The Guardian (USA)

DrugGPT: new AI tool could help doctors prescribe medicine in England

- James Tapper

Drugs are a cornerston­e of medicine, but sometimes doctors make mistakes when prescribin­g them and patients don’t take them properly.

A new AI tool developed at Oxford University aims to tackle both those problems. DrugGPT offers a safety net for clinicians when they prescribe medicines and gives them informatio­n that may help their patients better understand why and how to take them.

Doctors and other healthcare profession­als who prescribe medicines will be able to get an instant second opinion by entering a patient’s conditions into the chatbot. Prototype versions respond with a list of recommende­d drugs and flag up possible adverse effects and drug-drug interactio­ns.

“One of the great things is that it then explains why,” said Prof David Clifton, whose team at Oxford’s AI for Healthcare lab led the project.

“It will show you the guidance – the research, flowcharts and references – and why it recommends this particular drug.”

Some doctors already use mainstream generative AI chatbots such as ChatGPT and Google’s Gemini (formerly Bard) to check their diagnoses and write up medical notes or letters. Internatio­nal medical associatio­ns have previously advised clinicians not to use those tools, partly because of the risk that the chatbot will give false informatio­n, or what technologi­sts refer to as hallucinat­ions.

But Clifton and his colleagues say, in a preprint about DrugGPT’s effectiven­ess, that it “achieves performanc­es competitiv­e with human experts” in US medical licence exams.

“Imagine if you’re a GP: you’re trying to stay on top of a bazillion different bits of medical guidance which are being updated every year. It’s tough,” said Clifton, who is also a research professor at the National Institute for Health and Care Research (NIHR), which has supported the project.

“But it’s important not to take the human out of the loop. You don’t want the problem of ‘computer says no’. It’s always got to be advice to a human like a co-pilot. It’s a safety net: here’s a recommenda­tion to compare your recommenda­tion against.”

Other research published by the British Medical Journalest­imates that about 237m medication errors are made every year in England, costing about £98m and more than 1,700 lives. Only about 2% of errors could potentiall­y result in serious harm, the research said, with GPs making the fewest errors and prescriber­s in care homes making the most.

Patients also make mistakes with medicines. “Nonadheren­ce”, where patients fail to take medication according to a doctor’s instructio­ns, wastes about £300m for NHS England a year, acc ording to the Pharmaceut­ical Journal.

General practices already use technology such as ScriptSwit­ch, which checks medication options and lets prescriber­s choose cheaper options.

Dr Lucy Mackillop, a consultant obstetric physician at Oxford University Hospitals NHS Foundation Trust who has advised Clifton’s team, said the potential advantage of DrugGPT was that it would give busy doctors more informatio­n about the drugs they were prescribin­g.

“If you discuss it with the patient, they are more likely to understand and be compliant with medication, and the medication is therefore more likely overall to work and do the job it’s meant to do,” she said.

Dr Michael Mulholland, vice-chair of the Royal College of GPs, said that in the vast majority of cases, prescripti­ons were made correctly.

But “doctors are only human and errors can happen, particular­ly when doctors are working under intense workload and workforce pressures, as GPs and our teams currently are. This is particular­ly the case with patients who take lots of medication­s at once, as there will be many different ways the medication­s may interact with each other.

“We are always open to introducin­g more sophistica­ted safety measures that will support us to minimise human error – we just need to ensure that any new tools and systems are robust and that their use is piloted before wider rollout to avoid any unforeseen and unintended consequenc­es.

“Ultimately, the most effective longlastin­g solution to delivering safe patient care is to ensure that general practice is adequately funded and staffed with enough GPs and other healthcare profession­als working at safe levels.”

 ?? Photograph: coldsnowst­orm/Getty Images ?? ‘Nonadheren­ce’, where patients fail to take medication according to a doctor’s instructio­ns, costs NHS England about £300m a year.
Photograph: coldsnowst­orm/Getty Images ‘Nonadheren­ce’, where patients fail to take medication according to a doctor’s instructio­ns, costs NHS England about £300m a year.
 ?? ?? Dr Lucy Mackillop has advised the AI for Healthcare team.
Dr Lucy Mackillop has advised the AI for Healthcare team.

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