Integrating large language models in systematic reviews: a framework and case study using ROBINS-I for risk of bias assessment.

Journal: BMJ evidence-based medicine
PMID:

Abstract

Large language models (LLMs) may facilitate and expedite systematic reviews, although the approach to integrate LLMs in the review process is unclear. This study evaluates GPT-4 agreement with human reviewers in assessing the risk of bias using the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) tool and proposes a framework for integrating LLMs into systematic reviews. The case study demonstrated that raw per cent agreement was the highest for the ROBINS-I domain of 'Classification of Intervention'. Kendall agreement coefficient was highest for the domains of 'Participant Selection', 'Missing Data' and 'Measurement of Outcomes', suggesting moderate agreement in these domains. Raw agreement about the overall risk of bias across domains was 61% (Kendall coefficient=0.35). The proposed framework for integrating LLMs into systematic reviews consists of four domains: rationale for LLM use, protocol (task definition, model selection, prompt engineering, data entry methods, human role and success metrics), execution (iterative revisions to the protocol) and reporting. We identify five basic task types relevant to systematic reviews: selection, extraction, judgement, analysis and narration. Considering the agreement level with a human reviewer in the case study, pairing artificial intelligence with an independent human reviewer remains required.

Authors

  • Bashar Hasan
    Department of Medicine, Mayo Clinic, Rochester, MN, 55905, United States.
  • Samer Saadi
    Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota, USA.
  • Noora S Rajjoub
    Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota, USA.
  • Moustafa Hegazi
    Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota, USA.
  • Mohammad Al-Kordi
    Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota, USA.
  • Farah Fleti
    Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota, USA.
  • Magdoleen Farah
    Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota, USA.
  • Irbaz B Riaz
    Department of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ.
  • Imon Banerjee
    Mayo Clinic, Department of Radiology, Scottsdale, AZ, USA.
  • Zhen Wang
    Department of Otolaryngology, Longgang Otolaryngology hospital & Shenzhen Key Laboratory of Otolaryngology, Shenzhen Institute of Otolaryngology, Shenzhen, Guangdong, China.
  • Mohammad Hassan Murad
    Department of Medicine, Mayo Clinic, Rochester, MN, 55905, United States.