Empowering personalized pharmacogenomics with generative AI solutions

Author:

Murugan Mullai1ORCID,Yuan Bo12,Venner Eric12,Ballantyne Christie M3,Robinson Katherine M4,Coons James C45,Wang Liwen1,Empey Philip E46,Gibbs Richard A12

Affiliation:

1. Human Genome Sequencing Center, Baylor College of Medicine , Houston, TX, United States

2. Department of Molecular and Human Genetics, Baylor College of Medicine , Houston, TX, United States

3. Sections of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine , Houston, TX, United States

4. School of Pharmacy, University of Pittsburgh , Pittsburgh, PA, United States

5. Department of Pharmacy, UPMC Presbyterian-Shadyside Hospital , Pittsburgh, PA, United States

6. Institute for Precision Medicine, UPMC/University of Pittsburgh , Pittsburgh, PA, United States

Abstract

Abstract Objective This study evaluates an AI assistant developed using OpenAI’s GPT-4 for interpreting pharmacogenomic (PGx) testing results, aiming to improve decision-making and knowledge sharing in clinical genetics and to enhance patient care with equitable access. Materials and Methods The AI assistant employs retrieval-augmented generation (RAG), which combines retrieval and generative techniques, by harnessing a knowledge base (KB) that comprises data from the Clinical Pharmacogenetics Implementation Consortium (CPIC). It uses context-aware GPT-4 to generate tailored responses to user queries from this KB, further refined through prompt engineering and guardrails. Results Evaluated against a specialized PGx question catalog, the AI assistant showed high efficacy in addressing user queries. Compared with OpenAI’s ChatGPT 3.5, it demonstrated better performance, especially in provider-specific queries requiring specialized data and citations. Key areas for improvement include enhancing accuracy, relevancy, and representative language in responses. Discussion The integration of context-aware GPT-4 with RAG significantly enhanced the AI assistant’s utility. RAG’s ability to incorporate domain-specific CPIC data, including recent literature, proved beneficial. Challenges persist, such as the need for specialized genetic/PGx models to improve accuracy and relevancy and addressing ethical, regulatory, and safety concerns. Conclusion This study underscores generative AI’s potential for transforming healthcare provider support and patient accessibility to complex pharmacogenomic information. While careful implementation of large language models like GPT-4 is necessary, it is clear that they can substantially improve understanding of pharmacogenomic data. With further development, these tools could augment healthcare expertise, provider productivity, and the delivery of equitable, patient-centered healthcare services.

Funder

National Institutes of Health

Publisher

Oxford University Press (OUP)

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