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Artificial Intelligence-Generated Electronic Medical Record Summarization in Breast Surgical Oncology.

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Τίτλος: Artificial Intelligence-Generated Electronic Medical Record Summarization in Breast Surgical Oncology.
Συγγραφείς: Park KU; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA. kpark16@bwh.harvard.edu.; Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA. kpark16@bwh.harvard.edu.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA. kpark16@bwh.harvard.edu.; Harvard Medical School, Boston, MA, USA. kpark16@bwh.harvard.edu., Sather BK; Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Department of General and Thoracic Surgery, Virginia Mason Medical Center, Seattle, WA, USA., Shah A; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA., Minami CA; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Department of Surgery, Foothills Medical Centre, Cumming School of Medicine, University of Calgary, Alberta, Canada., Butler M; Brown University Health, Providence, RI, USA., Butler L; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA., Love JA; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA.; Division of Breast Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA., McLean K; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA.; Division of Breast Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA., Dunn A; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA.; Division of Breast Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA., Mittendorf EA; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Division of Breast Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA., King TA; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Winship Cancer Institute of Emory University, Atlanta, GA, USA.
Πηγή: Annals of surgical oncology [Ann Surg Oncol] 2026 Oct; Vol. 33 (10), pp. 9102-9109. Date of Electronic Publication: 2026 Jul 15.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer Country of Publication: United States NLM ID: 9420840 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-4681 (Electronic) Linking ISSN: 10689265 NLM ISO Abbreviation: Ann Surg Oncol Subsets: MEDLINE
Imprint Name(s): Publication: 2005- : New York, NY : Springer
Original Publication: New York, NY : Raven Press, c1994-
Ιατρικοί όροι (MeSH): Breast Neoplasms*/surgery , Breast Neoplasms*/pathology , Electronic Health Records*/standards , Surgical Oncology* , Artificial Intelligence* , Documentation*, Humans ; Female ; Prospective Studies ; Generative Artificial Intelligence ; Prognosis ; Pilot Projects
Περίληψη: Background: Reviewing pathology, imaging, and consultation documents in oncology can be time-consuming, particularly when records originate from external facilities in different file formats. This study aimed to evaluate the impact of a Retrieval-Augmented Generation (RAG)-enabled GPT-4o summarization agent on clinical workflows and quality of outside-record summaries in breast surgical oncology.
Methods: Initial performance evaluation of a GPT-4o/RAG agent to generate summaries of oncologic reports in 50 charts followed by a prospective pilot test of sequential cases, with each AI summary evaluated using a modified Provider Documentation Summarization Quality Instrument (PDSQI-9; 1-5 Likert scale), including dichotomized ratings (low [1-3], high [4, 5]), binomial testing, frequency and type of user-reported errors, clinician-coded error criticality (treatment-impacting vs noncritical). Pre- and post-use survey of documentation burden (NASA TLX) and user experience was performed.
Results: Among 62 cases, AI-generated summaries were rated high for accuracy, usefulness, succinctness, and source citation. Thoroughness without omission was rated low in 28 (45%) summaries. Errors were noted in 25 (40%) surveys, with 13 (52%) classified as critical (treatment-impacting). The most common error type involved imaging, reported in 17 (68%) cases. For perceived time savings, the median response was neutral, but qualitative feedback described the tool as helpful for straightforward cases and as reducing typing burden but requiring workflow adjustment and improvements for complex cases.
Conclusions: Although users rated RAG-enabled GPT-4o agent-generated documentation summaries favorably on several quality domains, they frequently lacked thoroughness and occasionally contained treatment-relevant errors. Human review and further iteration of the technology remain necessary before implementation.
(© 2026. The Author(s).)
Competing Interests: Disclosure: Elizabeth A. Mittendorf reports compensated service on scientific advisory boards for Astra Zeneca and Merck, uncompensated service on steering committees for Bristol Myers Squibb and Roche/Genentech, and institutional research support from Roche/Genentech (via SU2C grant) and Gilead. She also reports research funding from Susan Komen for the Cure, for which she serves as a Scientific Advisor, and uncompensated participation as a member of the American Society of Clinical Oncology Board of Directors. Tari A. King reports speaker honoraria for Exact Sciences, compensated service on the FES Steering Committee for GE Healthcare, compensated service for a Prosigna advisory board role for Veracyte, compensated service on the advisory board for Ataraxia AI, and compensated service as faculty for PrecisCa cancer information service. The remaining authors have no conflicts of interest.
References: NPJ Digit Med. 2023 Aug 24;6(1):158. (PMID: 37620423)
AMIA Jt Summits Transl Sci Proc. 2025 Jun 10;2025:312-321. (PMID: 40502261)
J Natl Cancer Inst. 2025 Jun 1;117(6):1253-1259. (PMID: 40037649)
JAMA Netw Open. 2025 Oct 1;8(10):e2538427. (PMID: 41118162)
Proc Conf Assoc Comput Linguist Meet. 2023 Jul;2023:9871-9889. (PMID: 39629493)
JAMA Netw Open. 2025 Aug 01;8(8):e2526339. (PMID: 40802185)
J Am Med Inform Assoc. 2025 Jun 1;32(6):1050-1060. (PMID: 40323321)
PLOS Digit Health. 2025 Jun 11;4(6):e0000877. (PMID: 40498738)
NPJ Digit Med. 2024 May 1;7(1):106. (PMID: 38693429)
Nat Med. 2025 Jan;31(1):60-69. (PMID: 39779929)
JAMA Netw Open. 2024 Dec 2;7(12):e2448723. (PMID: 39625719)
JAMIA Open. 2025 Jul 30;8(4):ooaf082. (PMID: 40741008)
Br J Radiol. 2018 Feb;91(1083):20170670. (PMID: 29189048)
Appl Clin Inform. 2022 Aug;13(4):857-864. (PMID: 36104154)
JAMA Netw Open. 2025 Aug 1;8(8):e2528056. (PMID: 40839265)
BMJ Open Qual. 2024 Jun 19;13(2):. (PMID: 38901878)
IIE Trans Healthc Syst Eng. 2011;1(2):131-143. (PMID: 22773941)
Sci Rep. 2022 Jul 8;12(1):11654. (PMID: 35803963)
Radiology. 2011 Jul;260(1):174-81. (PMID: 21518775)
J Am Coll Radiol. 2016 Apr;13(4):401-7. (PMID: 26681164)
Nat Med. 2024 Apr;30(4):1134-1142. (PMID: 38413730)
Contributed Indexing: Keywords: Artificial intelligence; Breast surgical oncology; Large language model; Medical record summarization; PDSQI-9
Entry Date(s): Date Created: 20260715 Date Completed: 20260919 Latest Revision: 20260920
Update Code: 20260920
PubMed Central ID: PMC13585955
DOI: 10.1245/s10434-026-20170-w
PMID: 42455485
Βάση Δεδομένων: MEDLINE
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  Data: Artificial Intelligence-Generated Electronic Medical Record Summarization in Breast Surgical Oncology.
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  Data: <searchLink fieldCode="AU" term="%22Park+KU%22">Park KU</searchLink>; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA. kpark16@bwh.harvard.edu.; Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA. kpark16@bwh.harvard.edu.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA. kpark16@bwh.harvard.edu.; Harvard Medical School, Boston, MA, USA. kpark16@bwh.harvard.edu.<br /><searchLink fieldCode="AU" term="%22Sather+BK%22">Sather BK</searchLink>; Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Department of General and Thoracic Surgery, Virginia Mason Medical Center, Seattle, WA, USA.<br /><searchLink fieldCode="AU" term="%22Shah+A%22">Shah A</searchLink>; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.<br /><searchLink fieldCode="AU" term="%22Minami+CA%22">Minami CA</searchLink>; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Department of Surgery, Foothills Medical Centre, Cumming School of Medicine, University of Calgary, Alberta, Canada.<br /><searchLink fieldCode="AU" term="%22Butler+M%22">Butler M</searchLink>; Brown University Health, Providence, RI, USA.<br /><searchLink fieldCode="AU" term="%22Butler+L%22">Butler L</searchLink>; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA.<br /><searchLink fieldCode="AU" term="%22Love+JA%22">Love JA</searchLink>; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA.; Division of Breast Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.<br /><searchLink fieldCode="AU" term="%22McLean+K%22">McLean K</searchLink>; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA.; Division of Breast Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.<br /><searchLink fieldCode="AU" term="%22Dunn+A%22">Dunn A</searchLink>; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA.; Division of Breast Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.<br /><searchLink fieldCode="AU" term="%22Mittendorf+EA%22">Mittendorf EA</searchLink>; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Division of Breast Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.<br /><searchLink fieldCode="AU" term="%22King+TA%22">King TA</searchLink>; Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.; Breast Oncology Program, Dana-Farber Cancer Institute, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Winship Cancer Institute of Emory University, Atlanta, GA, USA.
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  Data: <searchLink fieldCode="JN" term="%229420840%22">Annals of surgical oncology</searchLink> [Ann Surg Oncol] 2026 Oct; Vol. 33 (10), pp. 9102-9109. <i>Date of Electronic Publication: </i>2026 Jul 15.
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  Data: <searchLink fieldCode="MM" term="%22Breast+Neoplasms%22">Breast Neoplasms*</searchLink>/<searchLink fieldCode="MM" term="%22Breast+Neoplasms+surgery%22">surgery</searchLink> <br /><searchLink fieldCode="MM" term="%22Breast+Neoplasms%22">Breast Neoplasms*</searchLink>/<searchLink fieldCode="MM" term="%22Breast+Neoplasms+pathology%22">pathology</searchLink> <br /><searchLink fieldCode="MM" term="%22Electronic+Health+Records%22">Electronic Health Records*</searchLink>/<searchLink fieldCode="MM" term="%22Electronic+Health+Records+standards%22">standards</searchLink> <br /><searchLink fieldCode="MM" term="%22Surgical+Oncology%22">Surgical Oncology*</searchLink> <br /><searchLink fieldCode="MM" term="%22Artificial+Intelligence%22">Artificial Intelligence*</searchLink> <br /><searchLink fieldCode="MM" term="%22Documentation%22">Documentation*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Prospective+Studies%22">Prospective Studies</searchLink> ; <searchLink fieldCode="MH" term="%22Generative+Artificial+Intelligence%22">Generative Artificial Intelligence</searchLink> ; <searchLink fieldCode="MH" term="%22Prognosis%22">Prognosis</searchLink> ; <searchLink fieldCode="MH" term="%22Pilot+Projects%22">Pilot Projects</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Reviewing pathology, imaging, and consultation documents in oncology can be time-consuming, particularly when records originate from external facilities in different file formats. This study aimed to evaluate the impact of a Retrieval-Augmented Generation (RAG)-enabled GPT-4o summarization agent on clinical workflows and quality of outside-record summaries in breast surgical oncology.<br />Methods: Initial performance evaluation of a GPT-4o/RAG agent to generate summaries of oncologic reports in 50 charts followed by a prospective pilot test of sequential cases, with each AI summary evaluated using a modified Provider Documentation Summarization Quality Instrument (PDSQI-9; 1-5 Likert scale), including dichotomized ratings (low [1-3], high [4, 5]), binomial testing, frequency and type of user-reported errors, clinician-coded error criticality (treatment-impacting vs noncritical). Pre- and post-use survey of documentation burden (NASA TLX) and user experience was performed.<br />Results: Among 62 cases, AI-generated summaries were rated high for accuracy, usefulness, succinctness, and source citation. Thoroughness without omission was rated low in 28 (45%) summaries. Errors were noted in 25 (40%) surveys, with 13 (52%) classified as critical (treatment-impacting). The most common error type involved imaging, reported in 17 (68%) cases. For perceived time savings, the median response was neutral, but qualitative feedback described the tool as helpful for straightforward cases and as reducing typing burden but requiring workflow adjustment and improvements for complex cases.<br />Conclusions: Although users rated RAG-enabled GPT-4o agent-generated documentation summaries favorably on several quality domains, they frequently lacked thoroughness and occasionally contained treatment-relevant errors. Human review and further iteration of the technology remain necessary before implementation.<br /> (© 2026. The Author(s).)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: Disclosure: Elizabeth A. Mittendorf reports compensated service on scientific advisory boards for Astra Zeneca and Merck, uncompensated service on steering committees for Bristol Myers Squibb and Roche/Genentech, and institutional research support from Roche/Genentech (via SU2C grant) and Gilead. She also reports research funding from Susan Komen for the Cure, for which she serves as a Scientific Advisor, and uncompensated participation as a member of the American Society of Clinical Oncology Board of Directors. Tari A. King reports speaker honoraria for Exact Sciences, compensated service on the FES Steering Committee for GE Healthcare, compensated service for a Prosigna advisory board role for Veracyte, compensated service on the advisory board for Ataraxia AI, and compensated service as faculty for PrecisCa cancer information service. The remaining authors have no conflicts of interest.
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  Data: NPJ Digit Med. 2023 Aug 24;6(1):158. (PMID: <searchLink fieldCode="PM" term="%2237620423%22">37620423)</searchLink><br />AMIA Jt Summits Transl Sci Proc. 2025 Jun 10;2025:312-321. (PMID: <searchLink fieldCode="PM" term="%2240502261%22">40502261)</searchLink><br />J Natl Cancer Inst. 2025 Jun 1;117(6):1253-1259. (PMID: <searchLink fieldCode="PM" term="%2240037649%22">40037649)</searchLink><br />JAMA Netw Open. 2025 Oct 1;8(10):e2538427. (PMID: <searchLink fieldCode="PM" term="%2241118162%22">41118162)</searchLink><br />Proc Conf Assoc Comput Linguist Meet. 2023 Jul;2023:9871-9889. (PMID: <searchLink fieldCode="PM" term="%2239629493%22">39629493)</searchLink><br />JAMA Netw Open. 2025 Aug 01;8(8):e2526339. (PMID: <searchLink fieldCode="PM" term="%2240802185%22">40802185)</searchLink><br />J Am Med Inform Assoc. 2025 Jun 1;32(6):1050-1060. (PMID: <searchLink fieldCode="PM" term="%2240323321%22">40323321)</searchLink><br />PLOS Digit Health. 2025 Jun 11;4(6):e0000877. (PMID: <searchLink fieldCode="PM" term="%2240498738%22">40498738)</searchLink><br />NPJ Digit Med. 2024 May 1;7(1):106. (PMID: <searchLink fieldCode="PM" term="%2238693429%22">38693429)</searchLink><br />Nat Med. 2025 Jan;31(1):60-69. (PMID: <searchLink fieldCode="PM" term="%2239779929%22">39779929)</searchLink><br />JAMA Netw Open. 2024 Dec 2;7(12):e2448723. (PMID: <searchLink fieldCode="PM" term="%2239625719%22">39625719)</searchLink><br />JAMIA Open. 2025 Jul 30;8(4):ooaf082. (PMID: <searchLink fieldCode="PM" term="%2240741008%22">40741008)</searchLink><br />Br J Radiol. 2018 Feb;91(1083):20170670. (PMID: <searchLink fieldCode="PM" term="%2229189048%22">29189048)</searchLink><br />Appl Clin Inform. 2022 Aug;13(4):857-864. (PMID: <searchLink fieldCode="PM" term="%2236104154%22">36104154)</searchLink><br />JAMA Netw Open. 2025 Aug 1;8(8):e2528056. (PMID: <searchLink fieldCode="PM" term="%2240839265%22">40839265)</searchLink><br />BMJ Open Qual. 2024 Jun 19;13(2):. (PMID: <searchLink fieldCode="PM" term="%2238901878%22">38901878)</searchLink><br />IIE Trans Healthc Syst Eng. 2011;1(2):131-143. (PMID: <searchLink fieldCode="PM" term="%2222773941%22">22773941)</searchLink><br />Sci Rep. 2022 Jul 8;12(1):11654. (PMID: <searchLink fieldCode="PM" term="%2235803963%22">35803963)</searchLink><br />Radiology. 2011 Jul;260(1):174-81. (PMID: <searchLink fieldCode="PM" term="%2221518775%22">21518775)</searchLink><br />J Am Coll Radiol. 2016 Apr;13(4):401-7. (PMID: <searchLink fieldCode="PM" term="%2226681164%22">26681164)</searchLink><br />Nat Med. 2024 Apr;30(4):1134-1142. (PMID: <searchLink fieldCode="PM" term="%2238413730%22">38413730)</searchLink>
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