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Figueiredo RG, Duarte NFV, Campos DCB, de Jesus Diaz Verduzco M, Márquez ÁA, de Araujo GTB, Rubin AS. Improving Accessibility to Patients with Interstitial Lung Disease (ILD): Barriers to Early Diagnosis and Timely Treatment in Latin America. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:647. [PMID: 38791861 PMCID: PMC11121643 DOI: 10.3390/ijerph21050647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 05/12/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Delayed initiation of effective antifibrotic therapy in patients with interstitial lung diseases (ILD) may influence the progression and outcome of the disease. This study analyzes the differences in the journey of patients with ILD in the Brazilian and Mexican health systems. An evaluative study was conducted in reference centers for interstitial lung diseases in Brazil and Mexico with a panel of four specialists. The patient's journey in both countries begins when the patient seeks medical care after observing a chronic respiratory symptom. In both countries, due to diagnostic complexity, these patients arrive at ILD referral centers at an advanced stage of the disease. Once diagnosis is established, the treatment onset differs between Mexico and Brazil. In Brazil, access to antifibrotic drugs through the public health system has been a significant challenge, and their cost makes them unaffordable for most people. This situation forces medical specialists to provide only supportive care to patients until these drugs can be accessed. In Mexico, antifibrotics have been available in health sectors since 2018. Brazil and Mexico have several similarities regarding the initial journey of the patient due to diagnosis difficulties. Still, the outcome tends to be different due to a difference in access to treatment with antifibrotics. For this reason, advancing health policies that ensure proper treatment for patients with ILD is crucial for the sustainability and reliability of the health system.
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Affiliation(s)
- Ricardo G. Figueiredo
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana 44036-900, Brazil
| | | | | | - Manuel de Jesus Diaz Verduzco
- Hospital Regional “Dr. Manuel Cardenas de la Vega”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Culiacán Rosales 80230, Mexico;
| | - Ángel Alemán Márquez
- Hospital Naval de Especialidades de Veracruz, Hospital Español Veracruz, Universidad del Valle de México (UVM), UNAM Campus Veracruz, Veracruz 91700, Mexico;
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Uppalapati VK, Nag DS. A Comparative Analysis of AI Models in Complex Medical Decision-Making Scenarios: Evaluating ChatGPT, Claude AI, Bard, and Perplexity. Cureus 2024; 16:e52485. [PMID: 38371109 PMCID: PMC10874112 DOI: 10.7759/cureus.52485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
This study rigorously evaluates the performance of four artificial intelligence (AI) language models - ChatGPT, Claude AI, Google Bard, and Perplexity AI - across four key metrics: accuracy, relevance, clarity, and completeness. We used a strong mix of research methods, getting opinions from 14 scenarios. This helped us make sure our findings were accurate and dependable. The study showed that Claude AI performs better than others because it gives complete responses. Its average score was 3.64 for relevance and 3.43 for completeness compared to other AI tools. ChatGPT always did well, and Google Bard had unclear responses, which varied greatly, making it difficult to understand it, so there was no consistency in Google Bard. These results give important information about what AI language models are doing well or not for medical suggestions. They help us use them better, telling us how to improve future tech changes that use AI. The study shows that AI abilities match complex medical scenarios.
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Affiliation(s)
| | - Deb Sanjay Nag
- Department of Anesthesiology, Tata Main Hospital, Jamshedpur, IND
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Montani D, Savale L, Noel N, Meyrignac O, Colle R, Gasnier M, Corruble E, Beurnier A, Jutant EM, Pham T, Lecoq AL, Papon JF, Figuereido S, Harrois A, Humbert M, Monnet X. [Post-COVID-19 syndrome]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 2023; 207:812-820. [PMID: 37292432 PMCID: PMC10126882 DOI: 10.1016/j.banm.2023.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/17/2023] [Indexed: 06/10/2023]
Abstract
In the aftermath of acute infection with the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), a large number of symptoms persist or appear, constituting a real syndrome called "long COVID-19" or "post-COVID- 19" or "post-acute COVID-19 syndrome". Its incidence is very high, half of patients showing at least one symptom at 4-6 months after Coronarovirus infectious disease 2019 (COVID-19). They can affect many organs. The most common symptom is persistent fatigue, similar to that seen after other viral infections. Radiological pulmonary sequelae are relatively rare and not extensive. On the other hand, functional respiratory symptoms, primarily dyspnoea, are much more frequent. Dysfunctional breathing is a significant cause of dyspnoea. Cognitive disorders and psychological symptoms are also very common, with anxiety, depression and post-traumatic stress symptoms being widely described. On the other hand, cardiac, endocrine, cutaneous, digestive or renal sequelae are rarer. The symptoms generally improve after several months, even if their prevalence at two years remains significant. Most of the symptoms are favored by the severity of the initial illness, and the psychic symptoms by the female sex. The pathophysiology of most symptoms is poorly understood. The influence of the treatments used in the acute phase is also important. Vaccination, on the other hand, seems to reduce their incidence. The sheer number of affected patients makes long-term COVID-19 syndrome a public health challenge.
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Affiliation(s)
- David Montani
- Université Paris-Saclay, AP-HP, service de pneumologie et soins intensifs respiratoires, hôpital de Bicêtre, DMU 5 Thorinno, Inserm UMR_S999, Le Kremlin-Bicêtre, France
| | - Laurent Savale
- Université Paris-Saclay, AP-HP, service de pneumologie et soins intensifs respiratoires, hôpital de Bicêtre, DMU 5 Thorinno, Inserm UMR_S999, Le Kremlin-Bicêtre, France
| | - Nicolas Noel
- Université Paris-Saclay, AP-HP, service de médecine interne et immunologie clinique, hôpital de Bicêtre, DMU 7 endocrinologie-immunités-inflammations-cancer-urgences, Le Kremlin-Bicêtre, France
| | - Olivier Meyrignac
- Université Paris-Saclay, AP-HP, service de radiologie diagnostique et interventionnelle, Hôpital de Bicêtre, DMU 14 Smart Imaging, BioMaps, Le Kremlin-Bicêtre, France
| | - Romain Colle
- Université Paris-Saclay, AP-HP, service de psychiatrie, hôpital de Bicêtre, DMU 11 psychiatrie, santé mentale, addictologie et nutrition, équipe MOODS, Inserm U1178, centre de recherche en épidémiologie et santé des populations (CESP), Le Kremlin-Bicêtre, France
| | - Matthieu Gasnier
- Université Paris-Saclay, AP-HP, service de psychiatrie, hôpital de Bicêtre, DMU 11 psychiatrie, santé mentale, addictologie et nutrition, équipe MOODS, Inserm U1178, centre de recherche en épidémiologie et santé des populations (CESP), Le Kremlin-Bicêtre, France
| | - Emmanuelle Corruble
- Université Paris-Saclay, AP-HP, service de psychiatrie, hôpital de Bicêtre, DMU 11 psychiatrie, santé mentale, addictologie et nutrition, équipe MOODS, Inserm U1178, centre de recherche en épidémiologie et santé des populations (CESP), Le Kremlin-Bicêtre, France
| | - Antoine Beurnier
- Université Paris-Saclay, AP-HP, service de pneumologie et soins intensifs respiratoires, hôpital de Bicêtre, DMU 5 Thorinno, Inserm UMR_S999, Le Kremlin-Bicêtre, France
| | - Etienne-Marie Jutant
- Université Paris-Saclay, AP-HP, service de pneumologie et soins intensifs respiratoires, hôpital de Bicêtre, DMU 5 Thorinno, Inserm UMR_S999, Le Kremlin-Bicêtre, France
- Université de Poitiers, CHU de Poitiers, service de pneumologie, Inserm CIC 1402 Axe Is-ALIVE, Poitiers, France
| | - Tai Pham
- Université Paris-Saclay, AP-HP, service de médecine intensive-réanimation, hôpital de Bicêtre, DMU 4 CORREVE maladies du cœur et des vaisseaux, Inserm UMR_S999, FHU Sepsis, CARMAS, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Anne-Lise Lecoq
- Université Paris-Saclay, AP-HP, centre de recherche clinique Paris-Saclay, DMU 13 santé publique, information médicale, appui à la recherche clinique, Inserm U1018, centre de recherche en épidémiologie et santé des populations (CESP), Le Kremlin-Bicêtre, France
| | - Jean-François Papon
- Université Paris-Saclay, AP-HP, service d'ORL et de chirurgie cervico-faciale, DMU 9 neurosciences, Inserm, U955, E13, CNRS ERL7000, Le Kremlin-Bicêtre, France
| | - Samy Figuereido
- Université Paris-Saclay, AP-HP, service d'anesthésie-réanimation et médecine péri-opératoire, Hôpital de Bicêtre, DMU 12 anesthésie, réanimation, douleur, Le Kremlin-Bicêtre, France
| | - Anatole Harrois
- Université Paris-Saclay, AP-HP, service de réanimation chirurgicale, hôpital de Bicêtre, DMU 12 anesthésie, réanimation, douleur, Le Kremlin-Bicêtre, France
| | - Marc Humbert
- Université Paris-Saclay, AP-HP, service de pneumologie et soins intensifs respiratoires, hôpital de Bicêtre, DMU 5 Thorinno, Inserm UMR_S999, Le Kremlin-Bicêtre, France
| | - Xavier Monnet
- Université Paris-Saclay, AP-HP, service de médecine intensive-réanimation, hôpital de Bicêtre, DMU 4 CORREVE maladies du cœur et des vaisseaux, Inserm UMR_S999, FHU Sepsis, CARMAS, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
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