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Why do users override alerts? Utilizing large language model to summarize comments and optimize clinical decision

Siru Liu1,2, Allison B McCoy1, Aileen P Wright1,3

  • 1Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37212, United States.

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Summary

Generative artificial intelligence (AI) can effectively summarize clinical decision support (CDS) alert comments, offering potentially superior completeness and usefulness compared to human summaries. This technology can streamline the optimization of CDS alerts.

Keywords:
alert fatigueclinical decision supporthealth personnellarge language model

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Area of Science:

  • Medical Informatics
  • Artificial Intelligence in Healthcare
  • Clinical Decision Support Systems

Background:

  • End-user comments offer valuable feedback for improving clinical decision support (CDS) alerts.
  • The unstructured and voluminous nature of these comments often hinders their integration into the CDS review process.

Purpose of the Study:

  • To assess the capability of generative artificial intelligence (AI) in summarizing CDS alert comments.
  • To determine if AI-generated summaries can enhance the improvement of CDS alerts.

Main Methods:

  • User comments from CDS alerts at Vanderbilt University Medical Center were extracted over one year.
  • GPT-4 and physicians independently summarized a subset of alert comments.
  • CDS experts rated human-generated and AI-generated summaries on clarity, completeness, accuracy, and usefulness.

Main Results:

  • AI-generated summaries (GPT-4) were rated highly for clarity, accuracy, and usefulness, comparable to human summaries.
  • AI summaries demonstrated significantly greater completeness and usefulness than human summaries (P=.001).
  • Five of the top eight rated summaries were generated by GPT-4.

Conclusions:

  • Generative AI, specifically GPT-4, can effectively distill unstructured user comments into clear, accurate, and complete summaries.
  • AI-generated summaries are equivalent, and potentially superior, to human-generated summaries for CDS alert review.
  • AI summaries offer a novel method for rapidly optimizing CDS alerts by efficiently processing user feedback.