AI-assisted human clinical reasoning in the ICU: beyond “to err is human”

Diagnostic errors pose a significant public health challenge, affecting nearly 800,000 Americans annually, with even higher rates globally. In the ICU, these errors are particularly prevalent, leading to substantial morbidity and mortality. The clinical reasoning process aims to reduce diagnostic uncertainty and establish a plausible differential diagnosis but is often hindered by cognitive load, patient complexity, and clinician burnout. These factors contribute to cognitive biases that compromise diagnostic accuracy. Emerging technologies like large language models (LLMs) offer potential solutions to enhance clinical reasoning and improve diagnostic precision. In this perspective article, we explore the roles of LLMs, such as GPT-4, in addressing diagnostic challenges in critical care settings through a case study of a critically ill patient managed with LLM assistance.