amakuru

Ururimi runini (LLM) rushobora kwandika ingingo zemeza zishingiye kumagambo yihuse, gutsinda ibizamini byumwuga, no kwandika amakuru yinshuti kandi yishyira mu mwanya. Ariko, usibye ingaruka zizwi zizwi zimpimbano, gucika intege, hamwe nukuri kutari ukuri muri LLM, ibindi bibazo bitarakemuka bigenda bihinduka intumbero, nka moderi ya AI ikubiyemo "indangagaciro zabantu" zishobora kuvangura mukurema no kuyikoresha, ndetse niyo LLM itagihimbira ibirimo kandi ikuraho ibisubizo byangiza byangiza, "indangagaciro za LLM" zirashobora gukomeza gutandukana nindangagaciro zumuntu.

Ingero zitabarika zerekana uburyo amakuru yakoreshejwe mugutoza imiterere ya AI akubiyemo indangagaciro z'umuntu ku giti cye n'imibereho, zishobora gukomera murugero. Izi ngero zirimo porogaramu zitandukanye, zirimo gusobanura mu buryo bwikora X-imirasire yigituza, gutondekanya indwara zuruhu, no gufata ibyemezo bya algorithmic bijyanye no gutanga ibikoresho byubuvuzi. Nkuko byavuzwe mu kiganiro giherutse gusohoka mu kinyamakuru cyacu, amakuru abogamye ashobora kubogama no kwerekana indangagaciro no kubogama bigaragara muri sosiyete. Ibinyuranye, ubushakashatsi bwerekanye kandi ko AI ishobora gukoreshwa mu kugabanya kubogama. Kurugero, abashakashatsi bakoresheje uburyo bwimbitse bwo kwiga kuri firime ya X-ray hanyuma bavumbura ibintu byabuze kubipimo byerekana uburemere bukabije (byashyizwe mu majwi naba radiologiste) mu ivi, bityo bigabanya itandukaniro ry’ububabare budasobanutse hagati y’abarwayi b’abirabura n’abazungu.

Nubwo abantu benshi cyane bamenya kubogama mubyitegererezo bya AI, cyane cyane mubyerekeranye namakuru yamahugurwa, izindi ngingo nyinshi zinjira mumico yumuntu ntizitaweho bihagije mugutezimbere no kohereza mubikorwa bya AI. Ubuvuzi AI buherutse kugera ku bisubizo bitangaje, ariko ku rugero runini, ntabwo bwasuzumye mu buryo bweruye indangagaciro z’umuntu n’imikoranire yazo mu gusuzuma ingaruka hamwe n’ibitekerezo bishoboka, nta nubwo byigeze bigereranywa.

Kugirango usobanure neza ibyo bitekerezo bidafatika, tekereza ko uri endocrinologue usabwa kwandika imisemburo ikura ya recombinant kumuhungu wimyaka 8 uri munsi ya 3 kwijana ryimyaka ye. Umusemburo ukura wumuhungu ukura uri munsi ya 2 ng / mL (agaciro kerekana,> 10 ng / mL, agaciro kerekana ibihugu byinshi byo hanze y’Amerika ni> 7 ng / mL), kandi imisemburo ye ikura ya kimuntu yerekana ko ihinduka ryimikorere idasanzwe. Twizera ko uburyo bwo kuvura imisemburo ikura yumuntu bugaragara kandi budashidikanywaho muriyi miterere yubuvuzi.

Gushyira mu bikorwa imiti ivura imisemburo ikura yumuntu mu bihe bikurikira birashobora gutera impaka: uburebure bwumuhungu wimyaka 14 burigihe bwabaye mubice 10 kwijana rya bagenzi be, kandi impinga ya hormone yo gukura kwabantu nyuma yo gukanguka ni 8 ng / mL. Nta ihinduka ryimikorere rizwi rishobora kugira ingaruka ku burebure, cyangwa izindi mpamvu zizwi zitera uburebure buke, kandi imyaka ye yamagufa ifite imyaka 15 (ni ukuvuga kudatinda kwiterambere). Gusa igice cyimpaka ziterwa no gutandukanya indangagaciro ntarengwa zagenwe ninzobere zishingiye ku bushakashatsi bwinshi bwerekeranye n’imiterere y’imisemburo ikura y’umuntu ikoreshwa mu gusuzuma ibura ry’imisemburo ikura. Nibura impaka nyinshi zituruka ku kuringaniza inyungu ziterwa no gukoresha imiti ikura y’imisemburo ikura y’umuntu uhereye ku barwayi, ababyeyi barwayi, inzobere mu buvuzi, ibigo bikorerwamo ibya farumasi, n'abishyura. Inzobere mu kuvura indwara z'abana zirashobora gupima ingaruka zidasanzwe ziterwa no guterwa buri munsi imisemburo ikura ya hormone yo gukura kumyaka 2 hamwe nibishoboka ko nta mikurire nini cyangwa mike gusa mubunini bwumubiri ukuze ugereranije nubu. Abahungu barashobora kwizera ko nubwo uburebure bwabo bushobora kwiyongera kuri cm 2 gusa, birakwiye gutera imisemburo ikura, ariko abishyura hamwe nisosiyete ikora imiti barashobora kubona ibitekerezo bitandukanye.

Dufata urugero rwa eGFR ya creinine, nikimenyetso cyerekana imikorere yimpyiko ikoreshwa mugupima no gutera indwara zimpyiko zidakira, gushiraho impyiko cyangwa uburyo bwo gutanga impano, no kugena ibipimo byo kugabanya no kwirinda imiti myinshi yandikiwe. EGFR ni ikigereranyo cyoroheje cyo gusubira inyuma gikoreshwa mukugereranya igipimo cyapimwe cya glomerular filteri (mGFR), nigipimo ngenderwaho, ariko uburyo bwo gusuzuma buragoye. Iri gereranya ryo gusubira inyuma ntirishobora gufatwa nkicyitegererezo cya AI, ariko ryerekana amahame menshi yerekeye indangagaciro zabantu hamwe nibitekerezo bishoboka.

Ingingo yambere yo kwinjiza indangagaciro zumuntu kwinjira muri eGFR ni mugihe uhitamo amakuru kugirango akwiranye. Umurongo wumwimerere wakoreshejwe mugushushanya formulaire ya eGFR ahanini ugizwe nabirabura n'abazungu bitabiriye amahugurwa, kandi ikoreshwa mubindi moko menshi ntabwo risobanutse. Ingingo zinjira nyuma yindangagaciro zabantu muri iyi formula zirimo: guhitamo ukuri kwa mGFR nkintego yambere yo gusuzuma imikorere yimpyiko, nuruhe rwego rwemewe rwukuri, uburyo bwo gupima ukuri, no gukoresha eGFR nkurwego rwo gukurura ibyemezo byubuvuzi (nko kumenya uburyo bwo guhinduranya impyiko cyangwa kwandika imiti). Hanyuma, mugihe uhitamo ibikubiye mubyitegererezo byinjira, indangagaciro zabantu nazo zizinjira muriyi formula.

Kurugero, mbere ya 2021, umurongo ngenderwaho utanga igitekerezo cyo guhindura urwego rwa creinine muri formula ya eGFR ukurikije imyaka yabarwayi, igitsina, nubwoko (byashyizwe mubikorwa nkabirabura cyangwa abatari abirabura). Ivugurura rishingiye ku moko rigamije kunoza neza imiterere ya mGFR, ariko mu 2020, ibitaro bikuru byatangiye kwibaza ku ikoreshwa ry’amoko rishingiye ku bwoko bwa eGFR, biturutse ku mpamvu nko gutinza uburenganzira bw’umurwayi bwo guhindurwa no gutondeka ubwoko nk’ibitekerezo by’ibinyabuzima. Ubushakashatsi bwerekanye ko gukora moderi ya eGFR mubijyanye nubwoko bishobora kugira ingaruka zimbitse kandi zitandukanye kubintu byukuri nibisubizo byubuvuzi; Kubwibyo, guhitamo kwibanda ku kuri cyangwa kwibanda ku gice cyibisubizo byerekana imyanzuro yagaciro kandi irashobora guhisha ibyemezo bifata ibyemezo. Hanyuma, itsinda ryigihugu ryakoraga ryasabye formulaire nshya yongeye gushyirwaho utitaye kumoko yo guhuza imikorere nibibazo byuburinganire. Uru rugero rugaragaza ko na formulaire yubuvuzi yoroshye ifite ingingo nyinshi zinjira mumico yabantu.

Ugereranije na formulaire yubuvuzi ifite umubare muto gusa wibipimo byerekana, LLM irashobora kuba igizwe na miliyari kugeza kuri miliyari amagana y'ibipimo (uburemere bw'icyitegererezo) cyangwa byinshi, bigatuma kubyumva bigoye. Impamvu ituma tuvuga "bigoye kubyumva" nuko muri LLM nyinshi, inzira nyayo yo gutanga ibisubizo binyuze mubibazo idashobora gushushanywa. Umubare wibipimo bya GPT-4 ntabwo byatangajwe kugeza ubu; Uwayibanjirije GPT-3 yari ifite ibipimo bya miliyari 175. Ibipimo byinshi ntibisobanura byanze bikunze ubushobozi bukomeye, nkurugero ruto rurimo uruziga rwinshi rwo kubara (nka LLaMA [Ururimi runini Model Meta AI] ikurikirana) cyangwa moderi zahujwe neza zishingiye kubitekerezo byabantu zizakora neza kuruta moderi nini. Kurugero, ukurikije abasesengura abantu, icyitegererezo cya InstrumentGPT (icyitegererezo gifite miliyari 1,3 ibipimo) kiruta GPT-3 mugutezimbere ibisubizo byicyitegererezo.

Amahugurwa yihariye ya GPT-4 ntarashyirwa ahagaragara, ariko amakuru arambuye yerekana ibisekuruza byabanjirije harimo GPT-3, InstrumentGPT, hamwe nandi masoko menshi ya LLMs afungura isoko. Muri iki gihe, moderi nyinshi za AI zizana amakarita yicyitegererezo; Isuzuma n’umutekano bya GPT-4 byasohotse mu ikarita isa na sisitemu yatanzwe n’isosiyete ikora icyitegererezo OpenAI. Kurema kwa LLM birashobora kugabanywa mubice bibiri: icyiciro cyambere cyamahugurwa nicyiciro cyiza cyo guhuza intego igamije guhuza ibisubizo byicyitegererezo. Mu cyiciro kibanziriza amahugurwa, icyitegererezo gihabwa corpus nini harimo umwandiko wa interineti wambere kugirango uyitoze guhanura ijambo rikurikira. Ibi bisa nkibyoroshye "kurangiza byikora" bitanga urugero rukomeye rwibanze, ariko birashobora no kuganisha kumyitwarire mibi. Indangagaciro zumuntu zizinjira mubyiciro byambere byamahugurwa, harimo guhitamo amakuru yimyitozo ya GPT-4 no gufata icyemezo cyo kuvanaho ibintu bidakwiye nkibirimo porunogarafiya mumibare yabanjirije amahugurwa. Nubwo hashyizweho ingufu, icyitegererezo cyibanze kirashobora kuba ingirakamaro cyangwa ntigishobora kubamo ibisubizo byangiza. Mu cyiciro gikurikira cyo gutunganya neza, imyitwarire myinshi yingirakamaro kandi itagira ingaruka.

Murwego rwo gutunganya neza, imyitwarire yicyitegererezo cyururimi ikunze guhinduka cyane binyuze mugukurikirana neza-gutunganya no kwiga gushimangira bishingiye kubitekerezo byabantu. Mugenzuzi ikurikiranwa neza, abakozi ba rwiyemezamirimo bahawe akazi bazandika ingero zo gusubiza kumagambo yihuse kandi bahugure icyitegererezo. Mubyiciro byo kwiga gushimangira bishingiye kubitekerezo byabantu, abasesengura abantu bazatandukanya icyitegererezo cyibisubizo nkibisubizo byintangarugero. Noneho koresha ibisubizo byagereranijwe byavuzwe kugirango wige "ibihembo byigihembo" hanyuma urusheho kunoza icyitegererezo binyuze mukwiga gushimangira. Uruhare rutangaje rwurwego rwabantu rushobora guhuza neza izo moderi nini. Kurugero, Moderi ya InstrumentGPT yakoresheje itsinda ryabakozi bagera kuri 40 basezerana bashakishwa kurubuga rwa interineti kandi batsinze ikizamini cyo gusuzuma kigamije guhitamo itsinda ryabatanga ibitekerezo bumva ibyifuzo byimiryango itandukanye.

Nkuko izi ngero zombi zikabije, arizo formulaire yubuvuzi yoroshye [eGFR] hamwe na LLM ikomeye [GPT-4], yerekana, gufata ibyemezo byabantu nindangagaciro zabantu bigira uruhare runini mugushiraho umusaruro wicyitegererezo. Izi moderi za AI zishobora gufata indangagaciro zitandukanye z'abarwayi n'abaganga? Nigute ushobora kuyobora kumugaragaro ikoreshwa rya AI mubuvuzi? Nkuko byavuzwe haruguru, gusubiramo isesengura ryicyemezo cyubuvuzi birashobora gutanga igisubizo cyibanze kuri ibyo bibazo.

Isesengura ry'ibyemezo by'ubuvuzi ntabwo rimenyerewe n'abaganga benshi, ariko rirashobora gutandukanya imitekerereze ishoboka (ku bisubizo bitazwi neza bijyanye no gufata ibyemezo, nko kumenya niba gutanga imisemburo ikura y’umuntu mu mavuriro atavugwaho rumwe yerekanwe ku gishushanyo cya 1) hamwe n’ibitekerezo (ku ndangagaciro zishingiye ku bintu bifatika bifitanye isano n’ibi bisubizo, agaciro kabo kaba gafite agaciro kangana na cm 2 z'uburebure bw'abagabo), bitanga ibisubizo kuri gahunda. Mu isesengura ryibyemezo, abaganga bagomba kubanza kumenya ibyemezo byose bishoboka nibishoboka byose bifitanye isano na buri gisubizo, hanyuma bagashyiramo ibikorwa byumurwayi (cyangwa undi muburanyi) bifitanye isano na buri gisubizo kugirango bahitemo amahitamo akwiye. Kubwibyo, ishingiro ryisesengura ryibyemezo biterwa nimba ibizagerwaho byuzuye, kimwe no kumenya niba ibipimo byingirakamaro hamwe no kugereranya bishoboka. Byiza, ubu buryo bufasha kwemeza ko ibyemezo bishingiye ku bimenyetso kandi bigahuzwa n’ibyifuzo by’abarwayi, bityo bikagabanya itandukaniro riri hagati yamakuru afatika nindangagaciro z'umuntu ku giti cye. Ubu buryo bwinjijwe mu rwego rw’ubuvuzi mu myaka mirongo ishize kandi bukoreshwa mu gufata ibyemezo by’abarwayi ku giti cyabo no gusuzuma ubuzima bw’abaturage, nko gutanga ibyifuzo byo gusuzuma kanseri yibara ku baturage muri rusange.

Mu gusesengura ibyemezo byubuvuzi, uburyo butandukanye bwateguwe kugirango ubone akamaro. Uburyo bwinshi gakondo butanga agaciro kubarwayi kugiti cyabo. Uburyo bworoshye cyane ni ugukoresha igipimo cyerekana amanota, aho abarwayi basuzuma urwego rwabo rwo guhitamo ibisubizo runaka ku gipimo cya digitale (nk'urugero rw'umurongo uri hagati ya 1 na 10), hamwe n'ibisubizo by'ubuzima bukabije (nk'ubuzima bwuzuye n'urupfu) biherereye ku mpande zombi. Uburyo bwo guhanahana umwanya nubundi buryo bukunze gukoreshwa. Muri ubu buryo, abarwayi bakeneye gufata icyemezo cyigihe kingana iki biteguye kumara mugihe cyubuzima bubi. Uburyo busanzwe bwo gukina urusimbi nubundi buryo bukoreshwa muburyo bwo kumenya akamaro. Muri ubu buryo, abarwayi babazwa bumwe mu buryo bubiri bakunda: haba kubaho imyaka runaka mu buzima busanzwe ufite amahirwe yihariye (p) (t), kandi bakagira ibyago byo gupfa bafite amahirwe ya 1-p; Hitamo neza kubaho imyaka t mubihe byubuzima bwiza. Baza abarwayi inshuro nyinshi kuri p-gaciro zitandukanye kugeza igihe baterekanye ko badakunda amahitamo ayo ari yo yose, kugirango akamaro gashobore kubarwa hashingiwe kubisubizo byabarwayi.
Usibye uburyo bukoreshwa mugutanga ibyifuzo byabarwayi kugiti cyabo, hanashyizweho uburyo bwo kubona akamaro kubarwayi barwayi. Cyane cyane kwibanda kumatsinda yibiganiro (guhuza abarwayi kugirango baganire kuburambe bwihariye) birashobora gufasha kumva icyo batekereza. Kugirango duhuze neza ibikorwa byitsinda, hashyizweho uburyo butandukanye bwo kuganira mumatsinda.
Mubikorwa, kwinjiza muburyo butaziguye mugusuzuma kwa muganga no kuvura biratwara igihe. Nkigisubizo, ibibazo byubushakashatsi bitangwa kubantu batoranijwe kubushake kugirango babone amanota yingirakamaro kurwego rwabaturage. Ingero zimwe zirimo anketi ya EuroQol 5-ibipimo, ibipimo ngufi-6 byingirakamaro, Ifashayobora ryubuzima, hamwe na Kanseri yihariye y’ubushakashatsi n’ubuvuzi bw’ibihugu by’i Burayi Ubwiza bw’ubuzima Ikibazo 30.