GPT in Neurology Notes: A Case Study on Prompt Refinement

This repository provides resources and guidance for automating the summarization of clinical encounter notes using OpenAI's GPT-4. It includes a Python script (GPT-4-Chat.ipynb), sample clinical notes from our study, and a document that illustrates the effect of prompt refinement on summarization outcomes, along with explanations on what the refined prompts are.

Repository Contents:

1. Clinical Notes:

   • Sample clinical notes are provided for three distinct cases:
     • Case 1: 1130.txt – Hydrocephalus, Shunt Surgery Follow-up
     • Case 2: 1547.txt – Aneurysm, Complicated Recovery
     • Case 3: 1026.txt – Male Patient with Epilepsy

2. Impact of Prompt Refinement on Summarization (Impact-of-Prompt-Refinement.docx):

   • This document illustrates the variance in summarization outcomes between naive (original) and refined (improved) prompts across the three cases.

3. GPT-4-Chat Notebook (GPT-4-Chat.ipynb):

   • If you're interested in experimenting with prompt refinement, the GPT-4-Chat.ipynb file is included. In this notebook, you'll have the opportunity to interact with GPT-4.ipynb. When you run the program, you'll be greeted by the system, after which you'll need to input the desired prompt alongside the clinical note.

Prompts for this study:

Naive Prompt: Summarize this medical note

Refined Prompt: 
A clinical encounter refers to a medical visit or appointment between a
patient and a healthcare provider, such as a doctor, nurse practitioner, or physician assistant.During a clinical encounter, the healthcare provider typically evaluates the patient's medical history, performs a physical exam, orders and reviews diagnostic tests, and provides a diagnosis and treatment plan. The purpose of a clinical encounter is to provide medical care and improve the patient's health outcomes. 

Clinical encounters can occur in various settings, such as a doctor's office, clinic, hospital, or telehealth platform. Accurate and detailed documentation of the clinical encounter is vital for ensuring continuity of care and effective communication between healthcare providers.

These are the following components that must be included  in
a clinical encounter summarization.

Reason for the visit: This should describe the patient's primary reason for seeking medical care, including any symptoms or concerns they have.

History of present illness: This should provide a brief 
summary of the patient's background and current symptoms,
as well as any relevant events that may have led up to their 
current medical condition. This section typically includes the 
patient's age, gender, and any significant medical history,
as well as a description of the present symptoms and how 
they developed. It may also include information about any 
recent events or activities that may have contributed to the 
development of the symptoms, such as a recent injury or exposure
to an illness. 

Major findings: This should include any significant findings
from the physical exam, diagnostic tests, and lab tests.

Patient information: This should include demographic information
such as the patient's name, age, gender, medical history,
allergies, and any other pertinent information.

Medications: This should include any medications 
prescribed or recommended by the healthcare provider. This 
should include the name of the medication, dosage, 
frequency, and any special instructions.

Medical history: This should provide a comprehensive summary
of the patient's past medical conditions, surgeries, 
hospitalizations, and family medical history.

Physician information: This should list the healthcare 
provider's name, specialty, and contact information.

Follow-up instructions: This should outline any follow-up appointments, 
tests, or other recommendations made by the healthcare provider.

Course of treatment: This should include the expected trajectory of the patient's illness, the anticipated duration of treatment, or the specific steps that 
the healthcare provider plans to take to manage the patient's condition.

Outcome of the visit: This should describe the patient's response
to treatment and any changes in the patient's condition. 

Laboratory results: These are the findings from various laboratory
tests performed on the patient during the visit. Examples include 
blood tests, urine tests, and microbiology cultures. These laboratory 
tests can involve taking a sample of the patient's blood, urine,
or other bodily fluids or tissues, which is then analyzed 
in a laboratory using various techniques and equipment.

Imaging studies: They are non-invasive diagnostic tests that use
various techniques to produce images of the body's internal structures. 
Examples of these tests include X-rays, CT scans, MRI scans, and 
ultrasounds. Imaging studies can help identify abnormalities,
such as tumors or fractures, and diagnose and treat various 
medical conditions. When documenting the results of imaging studies 
in a clinical encounter note, it is important to include the date
that the test was performed and any relevant findings or 
abnormalities that were detected. For example, a CT scan performed
on 5/15/21 may have revealed a minor fracture in the patient's 
left tibia, while an MRI performed on 6/3/21 may have shown a 
herniated disc in the patient's lumbar spine. By including 
detailed information about imaging studies in the clinical 
encounter note, healthcare providers can ensure that 
other providers have access to accurate and up-to-date 
information about the patient's condition and treatment plan.
Make sure to include all imaging tests.

Other diagnostic tests: These are any other relevant diagnostic tests performed during the visit. Examples may include electrocardiograms (ECGs), pulmonary function tests, and biopsies.

Follow-up appointments: This should include any scheduled
follow-up appointments, as well as any instructions for 
the patient to schedule additional appointments.

Patient education: This should include any instructions 
or educational materials provided to the patient
during the visit.

Please summarize the following clinical note in a list, and 
include the components that I previously mentioned
that should be included in a clinical encounter summary.