A Large Language Model-based Chatbot for Alcohol Reduction in Patients With Metabolic Alcohol-Related Liver Disease

A Large Language Model-based Chatbot for Alcohol Reduction Counseling in MetALD Patients: A Pilot Randomized Controlled Trial

The goal of this pilot randomized controlled trial is to evaluate the trial feasibility and acceptability of LLM-based chatbot for reducing alcohol use among patients with metabolic alcohol-related liver disease. Specific objectives include:

1. To assess how many MetALD patients accept the invitation to participate in the trial
2. To assess the retention rate of the participants through 3 and 6 months after treatment initiation
3. To assess the acceptability of the LLM-based chatbot in terms of participants' compliance and usability rating
4. To estimate the intervention effect on alcohol reduction
5. To explore the participants' perception and experiences in the chatbot

Inclusion Criteria:

1. Hong Kong residents aged 18 years or above 2. Diagnosed of MASLD:

1. Evidence of hepatic steatosis (fat accumulation in the liver) confirmed by imaging techniques such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), or liver biopsy

2. Presence of metabolic dysfunction, indicated by at least one of the following:

   • Overweight or obesity (body mass index [BMI] ≥25 kg/m²),

     • Type 2 diabetes mellitus, ③Dyslipidemia (elevated triglycerides [≥150 mg/dL] or low high-density lipoprotein [HDL] cholesterol [<40 mg/dL for men, <50 mg/dL for women]), ④Hypertension (blood pressure ≥130/85 mmHg or use of antihypertensive medication).

       • Metabolic syndrome as defined by established criteria (e.g., International Diabetes Federation [IDF], Adult Treatment Panel III [ATP III]) 3. Alcohol consumption: males who drink 210-420 g/week (≈263-525 ml), female who drink 140-350 g/week (≈175-438 ml) 4. Intention to reduce/quit alcohol 5. Able to read and communicate in Chinese 6. Own a smartphone with internet access

Exclusion Criteria:

1. Diagnosed with mental disease or cognitive impairments, or
2. Participating in other ongoing clinic trials