Daily Archives: February 14, 2023
Consensus Paper | ED management of patients with alcohol intoxication, alcohol withdrawal, and alcohol use disorder
14 Feb, 2023 | 11:05h | UTC
Diagnostic Study | Level of attention to motherese speech as an early marker of autism spectrum disorder
14 Feb, 2023 | 11:04h | UTCSummary: A study was conducted to determine if levels of attention to motherese speech can be used as a diagnostic marker for autism spectrum disorder (ASD) and if they are associated with social and language abilities. The study involved 653 toddlers aged 12 to 48 months and used gaze-contingent eye tracking to measure attention to motherese speech. The results showed that toddlers without ASD had high levels of fixation on motherese speech, while those with ASD had significantly reduced levels. If a toddler fixated on motherese speech at or below 30%, the probability of them being accurately diagnosed with ASD was 94%, and it was also associated with reduced social and language abilities. The findings suggest that attention to motherese speech may be a diagnostic and prognostic marker of ASD.
(By ChatGPT, reviewed and edited)
Commentaries:
Toddlers’ Attention to ‘Motherese’ Could Give Clues to Autism – HealthDay
Developments under assisted dying legislation: the experience in Belgium and other countries
14 Feb, 2023 | 11:02h | UTCSummary: The legalization of assisted dying (including euthanasia and physician-assisted suicide) remains a controversial issue as more countries consider such laws. A selective literature review was conducted to examine the developments globally, and the experience in Belgium was found to be instructive. Since legalization, the practice of assisted dying has increased gradually, accompanied by a growing acceptance among the public and physicians. Although fears have been largely alleviated, ongoing monitoring and research are necessary to address important concerns. Research in Belgium has not found evidence of harmful effects, but the implementation of assisted dying laws should always consider integration into the healthcare system, physician training, conscientious objection, availability of palliative care, public education, and monitoring systems. To ensure the quality of end-of-life care, it is advisable to set up monitoring and evaluation systems and carry out impartial studies. It is important to have high levels of openness and involvement with healthcare providers and the general public.
(By ChatGPT, reviewed and edited)
Performance of ChatGPT on USMLE: potential for AI-assisted medical education using large language models
14 Feb, 2023 | 11:00h | UTCSummary: The researchers evaluated the performance of ChatGPT, a large language-based AI, on the United States Medical Licensing Exam (USMLE). The USMLE is a set of three standardized tests required for medical licensure in the US. The results showed that ChatGPT performed at or near the passing threshold (60%) on all three exams without specialized training or reinforcement. The AI also demonstrated a high level of concordance and insight in its explanations, suggesting that it may have potential to assist with medical education and potentially, clinical decision-making in the future. This marks a notable milestone in AI maturation and increased confidence in its trust and explainability.
(By ChatGPT, reviewed and edited)
News Release: ChatGPT can (almost) pass the US Medical Licensing Exam – PLOS
Commentaries:
Commentary from one of the authors on Twitter (thread – click for more)
our work showing that ChatGPT passed the US Medical Licensing Exam (USMLE) is published @PLOSDigiHealth!
there's tons of chatter about LLMs in healthcare.
AI is not going to replace doctors anytime soon, but here are the key takeaways from this work:
? https://t.co/OQs2Tlfwjx pic.twitter.com/v3UWjScLth
— Morgan Cheatham (@morgancheatham) February 13, 2023
Perspective | ChatGPT-assisted diagnosis: is the future suddenly here?
14 Feb, 2023 | 10:59h | UTCSummary: The article discusses the potential of ChatGPT, a new AI chatbot, to revolutionize medical diagnosis. It compares ChatGPT’s performance with that of symptom checkers and physicians, finding that it performs better than symptom checkers and is approaching the accuracy of physicians. The article highlights the limitations of the study, including the small sample size and sensitivity of results to the way information is presented. It also acknowledges potential challenges with the use of AI in medical diagnosis, including the need for more rigorous testing, the issue of feeding patient information into an algorithm, and the possibility of AI algorithms being biased. Despite these challenges, the article suggests that the future of computer-assisted diagnosis is here and the healthcare system will need to address these challenges.
(By ChatGPT, reviewed and edited)
Source: ChatGPT-assisted diagnosis: Is the future suddenly here? – STAT
Opinion | The “evidence pyramid” should be dismantled, brick by ill-conceived brick
14 Feb, 2023 | 10:57h | UTCSummary: The text criticizes the use of the so-called “evidence pyramid” in medicine, which suggests that systematic reviews and meta-analyses (SRMAs) are the highest level of evidence in medicine. The author argues that SRMAs are not evidence themselves, but a lens through which actual evidence from randomized controlled trials (RCTs) and observational studies is viewed. They depend on the quality of the review process and the evidence appraised, which are often low quality and small studies with various methodologies. The author suggests that a better framework would place RCTs at the top of the pyramid and relegates SRMAs to the role of a lens. The author also points out that good observational studies may be better than bad RCTs, and that each paper should be read and judged on its individual merits, not by its strata on a pyramid.
(By ChatGPT, reviewed and edited)
Source: The “evidence pyramid” should be dismantled, brick by ill-conceived brick – Sensible Medicine
Perspective | Generating scholarly content with ChatGPT: ethical challenges for medical publishing
14 Feb, 2023 | 10:58h | UTCSummary: The article discusses the ethical challenges posed by the use of ChatGPT, an AI chatbot, in medical publishing. The authors note that the impact of generative AI on medical publishing is currently unknown, but it could have substantial ethical implications, including copyright, attribution, plagiarism, and authorship issues. The authors argue that there is a growing need for robust AI author guidelines in scholarly publishing, and that the International Association of Scientific, Technical, and Medical Publishers has produced a white paper on AI ethics. They also raise concerns about the potential for ChatGPT to widen existing disparities in knowledge dissemination and scholarly publishing, as well as the potential for the chatbot to produce misleading or inaccurate content. The authors call on The Lancet Digital Health and the Lancet family to initiate discussions around the implications of AI-generated content within scholarly publishing and to create comprehensive guidance.
(By ChatGPT, reviewed and edited)
Podcast | “Things we do for no reason” pearls
14 Feb, 2023 | 10:56h | UTC#381 LIVE! Patient Centered Things We Do For No Reason – The Curbsiders
Cohort Study | In utero exposure to ADHD medication does not seem to result in worse offspring neurodevelopmental outcomes
14 Feb, 2023 | 10:54h | UTCSummary: The authors conducted a study to investigate the long-term effects of in utero exposure to ADHD medication (methylphenidate, amphetamine, dexamphetamine, lisdexamphetamine, modafinil, atomoxetine, clonidine) on offspring. The study followed 1,068,073 liveborn singletons from 1998 to 2018 and compared the outcomes of children whose mothers continued or discontinued ADHD medication during pregnancy. The main outcomes were neurodevelopmental psychiatric disorders, impairments in vision or hearing, epilepsy, seizures, or growth impairment during childhood or adolescence. After adjustment for demographic and psychiatric characteristics of the mother, no increased risk of any developmental disorders was found in offspring exposed to ADHD medication compared to those not exposed. The results provide reassurance for women with ADHD who depend on medication and consider continuing it during pregnancy.
(By ChatGPT, reviewed and edited)
Article: In utero exposure to ADHD medication and long-term offspring outcomes – Molecular Psychiatry (link to abstract – $ for full-text)
Commentary from the author on Twitter (thread – click for more)
In-utero exposure to ADHD medication is not associated with long-term adverse neurodevelopmental disorders and growth restriction in the offspring.
Read the thread below ?on our new paper just published in @molpsychiatry
? https://t.co/MKZ0aeFnhU#ADHD— Kathrine Bang Madsen (@Kathrine_BaMa) February 9, 2023
Study suggests long-term caloric restriction could slow biological aging in healthy adults
14 Feb, 2023 | 10:52h | UTCSummary: The article reports the results of a study that analyzed the impact of caloric restriction (CR), defined as reducing caloric intake without depriving essential nutrients, on DNA methylation, a measure of aging, in blood samples from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) trial. The results showed that the CALERIE intervention slowed the pace of aging, as measured by the DunedinPACE DNAm algorithm, but did not lead to significant changes in biological age estimates measured by various DNAm clocks. The authors note that while treatment effect sizes were small, a modest slowing of the pace of aging can have a significant impact on population health. They also highlight the need for further trials with long-term follow-up to establish the effects of interventions on primary healthy-aging endpoints, including the incidence of chronic disease and mortality.
(By ChatGPT, reviewed and edited)
Commentaries:
Restrict calories to live longer, study says, but critics say more proof is needed – CNN
Late diagnosis of HIV: an updated consensus definition
14 Feb, 2023 | 10:49h | UTCLate diagnosis of HIV: An updated consensus definition – HIV Medicine
SCAI expert consensus statement on percutaneous coronary intervention without on-site surgical backup
14 Feb, 2023 | 10:51h | UTCCommentaries:
SCAI Expert Consensus Statement Supports Safety of PCI Without On-Site Surgery – HCP Live
Position Statement | Immune checkpoint inhibitors and endocrine disorders
14 Feb, 2023 | 10:50h | UTCRelated:
Single-arm study | Effects of SER-109 as an investigational microbiome therapeutic in recurrent C. difficile infection
14 Feb, 2023 | 10:47h | UTCSummary: This was a phase 3, open-label, single-arm trial of 263 adults with recurrent Clostridioides difficile Infection (CDI). The trial aimed to evaluate the safety and rate of CDI recurrence after administration of the investigational microbiome therapeutic SER-109. The trial found that SER-109 was well tolerated and the overall rate of recurrent CDI was low, regardless of the number of prior recurrences, demographics, or diagnostic approach.
(By ChatGPT, reviewed and edited)
Commentary: Phase 3 trial provides more positive data for recurrent C diff microbiome drug – CIDRAP
Related:
Eight countries eliminated a neglected tropical disease in 2022
14 Feb, 2023 | 10:45h | UTCEight countries eliminated a neglected tropical disease in 2022 – Nature
Original report: WHO Global report on neglected tropical diseases 2023
Cohort study | Epidemiology and outcomes of hospital-acquired bloodstream infections in ICU patients
14 Feb, 2023 | 10:44h | UTCEpidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study – Intensive Care Medicine (if the link is paywalled, try this one)
Commentary on Twitter
Hospital‑acquired bloodstream infections in #ICU, @EuroBact2
?mainly due to Gram -, widespread carbapenem resistant, DTR pathogens
?resistance associated w longer delays to adequate ABT therapy
At day-28
?mortality 37%
?16.1% discharged alive from ?
?️https://t.co/0T4FK2mxc5 pic.twitter.com/e0u50hMKqO— Intensive Care Medicine (@yourICM) February 11, 2023
Cohort Study | Global epidemiology of carbapenem-resistant Pseudomonas aeruginosa and associated carbapenemases
14 Feb, 2023 | 10:43h | UTC
M-A | Prevalence of ocular candidiasis and Candida endophthalmitis in patients with candidemia
14 Feb, 2023 | 10:43h | UTC
Commentary on Twitter
Prevalence of ocular candidiasis and Candida endophthalmitis in patients with candidemia: A systematic review and meta-analysis
✅ Just Accepted
? Freely Available
? https://t.co/a8SYDUM8UH pic.twitter.com/L5niNTVIUd— Clinical Infectious Diseases (@CIDJournal) February 9, 2023
Design, power, and alpha levels in randomized phase II oncology trials
14 Feb, 2023 | 10:40h | UTCSummary: This study examined the methodology, reporting, and bias in the interpretation of outcomes in randomized phase II oncology trials. It found that many trials failed to report essential data for determining sample size calculations, did not use a comparator to determine efficacy, and had positive conclusions even though the results were indeterminate or the primary endpoint was not met. The study concluded that phase II trials need to adhere to the same reporting standards and be interpreted in the context of their primary endpoint and endpoints important for the patient.
(By ChatGPT, reviewed and edited)
Article: Design, power, and alpha levels in randomized phase II oncology trials – ESMO Open
Review | Anisocoria in the ED: pathophysiology, evaluation, and management
14 Feb, 2023 | 10:41h | UTCAnisocoria in the ED: Pathophysiology, Evaluation, and Management – emDocs
Takayasu Arteritis | JACC Focus Seminar
14 Feb, 2023 | 10:39h | UTCTakayasu Arteritis: JACC Focus Seminar 3/4 – Journal of the American College of Cardiology
Related:
Retrospective Study | Outcomes of percutaneous intervention in patients with Takayasu arteritis
14 Feb, 2023 | 10:38h | UTCRelated:
Takayasu Arteritis: JACC Focus Seminar 3/4 – Journal of the American College of Cardiology
Phase 2 RCT | Aficamten in patients with obstructive hypertrophic cardiomyopathy
14 Feb, 2023 | 10:37h | UTC
Retrospective Cohort | Phenotypes of overdiagnosed Long QT syndrome
14 Feb, 2023 | 10:35h | UTCPhenotypes of Overdiagnosed Long QT Syndrome – Journal of the American College of Cardiology (link to abstract – $ for full-text)
Commentaries:
Phenotypes of Overdiagnosed Long QT Syndrome – American College of Cardiology
Long QT syndrome overdiagnosis persists – MDedge
Commentary on Twitter
Increased physician & public awareness of LQTS-assoc. warning signs & an increase in #ECG screening programs may contribute to an overdiagnosis of #LQTS.
Authors discuss the top 5 causes of LQTS misdiagnosis & provide guidance to reduce this burden. https://t.co/CDUoiUhihY #JACC pic.twitter.com/BNTXMWQzGP
— JACC Journals (@JACCJournals) February 3, 2023
Development of a model to estimate the optimal number of oocytes to attempt to fertilize in IVF
14 Feb, 2023 | 10:36h | UTC
Commentary on Twitter
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799935