{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:10:07Z","timestamp":1792512607741,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001352","name":"National University of Singapore","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001352","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Large language models (LLMs) can support clinical decision\u2010making by parsing databases and extracting relevant information. However, evaluating drug\u2010induced liver injury (DILI) often requires processing lengthy clinical histories alongside reference materials like LiverTox, which can exceed context lengths of conventional LLMs. Challenges such as information truncation hinder standard approaches like prompt engineering and retrieval\u2010augmented generation (RAG). To address these limitations, this study introduces DILIConsult, an agentic LLM pipeline based on GPT\u20104, designed to intelligently parse clinical and drug information.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To develop DILIConsult, we compared GPT\u20104\u2010Turbo versus GPT\u20104o for extracting DILI characteristics from LiverTox descriptions. We tested two approaches to analyzing cases of suspected DILI: full\u2010length case analysis versus sequential drug\u2010specific evaluations. We evaluated DILIConsult on cases of suspected DILI identified from the open source Medical Information Mart for Intensive Care\u2010IV (MIMIC\u2010IV) ICU dataset based on American Association for the Study of Liver Diseases (AASLD) and European Association for the Study of the Liver (EASL) criteria. Outputs from DILIConsult were compared against a panel of clinicians comprising an ICU pharmacist, an ICU junior attending physician, and an ICU resident. Responses were evaluated by two senior ICU attending physicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Using GPT\u20104o and a sequential approach demonstrated improved performance in the extraction of DILI characteristics and analysis of suspected DILI. DILIConsult achieved the best mean rank of 1.66\u2009\u00b1\u20090.75 in knowledge recall and ranked second for reasoning (2.00\u2009\u00b1\u20090.64) and reflection of current medical consensus (2.05\u2009\u00b1\u20090.62). DILIConsult ranked last with mean ranks of 2.07\u2009\u00b1\u20090.52 and 2.09\u2009\u00b1\u20090.72 for less omission of important information and content inaccuracy, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DILIConsult demonstrates the potential of LLMs to assist clinicians in evaluating DILI. The findings emphasize the importance of task division in LLM\u2010driven workflows to minimize information loss.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.70131","type":"journal-article","created":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T04:10:47Z","timestamp":1773461447000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["<scp>DILIConsult<\/scp>\n                    : A Multi\u2010Agent Large Language Model Framework for Evaluating Drug\u2010Induced Liver Injury in\n                    <scp>ICU<\/scp>\n                    Settings"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5302-6393","authenticated-orcid":false,"given":"Alfred Zheng Ting","family":"Ho","sequence":"first","affiliation":[{"name":"Department of Pharmacy and Pharmaceutical Science, Faculty of Science National University of Singapore  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8920-9192","authenticated-orcid":false,"given":"Jeren Zheng Feng","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Pharmaceutical Science, Faculty of Science National University of Singapore  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2377-4389","authenticated-orcid":false,"given":"Aiwen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Pharmaceutical Science, Faculty of Science National University of Singapore  Singapore City Singapore"},{"name":"Division of Pharmacy Singapore General Hospital  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9715-6970","authenticated-orcid":false,"given":"Daniel Yan Zheng","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Singapore General Hospital  Singapore City Singapore"},{"name":"Medicine Academic Clinical Programme Duke\u2010NUS Medical School  Singapore City Singapore"},{"name":"Data Science and Artificial Intelligence Laboratory, Health Services Research Unit Singapore General Hospital  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6916-5960","authenticated-orcid":false,"given":"Jasmine Chiat Ling","family":"Ong","sequence":"additional","affiliation":[{"name":"Division of Pharmacy Singapore General Hospital  Singapore City Singapore"},{"name":"Duke\u2010NUS AI + Medical Sciences Initiative, Duke\u2010NUS Medical School  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1751\u20102980.13205"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23116049"},{"key":"e_1_2_11_4_1","first-page":"73","article-title":"Drug\u2010Induced Liver Injury","volume":"6","author":"David S.","year":"2010","journal-title":"US Gastroenterology and Hepatology Review"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29283"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2012.18.3.249"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.02.014"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32689"},{"key":"e_1_2_11_9_1","unstructured":"LiverTox: Clinical and Research Information on Drug\u2010Induced Liver Injury \u201cNational Institute of 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