Evidence map›Paper›PMID 38592470›Full record

ArticleEuropean journal of clinical pharmacology2024

Poor performance of ChatGPT in clinical rule-guided dose interventions in hospitalized patients with renal dysfunction.

Merel van Nuland, JaapJan D Snoep, Toine Egberts, Abdullah Erdogan, Ricky Wassink, Paul D van der Linden

Abstract read
PubMed Publisher
In one paragraph

Article in European journal of clinical pharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Merel van NulandDepartment of Clinical Pharmacy, Tergooi Medical Center, Laan van Tergooi 2, 1212 VG, Hilversum, The Netherlands. mvannuland@tergooi.nl.ORCID http://orcid.org/0000-0003-1763-7334
JaapJan D SnoepDepartment of Nephrology, Tergooi Medical Center, Hilversum, The Netherlands.
Toine EgbertsDepartment of Clinical Pharmacy, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Abdullah ErdoganDepartment of Clinical Pharmacy, Tergooi Medical Center, Laan van Tergooi 2, 1212 VG, Hilversum, The Netherlands.
Ricky WassinkDepartment of Clinical Pharmacy, Tergooi Medical Center, Laan van Tergooi 2, 1212 VG, Hilversum, The Netherlands.
Paul D van der LindenDepartment of Clinical Pharmacy, Tergooi Medical Center, Laan van Tergooi 2, 1212 VG, Hilversum, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeClinical decision support systems (CDSS) are used to identify drugs with potential need for dose modification in patients with renal impairment. ChatGPT holds the potential to be integrated in the electronic health record (EHR) system to give such dosing advices. In this study, we aim to evaluate the performance of ChatGPT in clinical rule-guided dose interventions in hospitalized patients with renal impairment.

methodsThis cross-sectional study was performed at Tergooi Medical Center, the Netherlands. CDSS alerts regarding renal dysfunction were collected from the electronic health record (EHR) during a 2-week period and were presented to ChatGPT and an expert panel. Alerts were presented with and without patient variables. To evaluate the performance, suggested medication interventions were compared.

resultsIn total, 172 CDDS alerts were generated for 80 patients. Indecisive responses by ChatGPT to alerts were excluded. For alerts presented without patient variables, ChatGPT provided "correct and identical" responses to 19.9%, "correct and different" responses to 26.7%, and "incorrect responses to 53.4% of the alerts. For alerts including patient variables, ChatGPT provided "correct and identical" responses to 16.7%, "correct and different" responses to 16.0%, and "incorrect responses to 67.3% of the alerts. Accuracy was better for newer drugs such as direct oral anticoagulants.

conclusionThe performance of ChatGPT in clinical rule-guided dose interventions in hospitalized patients with renal dysfunction was poor. Based on these results, we conclude that ChatGPT, in its current state, is not appropriate for automatic integration into our EHR to handle CDSS alerts related to renal dysfunction.

Indexed as

Decision Support Systems, ClinicalElectronic Health RecordsHospitalizationAdultAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMaleMedical Order Entry SystemsMiddle AgedNetherlandsRenal InsufficiencyCDSSChatGPTClinical rule-guided dose interventionsLanguage modelRenal dysfunction

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.