“Digital Clinicians” Performing Obesity Medication Self-Injection Education: Feasibility Randomized Controlled Trial
Bibliographic record
Abstract
Background: Artificial intelligence (AI) chatbots have shown competency in a range of areas, including clinical note taking, diagnosis, research, and emotional support. An obesity epidemic, alongside a growth in novel injectable pharmacological solutions, has put a strain on limited resources. Objective: This study aimed to investigate the use of a chatbot integrated with a digital avatar to create a "digital clinician." This was used to provide mandatory patient education for those beginning semaglutide once-weekly self-administered injections for the treatment of overweight and obesity at a national center. Methods: A "digital clinician" with facial and vocal recognition technology was generated with a bespoke 10- to 15-minute clinician-validated tutorial. A feasibility randomized controlled noninferiority trial compared knowledge test scores, self-efficacy, consultation satisfaction, and trust levels between those using the AI-powered clinician avatar onsite and those receiving conventional semaglutide education from nursing staff. Attitudes were recorded immediately after the intervention and again at 2 weeks after the education session. Results: A total of 43 participants were recruited, 27 to the intervention group and 16 to the control group. Patients in the "digital clinician" group were significantly more knowledgeable postconsultation (median 10, IQR 10-11 vs median 8, IQR 7-9.3; P<.001). Patients in the control group were more satisfied with their consultation (median 7, IQR 6-7 vs median 7, IQR 7-7; P<.001) and had more trust in their education provider (median 7, IQR 4.8-7 vs median 7, IQR 7-7; P<.001). There was no significant difference in reported levels of self-efficacy (P=.57). 81% (22/27) participants in the intervention group said they would use the resource in their own time. Conclusions: Bespoke AI chatbots integrated with digital avatars to create a "digital clinician" may perform health care education in a clinical environment. They can ensure higher levels of knowledge transfer yet are not as trusted as their human counterparts. "Digital clinicians" may have the potential to aid the redistribution of resources, alleviating pressure on bariatric services and health care systems, the extent to which remains to be determined in future studies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".