Ian Metzler, MD, on the role for telemedicine, digital health tools in stone disease

There are important roles for telehealth and digital health tools in the management and prevention of stone disease, according to Ian Metzler, MD, MTM. In a recent interview with Urology Times®, Metzler highlights the value of these tools for clinical practice.

For example, telehealth is an important offering for patients who face long travel distances to and from urologic care. Further, digital health tools such as ChatGPT or Gemini may aid in patient education.

“We have to understand as providers that we're not going to be the one and only conduit for this information anymore, which is a good thing, to be honest. We have to be facile with the resources that are out there and connect patients and help them match to something they will actually use and incorporate into their lives so that they can be successful with the type of prevention that makes a difference.”

Metzler is an assistant professor of urology at Oregon Health & Science University School of Medicine in Portland, Oregon.

During the discussion, Metzler referenced a 2024 study looking at the ability of ChatGPT to analyze 24-hour urine results and develop custom dietary recommendations.¹

In the study, the large language model achieved a 5.2 out of 6 for accuracy, a 2.4 out of 3 for completeness, and a 2.6 out of 3 for appropriateness. The tool was able to detect all “normal” values but was less apt to detect abnormalities and formulate appropriate recommendations. Specifically, the model did poorly in addressing calcium and citrate abnormalities.

Based on these findings, the authors concluded, “ChatGPT-4 exhibits potential in the dietary management of nephrolithiasis but requires further refinement for dependable performance.”

REFERENCE

1. Kiriakedis S, Duty B, Chase T, Wusirika R, Metzler I. Using ChatGPT-4 to analyze 24-hour urine results and generate custom dietary recommendations for nephrolithiasis. J Endourol. 2024;38(8):719-724. doi:10.1089/end.2024.0055