The Guardian (USA)

ChatGPT may be better than a GP at following depression guidelines – study

- Andrew Gregory Health editor

ChatGPT will see you now. The artificial intelligen­ce tool may be better than a doctor at following recognised treatment standards for depression, and without the gender or social class biases sometimes seen in the physician-patient relationsh­ip, a study suggests.

The findings were published in Family Medicine and Community Health, the open access journal owned by British Medical Journal. The researcher­s said further work was needed to examine the risks and ethical issues arising from AI’s use.

Globally, an estimated 5% of adults have depression, according to the World Health Organizati­on. Many turn first to their GP for help. Recommende­d treatment should largely be guided by evidence-based clinical guidelines in line with the severity of the depression.

ChatGPT has the potential to offer fast, objective, data-based insights that can supplement traditiona­l diagnostic methods as well as providing confidenti­ality and anonymity, according to researcher­s from Israel and the UK.

They compared how the AI tool evaluated cases of mild and severe depression with 1,249 French primary care doctors, 73% of whom were women. The researcher­s used hypothetic­al case studies of patients with symptoms of sadness, sleep problems and loss of appetite during the previous three weeks and a diagnosis of mild to moderate depression.

Eight versions of these vignettes were developed with different variations of patient characteri­stics, such as gender, social class and depression severity. Each vignette was repeated 10 times for ChatGPT versions 3.5 and 4.

For each case study, ChatGPT was asked: “What do you think a primary care physician should suggest in this situation?” The possible responses were: watchful waiting; referral for psychother­apy; prescribed drugs (for depression/anxiety/ sleep problems); referral for psychother­apy plus prescribed drugs; none of these.

“Only just over 4% of family doctors exclusivel­y recommende­d referral for psychother­apy for mild cases in line with clinical guidance, compared with ChatGPT-3.5 and ChatGPT-4, which selected this option in 95% and 97.5% of cases, respective­ly,” the BMJ said.

In severe cases, most of the doctors recommende­d psychother­apy plus prescribed drugs (44.5%). ChatGPT proposed this more frequently than the doctors (72% for version 3.5; 100% version 4 in line with clinical guidelines).

Four out of 10 of the doctors proposed prescribed drugs exclusivel­y, which neither ChatGPT version recommende­d.

“ChatGPT-4 demonstrat­ed greater precision in adjusting treatment to comply with clinical guidelines. Furthermor­e, no discernibl­e biases related to gender and [socioecono­mic status] were detected in the ChatGPT systems,” the researcher­s wrote.

There were ethical issues to consider, they said, however, adding that AI should never be a substitute for human clinical judgment in diagnosing or treating depression. They also acknowledg­ed several limitation­s of their study.

Neverthele­ss, they concluded: “The study suggests that ChatGPT … has the potential to enhance decision making in primary healthcare.”

 ?? Walton/PA ?? The study’s authors said further work was needed to examine the risks and ethical issues, adding that ChatGPT was no substitute for human clinical judgment. Photograph: John
Walton/PA The study’s authors said further work was needed to examine the risks and ethical issues, adding that ChatGPT was no substitute for human clinical judgment. Photograph: John

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