Abstract
Musculoskeletal diseases are among the leading causes of disability worldwide, creating a significant demand for rehabilitation. Recovery, remodeling, and degeneration often unfold over months or years, requiring longitudinal management that integrates evolving patient evidence, external medical knowledge, and stage-specific functional goals. However, in routine practice, this evidence is fragmented across visits, departments, and hospital systems, limiting individualized, evidence-based care.
Here, we report OrthoPilot, a clinical AI system powered by a large language model that integrates hospital data streams with authoritative external knowledge for continuous musculoskeletal management. OrthoPilot autonomously retrieves real-time imaging, laboratory, pathology, and order data, converting evolving patient states into evidence-based decisions from admission diagnosis to rehabilitation planning.
We established a specialist-validated benchmark from real-world electronic health records spanning 1,000 disease codes. In a reader study across the complete care pathway, OrthoPilot was compared with 81 orthopaedic physicians and surpassed experts with 25 years of experience in diagnostic reasoning, clinical decision-making, and management planning. It also outperformed all evaluated intelligent systems across 60 external clinical centres.
In a prospective study of 1,870 complex cases, OrthoPilot increased full-chain management success by 10.6%. During an 8-month randomized deployment involving 8,240 inpatients, it increased cumulative cases per bed by 9.7% and improved patient-reported access to health information. These results move clinical AI from predicting isolated events toward executing longitudinal management across complete musculoskeletal care pathways.
Blogger's Review: The development of OrthoPilot highlights the immense potential of AI in healthcare, not only improving diagnostic accuracy but also optimizing the overall patient care process. By integrating real-time data and external knowledge, this system significantly enhances the management of musculoskeletal diseases, indicating a shift towards intelligent medical services in the future.