening by three independent human reviewers and GPT-4. The Python script used for the analysis made Application Programming Interface (API) calls to GPT-4 with screening criteria in natural language. GPT-4's inclusion and exclusion decision were compared to those decided human reviewers. Results: The agreement between the GPT model and human decision was 85.58% for perioperative factors and 78.75% for preoperative factors. The AUC value was 0.87 and 0.75 for the perioperative and preoperative risk factors query, respectively. In the evaluation of perioperative risk factors, the GPT model demonstrated a high recall for included studies at 89%, a positive predictive value of 74%, and a negative predictive value of 84%, with a low false positive rate of 6% and a macro-F1 score of 0.81. For preoperative risk factors, the model showed a recall of 67% for included studies, a positive predictive value of 65%, and a negative predictive value of 85%, with a false positive rate of 15% and a macro-F1 score of 0.66. The interobserver reliability was substantial, with a kappa score of 0.69 for perioperative factors and 0.61 for preoperative factors. Despite lower accuracy under more stringent criteria, the GPT model proved valuable in streamlining the systematic review workflow. Preliminary evaluation of inclusion and exclusion justification provided by the GPT model were reported to have been useful by study screeners, especially in resolving discrepancies during title and abstract screening. Conclusion: This study demonstrates promising use of LLMs to streamline the workflow of systematic reviews. The integration of LLMs in systematic reviews could lead to significant time and cost savings, however caution must be taken for reviews involving stringent a narrower and exclusion criterion. Future research is needed and should explore integrating LLMs in other steps of the systematic review, such as full text screening or data extraction, and compare different LLMs for their effectiveness in various types of systematic reviews.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.200 | 0.536 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.004 | 0.009 |
| Bibliometrics | 0.017 | 0.008 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.003 | 0.005 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
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".