UCSD

A new study provides an early glimpse into the role that AI assistants could play in medicine. The research compared written responses from physicians with those from ChatGPT to real-world health questions. A panel of licensed healthcare professionals preferred ChatGPT's responses 79% of the time. There has been widespread speculation about how advances in artificial intelligence (AI) assistants like ChatGPT could be used in medicine. A new study published in JAMA Internal Medicine led by Dr. John W. Ayers from the Qualcomm Institute within the University of California San Diego provides an early glimpse into the role that AI assistants could play in medicine. The study compared written responses from physicians and those from ChatGPT to real-world health questions. A panel of licensed healthcare professionals preferred ChatGPT's responses 79% of the time and rated ChatGPT's responses as higher quality and more empathetic. "The opportunities for improving healthcare with AI are massive," said Ayers, who is also vice chief of innovation in the UC San Diego School of Medicine Division of Infectious Disease and Global Public Health. "AI-augmented care is the future of medicine." Is ChatGPT Ready for Healthcare? In the new study, the research team set out to answer the question: Can ChatGPT respond accurately to questions patients send to their doctors? If yes, AI models could be integrated into health systems to improve physician responses to questions sent by patients and ease the ever-increasing burden on physicians. "ChatGPT might be able to pass a medical licensing exam," said study co-author Dr. Davey Smith, a physician-scientist, co-director of the UC San Diego Altman Clinical and Translational Research Institute and professor at the UC San Diego School of Medicine, "but directly answering patient questions accurately and empathetically is a different ballgame." "The COVID-19 pandemic accelerated virtual healthcare adoption," added study co-author Dr. Eric Leas, a Qualcomm Institute affiliate and assistant professor in the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science. "While this made accessing care easier for patients, physicians are burdened by a barrage of electronic patient messages seeking medical advice that have contributed to record-breaking levels of physician burnout." Designing a Study to Test ChatGPT in a Healthcare Setting To obtain a large and diverse sample of healthcare questions and physician answers that did not contain identifiable personal information, the team turned to social media where millions of patients publicly post medical questions to which doctors respond: Reddit's AskDocs. r/AskDocs is a subreddit with approximately 452,000 members who post medical questions and verified healthcare professionals submit answers. While anyone can respond to a question, moderators verify healthcare professionals' credentials and responses display the respondent's level of credentials. The result is a large and diverse set of patient medical questions and accompanying answers from licensed medical professionals. While some may wonder if question-answer exchanges on social media are a fair test, team members noted that the exchanges were reflective of their clinical experience. The team randomly sampled 195 exchanges from AskDocs where a verified physician responded to a public question. The team provided the original question to ChatGPT and asked it to author a response. A panel of three licensed healthcare professionals assessed each question and the corresponding responses and were blinded to whether the response originated from a physician or ChatGPT. They compared responses based on information quality and empathy, noting which one they preferred. The panel of healthcare professional evaluators preferred ChatGPT responses to physician responses 79% of the time. "ChatGPT messages responded with nuanced and accurate information that often addressed more aspects of the patient's questions than physician responses," said Jessica Kelley, a nurse practitioner with San Diego firm Human Longevity and study co-author. Additionally, ChatGPT responses were rated significantly higher in quality than physician responses: good or very good quality responses were 3.6 times higher for ChatGPT than physicians (physicians 22.1% versus ChatGPT 78.5%). The responses were also more empathic: empathetic or very empathetic responses were 9.8 times higher for ChatGPT than for physicians (physicians 4.6% versus ChatGPT 45.1%). "I never imagined saying this," added Dr. Aaron Goodman, an associate clinical professor at UC San Diego School of Medicine and study coauthor, "but ChatGPT is a prescription I'd like to give to my inbox. The tool will transform the way I support my patients." Harnessing AI Assistants for Patient Messages "While our study pitted ChatGPT against physicians, the ultimate solution isn't throwing your doctor out altogether," said Dr. Adam Poliak, an assistant professor of Computer Science at Bryn Mawr College and study co-author. "Instead, a physician harnessing ChatGPT is the answer for better and empathetic care." "Our study is among the first to show how AI assistants can potentially solve real world healthcare delivery problems," said Dr. Christopher Longhurst, Chief Medical Officer and Chief Digital Officer at UC San Diego Health. "These results suggest that tools like ChatGPT can efficiently draft high quality, personalized medical advice for review by clinicians, and we are beginning that process at UCSD Health." Dr. Mike Hogarth, a physician-bioinformatician, co-director of the Altman Clinical and Translational Research Institute at UC San Diego, professor in the UC San Diego School of Medicine and study co-author, added, "It is important that integrating AI assistants into healthcare messaging be done in the context of a randomized controlled trial to judge how the use of AI assistants impact outcomes for both physicians and patients." In addition to improving workflow, investments into AI assistant messaging could impact patient health and physician performance. Dr. Mark Dredze, the John C Malone Associate Professor of Computer Science at Johns Hopkins and study co-author, noted: "We could use these technologies to train doctors in patient-centered communication, eliminate health disparities suffered by minority populations who often seek healthcare via messaging, build new medical safety systems, and assist doctors by delivering higher quality and more efficient care."

Researchers at the University of California San Diego (UCSD) developed a new biomaterial that promotes cell and tissue repair. The injectable biomaterial reduces inflammation and promotes repair, the UCSD researchers say. Testing proved it effective in treating tissue damage caused by heart attacks in both rodent and large animal models. Researchers also provided proof of concept in a rodent model that the biomaterial could benefit patients with traumatic brian injury and pulmonary arterial hypertension. Karen Christman, professor of bioengineering at UCSD, and lead researcher on the team that developed the material, said they could begin a study on the biomaterial’s safety and efficacy in human subjects within 1-2 years. The team presented its findings in the Dec. 29 issue of Nature Biomedical Engineering. “This biomaterial allows for treating damaged tissue from the inside out,” said Christman. “It’s a new approach to regenerative engineering.” UCSD researchers said no established treatment exists for repairing the damage to cardiac tissue caused by heart attacks. The development of scar tissue can diminish muscle function and lead to congestive heart failure. “Coronary artery disease, acute myocardial infarction, and congestive heart failure continue to be the most burdensome public health problems affecting our society today,” said Dr. Ryan R. Reeves, a physician in the division of cardiovascular medicine at UCSD Health. “As an interventional cardiologist, who treats patients with coronary artery disease and congestive heart failure on a daily basis, I would love to have another therapy to improve patient outcomes and reduce debilitating symptoms.” How the UCSD team got here Christman previously led a team that developed a hydrogel made from the natural scaffolding of cardiac muscle tissue — extracellular matrix. This can be injected into damaged heart muscle tissue via catheter, with the gel forming a scaffold in damaged areas of the heart. That encourages new cell growth and repair. However, because it must be injected directly into heart muscle, it can only be used a week or more after a heart attack. According to UCSD, any sooner and it would risk damage because of the needle-based injection procedure. To develop a treatment ready for administration immediately following a heart attack, the UCSD team developed a biomaterial for infusion into a blood vessel. It can be done in a vessel in the heart at the same time as other treatments like angioplasty or a stent. Intravenous injection also represents an option with the biomaterial. According to the UCSD team, an advantage of the new material comes through even distribution through damaged tissue. This happens because of the infusion/intravenous injection. Hydrogel injected via catheter remains in specific locations without spreading out. “We sought to design a biomaterial therapy that could be delivered to difficult-to-access organs and tissues, and we came up with the method to take advantage of the bloodstream – the vessels that already supply blood to these organs and tissues,” said Martin Spang, the paper’s first author, who earned his Ph.D. in Christman’s group in the Shu Chien-Gene Lay Department of Bioengineering at the UC San Diego Jacobs School of Engineering. About the biomaterial According to the researchers, the particle size in the hydrogel posed a problem. It was too big to target leaky blood vessels. So, Spang put the liquid precursor of the hydrogel through a centrifuge to allow for sifting out bigger particles and keeping only nano-sized particles. The researchers then put the resulting material through dialysis and sterile filtering before freeze-drying. They added sterile water to the final powder, resulting in a biomaterial ready for intravenous injection or infusion into a coronary artery. In rodent testing, the UCSD team expected the material to pass through blood vessels and into the tissue. However, the biomaterial bound to endothelial cells in blood vessels, closing the gaps developed after heart attacks. This accelerated the healing of the blood vessels, reducing inflammation. Similar results came through in a porcine model. The team successfully tested its hypothesis that the same biomaterial could target other inflammation types in rodents. These include traumatic brain injury and pulmonary arterial hypertension. The team plans to undertake further preclinical studies for these conditions. “While the majority of work in this study involved the heart, the possibilities of treating other difficult-to-access organs and tissues can open up the field of biomaterials/tissue engineering into treating new diseases,” Spang said. Christman and Ventrix Bio — a startup she founded — plan to ask for FDA authorization to conduct a study in humans for the biomaterial. They expect such trials for treating heart conditions to begin in one or two years.