Artificial Intelligence (AI) is increasingly influencing critical decisions in a rapidly evolving healthcare landscape, and the recent introduction of the Narx Score is generating significant controversy. Designed to combat the opioid epidemic which has led to a significant number of overdose deaths, the Narx Score is a tool used by healthcare providers to evaluate the risk of prescription drug misuse in patients.
A Pharmacist Prescribing Medicine to the Patient
Image Source: FatCamera
The Narx Score is part of a suite of tools developed by Bamboo Health, formerly known as Appriss Health. Its primary purpose is to help medical professionals screen the risk associated with opioid use, similar to how a credit score affects loan terms. It relies on algorithms that analyze data from prescription drug monitoring programs (PDMPs). In particular, it examines patients’ prescription activity involving narcotics, sedatives, and stimulants. Additionally, the score draws on the patient’s medication information, such as the number of doctors writing prescriptions, the number of pharmacies used, and drug dosage.
On the surface, the Narx Score seems valuable, as it helps healthcare providers to identify patients who may be at risk of misusing prescription drugs and protect patients from overdose. However, the lack of transparency regarding the algorithms that generate these scores is a significant concern. Critics argue that non-transparency can introduce biases and inaccuracies, which may lead to unfair consequences for patients. In addition, they argue that these systems can be punitive and may not accurately assess the complexities of patient care.
During a hospital visit in Fort Wayne, Indiana, Elizabeth Amirault, a patient who suffers from severe pain, was informed by a nurse practitioner that her Narx Score was too high. As a consequence, she was denied pain medication while awaiting a hip replacement. This highlights how these scores can result in patients being deprived of necessary pain relief, leaving them in anguish and feeling stigmatized.
The Centers for Disease Control and Prevention (CDC) estimated that millions of American adults suffer from chronic pain, with millions more enduring pain so severe that it limits their daily activities. For many of these individuals, prescription opioids offer a lifeline to manage their pain effectively. Denying access to these medications can lead to worsening health conditions, a decline in quality of life, and even an increased risk of mental health issues, such as depression and anxiety.
As AI continues to play an increasingly significant role in healthcare, it is essential to address the concerns raised by the Narx Score and similar tools. As Bamboo Health lacks transparency and has not addressed concerns about algorithm accuracy, it is essential to establish transparent practices, conduct independent testing, and implement oversight to ensure these systems function correctly. Therefore, striking a balance between preventing drug misuse and ensuring patient access to necessary medications remains a complex challenge that healthcare providers, policymakers, and technologists must navigate.
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