Algorithmic opacity in opioid risk scoring and the need for transparent AI regulation

NarxCare®, a proprietary opioid risk scoring system embedded in Prescription Drug Monitoring Programs (PDMPs), has generated significant patient complaints. We adhered to the technical specifications and applied them to PDMP and IQVIA PharMetrics® Plus Closed Health Plan claims database. Despite adding socioeconomic covariates, precision (0.01-0.32) was far below the reported benchmark of 0.75, and F1 scores (0.02-0.39) were also substantially lower than the benchmark value of 0.65, across all our reconstructed models.