Use of artificial intelligence chatbots in clinical management of immune-related adverse events

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Burnette, H
Pabani, A
Von Itzstein, MS
Switzer, B
Fan, R
Ye, F
Puzanov, I
Naidoo, J
Ascierto, PA
Gerber, DE
Ernstoff, MS
Johnson, DB
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2024
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Abstract

Background Artificial intelligence (AI) chatbots have become a major source of general and medical information, though their accuracy and completeness are still being assessed. Their utility to answer questions surrounding immune-related adverse events (irAEs), common and potentially dangerous toxicities from cancer immunotherapy, are not well defined. Methods We developed 50 distinct questions with answers in available guidelines surrounding 10 irAE categories and queried two AI chatbots (ChatGPT and Bard), along with an additional 20 patient-specific scenarios. Experts in irAE management scored answers for accuracy and completion using a Likert scale ranging from 1 (least accurate/complete) to 4 (most accurate/complete). Answers across categories and across engines were compared. Results Overall, both engines scored highly for accuracy (mean scores for ChatGPT and Bard were 3.87 vs 3.5, p<0.01) and completeness (3.83 vs 3.46, p<0.01). Scores of 1-2 (completely or mostly inaccurate or incomplete) were particularly rare for ChatGPT (6/800 answer-ratings, 0.75%). Of the 50 questions, all eight physician raters gave ChatGPT a rating of 4 (fully accurate or complete) for 22 questions (for accuracy) and 16 questions (for completeness). In the 20 patient scenarios, the average accuracy score was 3.725 (median 4) and the average completeness was 3.61 (median 4). Conclusions AI chatbots provided largely accurate and complete information regarding irAEs, and wildly inaccurate information ("hallucinations") was uncommon. However, until accuracy and completeness increases further, appropriate guidelines remain the gold standard to follow

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Journal for ImmunoTherapy of Cancer

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12

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5

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© Author(s) (or their employer(s)) 2024. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See http://creativecommons.org/licenses/by-nc/4.0/.

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Burnette, H; Pabani, A; Von Itzstein, MS; Switzer, B; Fan, R; Ye, F; Puzanov, I; Naidoo, J; Ascierto, PA; Gerber, DE; Ernstoff, MS; Johnson, DB, Use of artificial intelligence chatbots in clinical management of immune-related adverse events, Journal for ImmunoTherapy of Cancer, 2024, 12 (5), pp. e008599

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