Academic Journal
From Innovation to Impact: The CREATE Framework as a Blueprint for Large Language Model Adoption in Opioid Treatment Programs.
| Τίτλος: | From Innovation to Impact: The CREATE Framework as a Blueprint for Large Language Model Adoption in Opioid Treatment Programs. |
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| Συγγραφείς: | Markatou M; Department of Biostatistics, SPHHP, University at Buffalo, State University of New York, Kimball Tower, Buffalo, NY, 14214, United States, 1 7168292894., Mukhopadhyay R; Department of Biostatistics, SPHHP, University at Buffalo, State University of New York, Kimball Tower, Buffalo, NY, 14214, United States, 1 7168292894., Good J; Department of Linguistics, CAS, University at Buffalo, State University of New York, Buffalo, NY, United States.; Department of AI and Society, CAS, University at Buffalo, State University of New York, Buffalo, NY, United States., Tan Y; Department of Biostatistics, SPHHP, University at Buffalo, State University of New York, Kimball Tower, Buffalo, NY, 14214, United States, 1 7168292894., Dharia A; Division of Gastroenterology, Hepatology and Nutrition, JSMBS, University at Buffalo, State University of New York, Buffalo, NY, United States., Brown LS; Department of Public Health, Weill Cornell Medicine, New York, NY, United States., Talal AH; Division of Gastroenterology, Hepatology and Nutrition, JSMBS, University at Buffalo, State University of New York, Buffalo, NY, United States. |
| Πηγή: | Journal of medical Internet research [J Med Internet Res] 2026 Oct 07; Vol. 28, pp. e97131. Date of Electronic Publication: 2026 Oct 07. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: JMIR Publications Country of Publication: Canada NLM ID: 100959882 Publication Model: Electronic Cited Medium: Internet ISSN: 1438-8871 (Electronic) Linking ISSN: 14388871 NLM ISO Abbreviation: J Med Internet Res Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2011- > : Toronto : JMIR Publications Original Publication: [Pittsburgh, PA? : s.n., 1999- |
| Ιατρικοί όροι (MeSH): | Opioid-Related Disorders*/therapy , Analgesics, Opioid*/therapeutic use , Large Language Models*, Humans ; Patient-Centered Care |
| Περίληψη: | Unlabelled: Large language model (LLM)-based systems have tremendous potential to improve patient-centered health care, especially for medically underserved populations. However, realizing this potential requires careful consideration of the socio-technical contexts in which LLMs are used. The design of such systems should consider the vulnerabilities of any medically underserved group that the system intends to support, and provide trustworthy evidence for its use. This viewpoint reports the lessons learned from our experience and research with the CREATE (Culture, Respect, Education, Advancement, Trust, and Expertise) framework for engaging multiple stakeholders to guide the integration of LLM-based systems for improved health care delivery. We propose an extension of the traditional hierarchy of evidence model and identify key junction points in clinical workflows at which LLM-based systems can potentially be used to improve patient care. The key messages can be summarized as follows: (1) users of AI technologies, such as LLM-based tools, must be aware of the strengths, limitations, and impact of these technologies on health care delivery workflows and on the quality of generated evidence on which health care recommendations are based; (2) users must also be aware of the impact of data quality on AI outputs and on the evidence generated from the use of these systems; (3) the evidence pyramid provides a framework that facilitates the evaluation of the output generated by AI systems; (4) the CREATE framework facilitates the engagement of a variety of stakeholders. We propose concrete approaches for its validation and implementation; (5) any system designed to support people with opioid use disorder (OUD) needs to consider the overall lack of trust and stigmatizing experiences of this population with the health care system, and we discuss various aspects of the evaluation process necessary to build trust; (6) to discuss research directions that need to be addressed before LLM-based systems can be integrated usefully in patient health care. (© Marianthi Markatou, Raktim Mukhopadhyay, Jeff Good, Yihao Tan, Arpan Dharia, Lawrence S Brown, Andrew H Talal. Originally published in the Journal of Medical Internet Research (https://www.jmir.org).) |
| Contributed Indexing: | Keywords: CREATE framework; Large language models; engagement; evaluation; evidence generation; medically underserved populations; opioid use disorder; risk |
| Substance Nomenclature: | 0 (Analgesics, Opioid) |
| Entry Date(s): | Date Created: 20261008 Date Completed: 20261008 Latest Revision: 20261008 |
| Update Code: | 20261008 |
| DOI: | 10.2196/97131 |
| PMID: | 42844923 |
| Βάση Δεδομένων: | MEDLINE |
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| Items | – Name: Title Label: Title Group: Ti Data: From Innovation to Impact: The CREATE Framework as a Blueprint for Large Language Model Adoption in Opioid Treatment Programs. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AU" term="%22Markatou+M%22">Markatou M</searchLink>; Department of Biostatistics, SPHHP, University at Buffalo, State University of New York, Kimball Tower, Buffalo, NY, 14214, United States, 1 7168292894.<br /><searchLink fieldCode="AU" term="%22Mukhopadhyay+R%22">Mukhopadhyay R</searchLink>; Department of Biostatistics, SPHHP, University at Buffalo, State University of New York, Kimball Tower, Buffalo, NY, 14214, United States, 1 7168292894.<br /><searchLink fieldCode="AU" term="%22Good+J%22">Good J</searchLink>; Department of Linguistics, CAS, University at Buffalo, State University of New York, Buffalo, NY, United States.; Department of AI and Society, CAS, University at Buffalo, State University of New York, Buffalo, NY, United States.<br /><searchLink fieldCode="AU" term="%22Tan+Y%22">Tan Y</searchLink>; Department of Biostatistics, SPHHP, University at Buffalo, State University of New York, Kimball Tower, Buffalo, NY, 14214, United States, 1 7168292894.<br /><searchLink fieldCode="AU" term="%22Dharia+A%22">Dharia A</searchLink>; Division of Gastroenterology, Hepatology and Nutrition, JSMBS, University at Buffalo, State University of New York, Buffalo, NY, United States.<br /><searchLink fieldCode="AU" term="%22Brown+LS%22">Brown LS</searchLink>; Department of Public Health, Weill Cornell Medicine, New York, NY, United States.<br /><searchLink fieldCode="AU" term="%22Talal+AH%22">Talal AH</searchLink>; Division of Gastroenterology, Hepatology and Nutrition, JSMBS, University at Buffalo, State University of New York, Buffalo, NY, United States. – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22100959882%22">Journal of medical Internet research</searchLink> [J Med Internet Res] 2026 Oct 07; Vol. 28, pp. e97131. <i>Date of Electronic Publication: </i>2026 Oct 07. – Name: TypePub Label: Publication Type Group: TypPub Data: Journal Article – Name: Language Label: Language Group: Lang Data: English – Name: TitleSource Label: Journal Info Group: Src Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22JMIR+Publications%22">JMIR Publications </searchLink><i>Country of Publication: </i>Canada <i>NLM ID: </i>100959882 <i>Publication Model: </i>Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1438-8871 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2214388871%22">14388871 </searchLink><i>NLM ISO Abbreviation: </i>J Med Internet Res <i>Subsets: </i>MEDLINE – Name: PublisherInfo Label: Imprint Name(s) Group: PubInfo Data: <i>Publication</i>: <2011- > : Toronto : JMIR Publications<br /><i>Original Publication</i>: [Pittsburgh, PA? : s.n., 1999- – Name: SubjectMESH Label: MeSH Terms Group: Su Data: <searchLink fieldCode="MM" term="%22Opioid-Related+Disorders%22">Opioid-Related Disorders*</searchLink>/<searchLink fieldCode="MM" term="%22Opioid-Related+Disorders+therapy%22">therapy</searchLink> <br /><searchLink fieldCode="MM" term="%22Analgesics%2C+Opioid%22">Analgesics, Opioid*</searchLink>/<searchLink fieldCode="MM" term="%22Analgesics%2C+Opioid+therapeutic+use%22">therapeutic use</searchLink> <br /><searchLink fieldCode="MM" term="%22Large+Language+Models%22">Large Language Models*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Patient-Centered+Care%22">Patient-Centered Care</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Unlabelled: Large language model (LLM)-based systems have tremendous potential to improve patient-centered health care, especially for medically underserved populations. However, realizing this potential requires careful consideration of the socio-technical contexts in which LLMs are used. The design of such systems should consider the vulnerabilities of any medically underserved group that the system intends to support, and provide trustworthy evidence for its use. This viewpoint reports the lessons learned from our experience and research with the CREATE (Culture, Respect, Education, Advancement, Trust, and Expertise) framework for engaging multiple stakeholders to guide the integration of LLM-based systems for improved health care delivery. We propose an extension of the traditional hierarchy of evidence model and identify key junction points in clinical workflows at which LLM-based systems can potentially be used to improve patient care. The key messages can be summarized as follows: (1) users of AI technologies, such as LLM-based tools, must be aware of the strengths, limitations, and impact of these technologies on health care delivery workflows and on the quality of generated evidence on which health care recommendations are based; (2) users must also be aware of the impact of data quality on AI outputs and on the evidence generated from the use of these systems; (3) the evidence pyramid provides a framework that facilitates the evaluation of the output generated by AI systems; (4) the CREATE framework facilitates the engagement of a variety of stakeholders. We propose concrete approaches for its validation and implementation; (5) any system designed to support people with opioid use disorder (OUD) needs to consider the overall lack of trust and stigmatizing experiences of this population with the health care system, and we discuss various aspects of the evaluation process necessary to build trust; (6) to discuss research directions that need to be addressed before LLM-based systems can be integrated usefully in patient health care.<br /> (© Marianthi Markatou, Raktim Mukhopadhyay, Jeff Good, Yihao Tan, Arpan Dharia, Lawrence S Brown, Andrew H Talal. Originally published in the Journal of Medical Internet Research (https://www.jmir.org).) – Name: SubjectMinor Label: Contributed Indexing Group: Data: <i>Keywords: </i>CREATE framework; Large language models; engagement; evaluation; evidence generation; medically underserved populations; opioid use disorder; risk – Name: NumberCAS Label: Substance Nomenclature Group: ID Data: 0 (Analgesics, Opioid) – Name: DateEntry Label: Entry Date(s) Group: Date Data: <i>Date Created: </i>20261008 <i>Date Completed: </i>20261008 <i>Latest Revision: </i>20261008 – Name: DateUpdate Label: Update Code Group: Date Data: 20261008 – Name: DOI Label: DOI Group: ID Data: 10.2196/97131 – Name: AN Label: PMID Group: ID Data: 42844923 |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42844923 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.2196/97131 Languages: – Code: eng Text: English PhysicalDescription: Pagination: StartPage: e97131 Subjects: – SubjectFull: Humans Type: general – SubjectFull: Patient-Centered Care Type: general – SubjectFull: Opioid-Related Disorders therapy Type: general – SubjectFull: Analgesics, Opioid therapeutic use Type: general – SubjectFull: Large Language Models Type: general Titles: – TitleFull: From Innovation to Impact: The CREATE Framework as a Blueprint for Large Language Model Adoption in Opioid Treatment Programs. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Markatou M – PersonEntity: Name: NameFull: Mukhopadhyay R – PersonEntity: Name: NameFull: Good J – PersonEntity: Name: NameFull: Tan Y – PersonEntity: Name: NameFull: Dharia A – PersonEntity: Name: NameFull: Brown LS – PersonEntity: Name: NameFull: Talal AH IsPartOfRelationships: – BibEntity: Dates: – D: 07 M: 10 Text: 2026 Oct 07 Type: published Y: 2026 Identifiers: – Type: issn-electronic Value: 1438-8871 Numbering: – Type: volume Value: 28 Titles: – TitleFull: Journal of medical Internet research Type: main |
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