Prototyping a Generative AI-powered Person-centered Digital Health Tool to Mitigate Risk of Preventable Adverse Drug Events
Dobbins, D.; Russell, A.; Gunther, M.; Shetty, V.; Shomali, A.; Vawdrey, D.; Waring, S.; Whary, P.; Wong, J.; Wright, E. A.; Olson, A. W.
Show abstract
Objectives: Older adults with comorbidities and polypharmacy have disproportionately high risk of hospitalization as well as readmission from adverse drug events (ADEs), of which 28%-71% are preventable (pADEs). This paper introduces an LLM application, CommunicADE, designed to support risk-mitigation of pADE-related readmission for the aforementioned population. We aim to evaluate CommunicADE's technical performance with OpenAI's HealthBench criteria: accuracy, completeness, communication quality, context awareness, and instruction following. Materials and Methods: Our technical validation study used an LLM (KimiK2.5) to simulate interviews between CommunicADE and nine high-fidelity synthetic patients hospitalized and at increased risk for pADE-related readmission (65+ years, comorbidities, 5+ medications). Some pADE risk mechanisms clues were visible to CommunicADE in patient H&Ps, but most mechanisms were solely discoverable in interviews. Two pharmacists evaluated CommunicADE's interview questions and EHR notes with HealthBench-informed variables. Analyzes used descriptive statistics. Results: For 35 mechanisms across 9 patients (avg=3.89 mechanisms/patient), CommunicADE's precision and recall were 0.92 and 0.63, respectively. Hallucinations were absent. Coherence and person-centeredness scored 4.28 and 4.44 on a 5-point scale (5=highest). On average, communication was at a 5th grade level and objective for 78% of patients. Most patient-reported quotes included in notes (92%) supported detected mechanisms. CommunicADE followed all instructions regarding interview length and patient approvals. Discussion: CommunicADE's strongest performance was in accuracy (precision, hallucinations), communication quality (coherence, readability), context awareness (person-centeredness). Completeness (recall) and instruction following (objectivity, pADE mechanism/quote alignment) show room for improvement. Conclusion: Findings suggest technical readiness for a feasibility pilot with real-world patients, and key areas for performance improvement.
Matching journals
The top 6 journals account for 50% of the predicted probability mass.
Similar papers in this journal
Similar papers in this journal
- Development and preliminary testing of Health Equity Across the AI Lifecycle (HEAAL): A framework for healthcare delivery organizations to mitigate the risk of AI solutions worsening health inequities 93%
- Accuracy of preferred language data in a multi-hospital electronic health record in Toronto, Canada 92%
- Feasibility characteristics of wrist-worn fitness trackers in health status monitoring for post-COVID patients in remote and rural areas 91%
Similar papers in this journal
- User Perceptions of Individually-Tailored Health Information in 1 Digital Apps: Development of a Scale 90%
- Development and Validation of a Machine Learning Model Integrated with the Clinical Workflow for Inpatient Discharge Date Prediction 90%
- Large Language Models in Real-World Clinical Workflows: A Systematic Review of Applications and Implementation 89%
Similar papers in this journal
- Clinical code sets and the problem of redundancy in code set repositories 93%
- Development of the AD F ICE_IT clinical decision support system to assist deprescribing of fall-risk increasing drugs: A user-centered design approach 93%
- ChatGPT- versus human-generated answers to frequently asked questions about diabetes: a Turing test-inspired survey among employees of a Danish diabetes center 92%
"Similar papers" are the closest papers from that journal in the model's embedding space. They show what the match is built on, but the ranking comes mostly from a classifier over the whole training set, not from these examples alone.