Evidence map›Paper›PMID 40999038›Full record

ArticleNPJ digital medicine2025

Quality safety and disparity of an AI chatbot in managing chronic diseases: simulated patient experiments.

Yafei Si, Yurun Meng, Xi Chen, Ruopeng An, Limin Mao, Bingqin Li, Hazel Bateman, Han Zhang, Hongbin Fan, Jiaqi Zu and 5 more

Abstract read
In one paragraph

Article in NPJ digital medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Review
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

15 authors.

Yafei SiMelbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
Yurun MengSchool of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Xi ChenDepartment of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA.
Ruopeng AnSilver School of Social Work, New York University, New York, NY, USA.
Limin MaoCenter for Social Research in Health, UNSW Sydney, Kensington, NSW, Australia.
Bingqin LiSocial Policy Research Center, UNSW Sydney, Kensington, NSW, Australia.
Hazel BatemanUNSW Business School, UNSW Sydney, Kensington, NSW, Australia.
Han ZhangSchool of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Hongbin FanSchool of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Jiaqi ZuSchool of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Shaoqing GongLuohe Medical College, Luohe, Henan, China. gongshaoqingmd@163.com.
Zhongliang ZhouSchool of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Yudong MiaoCollege of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
Xiaojing FanSchool of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China. emirada@163.com.
Gang ChenMelbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.

Funding

A Life Course Approach to Understanding Racial and Ethnic Disparities in Alzheimer's Disease and Related Dementias and Health CareR01AG077529 · NIA · YALE UNIVERSITY · PI Xi Chen · 2022 to 2026
$3.6M
NIA NIH HHS R01 AG077529
6 · The paper itself

Abstract

The rapid development of AI solutions reveals opportunities to address the underdiagnosis and poor management of chronic conditions in developing settings. Using the method of simulated patients and experimental designs, we evaluate the quality, safety, and disparity of medical consultation with ERNIE Bot in China among 384 patient-AI trials. ERNIE Bot reached a diagnostic accuracy of 77.3%, correct drug prescriptions of 94.3%, but prescribed high rates of unnecessary medical tests (91.9%) and unnecessary medications (57.8%). Disparities were observed based on patient age and household economic status, with older and wealthier patients receiving more intensive care. Under standardized conditions, ERNIE Bot, ChatGPT, and DeepSeek demonstrated higher diagnostic accuracy but a greater tendency toward overprescription than human physicians. The results suggest the great potential of ERNIE Bot in empowering quality, accessibility, and affordability of healthcare provision in developing contexts, but also highlight critical risks related to safety and amplification of sociodemographic disparities.

Identifiers

PMID40999038
PMCPMC12462510

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.