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Davies NP, Wilson R, Winder MS, Tunster SJ, McVicar K, Thakrar S, Williams J, Reid A. ChatGPT sits the DFPH exam: large language model performance and potential to support public health learning. BMC Med Educ 2024; 24:57. [PMID: 38212802 PMCID: PMC10782695 DOI: 10.1186/s12909-024-05042-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/06/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Artificial intelligence-based large language models, like ChatGPT, have been rapidly assessed for both risks and potential in health-related assessment and learning. However, their applications in public health professional exams have not yet been studied. We evaluated the performance of ChatGPT in part of the Faculty of Public Health's Diplomat exam (DFPH). METHODS ChatGPT was provided with a bank of 119 publicly available DFPH question parts from past papers. Its performance was assessed by two active DFPH examiners. The degree of insight and level of understanding apparently displayed by ChatGPT was also assessed. RESULTS ChatGPT passed 3 of 4 papers, surpassing the current pass rate. It performed best on questions relating to research methods. Its answers had a high floor. Examiners identified ChatGPT answers with 73.6% accuracy and human answers with 28.6% accuracy. ChatGPT provided a mean of 3.6 unique insights per question and appeared to demonstrate a required level of learning on 71.4% of occasions. CONCLUSIONS Large language models have rapidly increasing potential as a learning tool in public health education. However, their factual fallibility and the difficulty of distinguishing their responses from that of humans pose potential threats to teaching and learning.
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Affiliation(s)
- Nathan P Davies
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham City Hospital, Hucknall Rd, Nottingham, NG5 1PB, England.
| | - Robert Wilson
- NHS England, Seaton House, City Link, London Road, Nottingham, NG2 4LA, England
| | - Madeleine S Winder
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham City Hospital, Hucknall Rd, Nottingham, NG5 1PB, England
| | - Simon J Tunster
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham City Hospital, Hucknall Rd, Nottingham, NG5 1PB, England
| | - Kathryn McVicar
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham City Hospital, Hucknall Rd, Nottingham, NG5 1PB, England
| | - Shivan Thakrar
- Leicester City Council, Public Health, 115 Charles Street, Leicester, LE1 1FZ, England
| | - Joe Williams
- School of Health and Related Research (ScHARR), The University of Sheffield, 30 Regent St, Sheffield, S1 4DA, England
| | - Allan Reid
- NHS England, Seaton House, City Link, London Road, Nottingham, NG2 4LA, England
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Bamford NS, McVicar K. Localising movement disorders in childhood. Lancet Child Adolesc Health 2019; 3:917-928. [PMID: 31653548 DOI: 10.1016/s2352-4642(19)30330-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/22/2019] [Accepted: 09/16/2019] [Indexed: 12/16/2022]
Abstract
The diagnosis and management of movement disorders in children can be improved by understanding the pathways, neurons, ion channels, and receptors involved in motor learning and control. In this Review, we use a localisation approach to examine the anatomy, physiology, and circuitry of the basal ganglia and highlight the mechanisms that underlie some of the major movement disorders in children. We review the connections between the basal ganglia and the thalamus and cortex, address the basic clinical definitions of movement disorders, and then place diseases within an anatomical or physiological framework that highlights basal ganglia function. We discuss how new pharmacological, behavioural, and electrophysiological approaches might benefit children with movement disorders by modifying synaptic function. A better understanding of the mechanisms underlying movement disorders allows improved diagnostic and treatment decisions.
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Affiliation(s)
- Nigel S Bamford
- Departments of Pediatrics and Neurology, Yale University, New Haven, CT, USA; Department of Cellular and Molecular Physiology, Yale University, New Haven, CT, USA; Department of Neurology, University of Washington, Seattle, WA, USA.
| | - Kathryn McVicar
- Departments of Pediatrics and Neurology, Yale University, New Haven, CT, USA
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Urraca N, Potter B, Hundley R, Pivnick EK, McVicar K, Thibert RL, Ledbetter C, Chamberlain R, Miravalle L, Sirois CL, Chamberlain S, Reiter LT. A Rare Inherited 15q11.2-q13.1 Interstitial Duplication with Maternal Somatic Mosaicism, Renal Carcinoma, and Autism. Front Genet 2016; 7:205. [PMID: 27933089 PMCID: PMC5122884 DOI: 10.3389/fgene.2016.00205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/03/2016] [Indexed: 11/26/2022] Open
Abstract
Chromosome 15q11-q13.1 duplication is a common copy number variant associated with autism spectrum disorder (ASD). Most cases are de novo, maternal in origin and fully penetrant for ASD. Here, we describe a unique family with an interstitial 15q11.2-q13.1 maternal duplication and the presence of somatic mosaicism in the mother. She is typically functioning, but formal autism testing showed mild ASD. She had several congenital anomalies, and she is the first 15q Duplication case reported in the literature to develop unilateral renal carcinoma. Her two affected children share some of these clinical characteristics, and have severe ASD. Several tissues in the mother, including blood, skin, a kidney tumor, and normal kidney margin tissues were studied for the presence of the 15q11-q13.1 duplication. We show the mother has somatic mosaicism for the duplication in several tissues to varying degrees. A growth competition assay in two types of stem cells from duplication 15q individuals was also performed. Our results suggest that the presence of this interstitial duplication 15q chromosome may confer a previously unknown growth advantage in this particular individual, but not in the general interstitial duplication 15q population.
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Affiliation(s)
- Nora Urraca
- Department of Neurology, University of Tennessee Health Science CenterMemphis, TN, USA; Pediatric Clinical Research Unit, Le Bonheur Children's HospitalMemphis, TN, USA
| | - Brian Potter
- Department of Pediatrics, University of Tennessee Health Science CenterMemphis, TN, USA; Neuroscience Institute, Le Bonheur Children's HospitalMemphis, TN, USA
| | - Rachel Hundley
- Division of Developmental Medicine, Department of Pediatrics, Vanderbilt University School of Medicine Nashville, TN, USA
| | - Eniko K Pivnick
- Department of Pediatrics, University of Tennessee Health Science CenterMemphis, TN, USA; Department of Ophthalmology, University of Tennessee Health Science CenterMemphis, TN, USA
| | - Kathryn McVicar
- Department of Pediatrics, University of Tennessee Health Science Center Memphis, TN, USA
| | - Ronald L Thibert
- Department of Neurology, Massachusetts General Hospital Boston, MA, USA
| | - Christopher Ledbetter
- Department of Urology, University of Tennessee Health Science Center Memphis, TN, USA
| | | | | | - Carissa L Sirois
- Department of Genetics and Genome Sciences, University of Connecticut Health Center Farmington, CT, USA
| | - Stormy Chamberlain
- Department of Genetics and Genome Sciences, University of Connecticut Health Center Farmington, CT, USA
| | - Lawrence T Reiter
- Department of Neurology, University of Tennessee Health Science CenterMemphis, TN, USA; Department of Pediatrics, University of Tennessee Health Science CenterMemphis, TN, USA
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Patterson AL, Choudhri AF, Igarashi M, McVicar K, Shah N, Morgan R. Severe Neurological Complications Associated With Tourette Syndrome. Pediatr Neurol 2016; 61:99-106. [PMID: 27353696 DOI: 10.1016/j.pediatrneurol.2016.05.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/15/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Tics and Tourette syndrome are common problems evaluated by both the general pediatrician and pediatric neurologist. The common comorbidities of tics are well known, but the severe neurological complications are rare and may not be appreciated. METHODS This is a retrospective case series and literature review. RESULTS We present here four adolescents with Tourette syndrome who had severe neurological complications secondary to motor tics. We provide the history, neurological examination, and radiological findings in addition to a review of previously reported cases of vascular and cervical cord complications associated with violent motor tics. CONCLUSIONS We highlight the importance of recognizing the presenting signs of these complications early and the need to vigorously treat violent motor tics to prevent significant neurological complications.
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Affiliation(s)
- Amy L Patterson
- Division of Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee; Division of Neurology, Department of Pediatrics, Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Asim F Choudhri
- Division of Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee; Division of Neurology, Department of Pediatrics, Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Masanori Igarashi
- Division of Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee; Division of Neurology, Department of Pediatrics, Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Kathryn McVicar
- Division of Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee; Division of Neurology, Department of Pediatrics, Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Namrata Shah
- Division of Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee; Division of Neurology, Department of Pediatrics, Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Robin Morgan
- Division of Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee; Division of Neurology, Department of Pediatrics, Le Bonheur Children's Hospital, Memphis, Tennessee.
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Urraca N, Cleary J, Brewer V, Pivnick EK, McVicar K, Thibert RL, Schanen NC, Esmer C, Lamport D, Reiter LT. The interstitial duplication 15q11.2-q13 syndrome includes autism, mild facial anomalies and a characteristic EEG signature. Autism Res 2013; 6:268-79. [PMID: 23495136 PMCID: PMC3884762 DOI: 10.1002/aur.1284] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 02/15/2013] [Indexed: 12/04/2022]
Abstract
Chromosomal copy number variants (CNV) are the most common genetic lesion found in autism. Many autism-associated CNVs are duplications of chromosome 15q. Although most cases of interstitial (int) dup(15) that present clinically are de novo and maternally derived or inherited, both pathogenic and unaffected paternal duplications of 15q have been identified. We performed a phenotype/genotype analysis of individuals with interstitial 15q duplications to broaden our understanding of the 15q syndrome and investigate the contribution of 15q duplication to increased autism risk. All subjects were recruited solely on the basis of interstitial duplication 15q11.2-q13 status. Comparative array genome hybridization was used to determine the duplication size and boundaries while the methylation status of the maternally methylated small nuclear ribonucleoprotein polypeptide N gene was used to determine the parent of origin of the duplication. We determined the duplication size and parental origin for 14 int dup(15) subjects: 10 maternal and 4 paternal cases. The majority of int dup(15) cases recruited were maternal in origin, most likely due to our finding that maternal duplication was coincident with autism spectrum disorder. The size of the duplication did not correlate with the severity of the phenotype as established by Autism Diagnostic Observation Scale calibrated severity score. We identified phenotypes not comprehensively described before in this cohort including mild facial dysmorphism, sleep problems and an unusual electroencephalogram variant. Our results are consistent with the hypothesis that the maternally expressed ubiquitin protein ligase E3A gene is primarily responsible for the autism phenotype in int dup(15) since all maternal cases tested presented on the autism spectrum.
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Affiliation(s)
- Nora Urraca
- Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Valicenti-McDermott MD, McVicar K, Cohen HJ, Wershil BK, Shinnar S. Gastrointestinal symptoms in children with an autism spectrum disorder and language regression. Pediatr Neurol 2008; 39:392-8. [PMID: 19027584 DOI: 10.1016/j.pediatrneurol.2008.07.019] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2007] [Revised: 07/28/2008] [Accepted: 07/30/2008] [Indexed: 02/08/2023]
Abstract
Few studies have compared gastrointestinal problems in children with an autism spectrum disorder with and without a history of language regression. A cross-sectional study was conducted with structured interviews in 100 children with autism spectrum disorder, using a gastrointestinal questionnaire and a familial autoimmune questionnaire. By parental report, children with language regression more frequently exhibited an abnormal stool pattern (40% vs 12%, P = 0.006) and had an increased family history of celiac disease or inflammatory bowel disease (24% vs 0%, P = 0.001) and of rheumatoid arthritis (30% vs 11%, P = 0.03). Among 35 children with a family history of autoimmune disease, an abnormal stool pattern was reported more frequently in those with language regression (78% vs 15%, P = 0.001) than in those without. An association was observed between children with language regression, a family history of autoimmune disease, and gastrointestinal symptoms. Additional studies are needed to examine a possible shared autoimmune process.
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Valicenti-McDermott M, McVicar K, Rapin I, Wershil BK, Cohen H, Shinnar S. Frequency of gastrointestinal symptoms in children with autistic spectrum disorders and association with family history of autoimmune disease. J Dev Behav Pediatr 2006; 27:S128-36. [PMID: 16685179 DOI: 10.1097/00004703-200604002-00011] [Citation(s) in RCA: 183] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This is a cross-sectional study that compares lifetime prevalence of gastrointestinal (GI) symptoms in children with autistic spectrum disorders (ASDs) and children with typical development and with other developmental disabilities (DDs) and examines the association of GI symptoms with a family history of autoimmune disease. A structured interview was performed in 50 children with ASD and 2 control groups matched for age, sex, and ethnicity-50 with typical development and 50 with other DDs. Seventy-four percent were boys with a mean age of 7.6 years (SD, +/-3.6). A history of GI symptoms was elicited in 70% of children with ASD compared with 28% of children with typical development (p <.001) and 42% of children with DD (p =.03). Abnormal stool pattern was more common in children with ASD (18%) than controls (typical development: 4%, p =.039; DD: 2%, p =.021). Food selectivity was also higher in children with ASD (60%) compared with those with typical development (22%, p =.001) and DD (36%, p =.023). Family history of autoimmune disease was reported in 38% of the ASD group and 34% of controls and was not associated with a differential rate of GI symptoms. In the multivariate analysis, autism (adjusted odds ratio (OR), 3.8; 95% confidence interval (CI), 1.7-11.2) and food selectivity (adjusted OR, 4.1; 95% CI, 1.8-9.1) were associated with GI symptoms. Children with ASD have a higher rate of GI symptoms than children with either typical development or other DDs. In this study, there was no association between a family history of autoimmune disease and GI symptoms in children with ASD.
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