"Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Questions Posted to a Public Social Media Forum" is the title of a new Original Investigation report appeared on JAMA Intern Med (doi:10.1001/jamainternmed.2023.1838)
The article is free online, so we leave it to you to read the full text if you are interested, here however we would like to reflect a bit about the findings, and the context.
In the words of Mark Dredze (one of the authors) on Twitter they"compared ChatGPT responses to people's medical questions with those of doctors. Healthcare professionals preferred ChatGPT 79% of the time; as more empathetic and higher quality".
Now, before anything else, let's first focus on the limitations of the study, as reported by the authors themselves, and specifically let's devote our attention to the following paragraph:
Additional limitations of this study include, the summary measures of quality and empathy were not pilot tested or validated; this study’s evaluators despite being blinded to the source of a response and any initial results were also coauthors, which could have biased their assessments; the additional length of the chatbot responses could have been erroneously associated with greater empathy; and evaluators did not assess the chatbot responses for accuracy or fabricated information.
...and to this one:
we did not evaluate patient assessments whose judgements of empathy may differ from our health care professional evaluators and who may have adverse reactions to AI assistant–generated responses
It's arguable, after reading the above text, that we are reading a report about an interesting experience of exploration by fellow colleagues, but any extrapolation of strong claim should be avoided: the experience was lacking any and all foundational criteria of objectivity, and even ignored the accuracy of the responses!!
Why, then, is the study capturing the attention of the community? To use the words of another research group "Patients respond differentially to different information and respond most to information about physicians’ interpersonal and clinical skills" (source: Journal of Marketing, DOI: 10.1177/00222429221146511) an argument that resonates with a recent reflection appeared on the Italian periodic newspaper Percorsi di Secondo Welfare (maintained by the Dip.to di Scienze Sociali e Politiche dell'Università degli Studi di Milano). Reputation correlates with patients choices when searching for a new care provider, and the feedbacks expressed by patients about their care givers on reputation platforms capture more the empathy and ability to communicate, than the level of competence. This may sound wrong to some at first, but it connects to the transformation from to cure to to care in medical practice and healthcare management, and it has deep roots in the past, captured by the tradition of narrative medicine.
If the interest for the report appeared on JAMA Intern Med is justified (albeit a complex tangle of financial interests and response to patient needs) then, we need to stress that the same report is objectively not the last word about the issue... dare we say more, not even a word to pay much heed to, once the limitations are taken into account.
It is an invitation to do research on the matter though, and as such a very welcome and timely one as well. So do read it, and formulate your own questions and conjectures, share them with your peers (contact us, and we will be glad to find ways to work together), and study... the world of care is changing fast.
Post Scriptum:
- This one is not about medical AI, but it touches on several sensitivities of the current market of AI and it is well worth reading if you want to catch up to speed https://blog.eladgil.com/p/ai-platforms-markets-and-open-source
- This one is about evaluating innovation, and will walk you through both technical and socio-technical considerations that should be embraced in our R&I effort https://blog.shakirm.com/2023/04/elevating-our-evaluations-technical-and-sociotechnical-standards-of-assessment-in-machine-learning/
- This one about Organizational Governance of Emerging Technologies: AI Adoption in Healthcare, albeit US centric, could also interest many of the readers https://arxiv.org/abs/2304.13081
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