HELIOT: LLM-Based CDSS for Adverse Drug Reaction Management

TL;DR

HELIOT tackles medication safety by using a Retrieval-Augmented Generation workflow to interpret unstructured clinical narratives and produce context-aware adverse drug reaction alerts. It integrates a modular, scalable pharma knowledge base with an LLM-driven decision-support loop, supporting streaming, service-oriented deployment. In synthetic evaluations, HELIOT achieves high classification accuracy and reduces interruptive alerts, indicating improved specificity over traditional CDSSs. The work establishes a foundation for real-world validation and deployment across care settings to enhance patient safety and reduce costs associated with adverse drug events.

Abstract

Medication errors significantly threaten patient safety, leading to adverse drug events and substantial economic burdens on healthcare systems. Clinical Decision Support Systems (CDSSs) aimed at mitigating these errors often face limitations when processing unstructured clinical data, including reliance on static databases and rule-based algorithms, frequently generating excessive alerts that lead to alert fatigue among healthcare providers. This paper introduces HELIOT, an innovative CDSS for adverse drug reaction management that processes free-text clinical information using Large Language Models (LLMs) integrated with a comprehensive pharmaceutical data repository. HELIOT leverages advanced natural language processing capabilities to interpret medical narratives, extract relevant drug reaction information from unstructured clinical notes, and learn from past patient-specific medication tolerances to reduce false alerts, enabling more nuanced and contextual adverse drug event warnings across primary care, specialist consultations, and hospital settings. An initial evaluation using a synthetic dataset of clinical narratives and expert-verified ground truth shows promising results. HELIOT achieves high accuracy in a controlled setting. In addition, by intelligently analyzing previous medication tolerance documented in clinical notes and distinguishing between cases requiring different alert types, HELIOT can potentially reduce interruptive alerts by over 50% compared to traditional CDSSs. While these preliminary findings are encouraging, real-world validation will be essential to confirm these benefits in clinical practice.

Figures (7)

• Figure 1: Decision Support Prompt: System Prompt.
• Figure 2: Decision Support Prompt: User Prompt.
• Figure 3: Ingredient Translation Prompt.
• Figure 4: HELIOT CDSS Architecture.
• Figure 5: Overview of the Pharmaceutical Data Pipeline Process.