Opportunities and Challenges for ChatGPT and Large Language Models in Biomedicine and Health

ChatGPT has drawn considerable attention from both the general public and domain experts with its remarkable text generation capabilities. This has subsequently led to the emergence of diverse applications in the field of biomedicine and health. In this work, we examine the diverse applications of large language models (LLMs), such as ChatGPT, in biomedicine and health. Specifically we explore the areas of biomedical information retrieval, question answering, medical text summarization, information extraction, and medical education, and investigate whether LLMs possess the transformative power to revolutionize these tasks or whether the distinct complexities of biomedical domain presents unique challenges. Following an extensive literature survey, we find that significant advances have been made in the field of text generation tasks, surpassing the previous state-of-the-art methods. For other applications, the advances have been modest. Overall, LLMs have not yet revolutionized the biomedicine, but recent rapid progress indicates that such methods hold great potential to provide valuable means for accelerating discovery and improving health. We also find that the use of LLMs, like ChatGPT, in the fields of biomedicine and health entails various risks and challenges, including fabricated information in its generated responses, as well as legal and privacy concerns associated with sensitive patient data. We believe this first-of-its-kind survey can provide a comprehensive overview to biomedical researchers and healthcare practitioners on the opportunities and challenges associated with using ChatGPT and other LLMs for transforming biomedicine and health

Making sense of personal health information: Challenges for information visualization

This article presents a systematic review of the literature on information visualization for making sense of personal health information. Based on this review, five application themes were identified: treatment planning, examination of patients' medical records, representation of pedigrees and family history, communication and shared decision making, and life management and health monitoring. While there are recognized design challenges associated with each of these themes, such as how best to represent data visually and integrate qualitative and quantitative information, other challenges and opportunities have received little attention to date. In this article, we highlight, in particular, the opportunities for supporting people in better understanding their own illnesses and making sense of their health conditions in order to manage them more effectively

Adverse Drug Event Detection, Causality Inference, Patient Communication and Translational Research

Adverse drug events (ADEs) are injuries resulting from a medical intervention related to a drug. ADEs are responsible for nearly 20% of all the adverse events that occur in hospitalized patients. ADEs have been shown to increase the cost of health care and the length of stays in hospital. Therefore, detecting and preventing ADEs for pharmacovigilance is an important task that can improve the quality of health care and reduce the cost in a hospital setting. In this dissertation, we focus on the development of ADEtector, a system that identifies ADEs and medication information from electronic medical records and the FDA Adverse Event Reporting System reports. The ADEtector system employs novel natural language processing approaches for ADE detection and provides a user interface to display ADE information. The ADEtector employs machine learning techniques to automatically processes the narrative text and identify the adverse event (AE) and medication entities that appear in that narrative text. The system will analyze the entities recognized to infer the causal relation that exists between AEs and medications by automating the elements of Naranjo score using knowledge and rule based approaches. The Naranjo Adverse Drug Reaction Probability Scale is a validated tool for finding the causality of a drug induced adverse event or ADE. The scale calculates the likelihood of an adverse event related to drugs based on a list of weighted questions. The ADEtector also presents the user with evidence for ADEs by extracting figures that contain ADE related information from biomedical literature. A brief summary is generated for each of the figures that are extracted to help users better comprehend the figure. This will further enhance the user experience in understanding the ADE information better. The ADEtector also helps patients better understand the narrative text by recognizing complex medical jargon and abbreviations that appear in the text and providing definitions and explanations for them from external knowledge resources. This system could help clinicians and researchers in discovering novel ADEs and drug relations and also hypothesize new research questions within the ADE domain

The Mobile Generation: Global Transformations at the Cellular Level

Every year we see a new dimension of the ongoing Digital Revolution, which is enabling an abundance of information to move faster, cheaper, in more intelligible forms, in more directions, and across borders of every kind. The exciting new dimension on which the Aspen Institute focused its 2006 Roundtable on Information Technology was mobility, which is making the Digital Revolution ubiquitous. As of this writing, there are over two billion wireless subscribers worldwide and that number is growing rapidly. People are constantly innovating in the use of mobile technologies to allow them to be more interconnected. Almost a half century ago, Ralph Lee Smith conjured up "The Wired Nation," foretelling a world of interactive communication to and from the home that seems commonplace in developed countries today. Now we have a "Wireless World" of communications potentially connecting two billion people to each other with interactive personal communications devices. Widespead adoption of wireless handsets, the increasing use of wireless internet, and the new, on-the-go content that characterizes the new generation of users are changing behaviors in social, political and economic spheres. The devices are easy to use, pervasive and personal. The affordable cell phone has the potential to break down the barriers of poverty and accessibility previously posed by other communications devices. An entire generation that is dependant on ubiquitous mobile technologies is changing the way it works, plays and thinks. Businesses, governments, educational institutions, religious and other organizations in turn are adapting to reach out to this mobile generation via wireless technologies -- from SMS-enabled vending machines in Finland to tech-savvy priests in India willing to conduct prayers transmitted via cell phones. Cellular devices are providing developing economies with opportunities unlike any others previously available. By opening the lines of communication, previously disenfranchised groups can have access to information relating to markets, economic opportunities, jobs, and weather to name just a few. When poor village farmers from Bangladesh can auction their crops on a craigslist-type service over the mobile phone, or government officials gain instantaneous information on contagious diseases via text message, the miracles of mobile connectivity move us from luxury to necessity. And we are only in the early stages of what the mobile electronic communications will mean for mankind. We are now "The Mobile Generation." Aspen Institute Roundtable on Information Technology. To explore the implications of these phenomena, the Aspen Institute Communications and Society Program convened 27 leaders from business, academia, government and the non-profit sector to engage in three days of dialogue on related topics. Some are experts in information and communications technologies, others are leaders in the broader society affected by these innovations. Together, they examined the profound changes ahead as a result of the convergence of wireless technologies and the Internet. In the following report of the Roundtable meeting held August 1-4, 2006, J. D. Lasica, author of Darknet and co-founder of Ourmedia.org, deftly sets up, contextualizes, and captures the dialogue on the impact of the new mobility on economic models for businesses and governments, social services, economic development, and personal identity

Clinical foundations and information architecture for the implementation of a federated health record service

Clinical care increasingly requires healthcare professionals to access patient record information that may be distributed across multiple sites, held in a variety of paper and electronic formats, and represented as mixtures of narrative, structured, coded and multi-media entries. A longitudinal person-centred electronic health record (EHR) is a much-anticipated solution to this problem, but its realisation is proving to be a long and complex journey. This Thesis explores the history and evolution of clinical information systems, and establishes a set of clinical and ethico-legal requirements for a generic EHR server. A federation approach (FHR) to harmonising distributed heterogeneous electronic clinical databases is advocated as the basis for meeting these requirements. A set of information models and middleware services, needed to implement a Federated Health Record server, are then described, thereby supporting access by clinical applications to a distributed set of feeder systems holding patient record information. The overall information architecture thus defined provides a generic means of combining such feeder system data to create a virtual electronic health record. Active collaboration in a wide range of clinical contexts, across the whole of Europe, has been central to the evolution of the approach taken. A federated health record server based on this architecture has been implemented by the author and colleagues and deployed in a live clinical environment in the Department of Cardiovascular Medicine at the Whittington Hospital in North London. This implementation experience has fed back into the conceptual development of the approach and has provided "proof-of-concept" verification of its completeness and practical utility. This research has benefited from collaboration with a wide range of healthcare sites, informatics organisations and industry across Europe though several EU Health Telematics projects: GEHR, Synapses, EHCR-SupA, SynEx, Medicate and 6WINIT. The information models published here have been placed in the public domain and have substantially contributed to two generations of CEN health informatics standards, including CEN TC/251 ENV 13606

Coronary Care Unit Nurses’ Experiences of Care Management Self-Efficacy: A Qualitative Content Analysis

Recognizing various aspects of the self-efficacy concept in specialized medical units such as intensive care units (ICUs) and coronary care units (CCUs) has the potential to help nurses improve their quality of care. Therefore, we conducted a qualitative content analysis study in 2018 in hospitals of the Guilan Province, northern Iran, to help explain nurses’ perceptions of self-efficacy in care management within CCU wards. Thirty-four semi-structured interviews were conducted with nurses from CCUs. Using Graneheim and Lundman’s (2004) analytical techniques, we extracted three main themes and nine sub-themes from the data: decline in self-efficacy (e.g., time constraint, high work pressure, emotional stresses, and loss of motivation); care development (e.g., experience-based care, knowledge-based care, and personal capability); and organizational challenges (e.g., weak management and unavailable physician). Our findings suggest that decreases in nurse self-efficacy (and resulting weak care management) could be prevented by establishing clear plans and enrolling nurses into appropriate training courses. The constant development of knowledge and experience alongside supportive supervisors and physicians are also effective in improving nurses’ self-efficacy

(Almost) No Bad Drugs: Near-Total Products Liability Immunity for Pharmaceuticals Explained

This Article explores four beliefs about supposed pharma-benevolence that appear to be shared by more than the industry, reaching the level almost of conventional wisdom. These figurative pillars help support one-sided results in court. However, each of the pillars on examination turns out at least a bit shaky. This Article puts them forward for review to start a necessary discussion. The locus of this Article is products liability, where a court concludes that a manufactured object is defective or could be called defective by a factfinder following a trial. Drug manufacturers enjoy near-immunity from this consequence. Modern products liability identifies three categories of product defect, and courts insulate drug manufacturers from responsibility for all three. In clarifying an ill-understood state of the law, this Article holds back on overt condemnation of what it observes. Skepticism about the fit between products liability and prescription drugs certainly could be defended. Judges and juries competent enough to assess a more mundane product might be unsuited to the task of determining defectiveness of a prescription drug. Instead of lamenting the absence of products liability redress for injured drug consumers, this Article pursues transparency about what it reports. The author argues that the current state of the law appears healthier than it really is because unexamined premises about the no-liability status quo sound plausible and soothing: Figurative pillars hold up a barely seen exception to accountability under the law. Prescription drugs look worthier of indulgence than other products because they purport to increase welfare beyond the satisfaction of individual preferences. In contrast to other products that purport only to give buyers what they want, pharmaceuticals purport to give every one of us what we need. Judgments that transfer money to individuals at the expense of a savior-sector seem perverse. From there, a deferential-to-manufacturers consensus has emerged and holds steady