1
|
Young AT, Lane BN, Ozog D, Matthews NH. Patients and dermatologists are largely satisfied with ChatGPT-generated after-visit summaries: A pilot study. JAAD Int 2024; 15:33-35. [PMID: 38371667 PMCID: PMC10869927 DOI: 10.1016/j.jdin.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Affiliation(s)
- Albert T. Young
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Brittany N. Lane
- Department of Medicine, Michigan State University College of Human Medicine, East Lansing, Michigan
| | - David Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
- Department of Medicine, Michigan State University College of Human Medicine, East Lansing, Michigan
| | - Natalie H. Matthews
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
- Department of Medicine, Michigan State University College of Human Medicine, East Lansing, Michigan
| |
Collapse
|
2
|
Myllykangas K, Härkönen H, Kääriäinen M, Kärppä M, Jansson M. Patient experiences on the quality of cerebrovascular diseases counselling using digital solutions in hospital-A qualitative research study. J Clin Nurs 2024; 33:2259-2273. [PMID: 38413773 DOI: 10.1111/jocn.17025] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 12/29/2023] [Accepted: 01/15/2024] [Indexed: 02/29/2024]
Abstract
AIM To describe patients' experiences of the quality of counselling to develop new digital counselling solutions for patients with cerebrovascular disease. DESIGN A descriptive, qualitative approach. METHODS Semi-structured in-person interviews were conducted among 22 patients diagnosed with acute cerebrovascular disease and treated as inpatients at a single university hospital in Finland between September 2021 and February 2022. Data were analysed using deductive and inductive content analysis. RESULTS The identified facilitators, barriers and possible solutions for the development of new digital counselling solutions were deductively categorized into five main categories: (1) background factors, (2) resources, (3) implementation, (4) sufficiency, and (5) effects and 12 generic categories. Patients with cerebrovascular diseases worry about symptoms affecting their ability to receive information and valued a supportive atmosphere. Staff should have more time for counselling and use motivational digital counselling solutions in plain language, moderate length and with multimedia content. Patients desired reminders, easy search functions and possibilities for two-way communication. CONCLUSION New digital counselling solutions could be beneficial in supporting the patients' knowledge, emotions and adherence. For the success of such solutions, patients' special needs concerning different levels of cognitive impairment need to be considered. IMPACT The results of this study may benefit healthcare organizations in the development of digital counselling solutions that meet the patients' needs. REPORTING METHOD We have adhered to relevant EQUATOR guidelines with the COREQ reporting method. PATIENT OR PUBLIC CONTRIBUTION Patients were involved as the study population.
Collapse
Affiliation(s)
- Kirsi Myllykangas
- Research Unit of Health Sciences and Technology (HST), University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Henna Härkönen
- Research Unit of Health Sciences and Technology (HST), University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Health Sciences and Technology (HST), University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Mikko Kärppä
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital and Research Unit of Clinical Medicine, Neurology, Oulu University, Oulu University Hospital, Oulu, Finland
| | - Miia Jansson
- Research Unit of Health Sciences and Technology (HST), University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Royal Melbourne Institute of Technology RMIT University, Melbourne, Australia
| |
Collapse
|
3
|
Chang CT, Ticknor IL, Spinelli JA, Bhatia BK, Marwaha S, Mirmirani P, Seidler AM, Man JR, McCleskey PE. Comparison of large language models in generating patient handouts for the dermatology clinic: A blinded study. JAAD Int 2024; 15:152-154. [PMID: 38571697 PMCID: PMC10988028 DOI: 10.1016/j.jdin.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Affiliation(s)
- Crystal T. Chang
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Iesha L. Ticknor
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | | | - Bhavnit K. Bhatia
- Department of Dermatology, The Permanente Medical Group, Richmond, California
| | - Sangeeta Marwaha
- Department of Dermatology, The Permanente Medical Group, Napa, California
| | - Paradi Mirmirani
- Department of Dermatology, The Permanente Medical Group, Vallejo, California
| | - Anne M. Seidler
- Department of Dermatology, The Permanente Medical Group, Oakland, California
| | - Jeremy R. Man
- Department of Dermatology, Southern California Permanente Medical Group, Los Angeles, California
| | | |
Collapse
|
4
|
Özkan M, Yıldızelı Topçu S. The Effect of Preoperative Education Regarding Intraoperative Care on a Patient's Level of Fear of Surgery: A Randomized Controlled Study. AORN J 2024; 119:332-339. [PMID: 38661431 DOI: 10.1002/aorn.14129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 05/11/2023] [Accepted: 06/08/2023] [Indexed: 04/26/2024]
Abstract
This randomized controlled study aimed to investigate the effect that preoperative education provided by the perioperative nurse about the OR environment and intraoperative care has on surgical fear in patients who come to the OR for surgical intervention. The study involved 92 patients undergoing elective abdominal surgery who were randomly assigned to the intervention or routine care group. Preoperatively, patients in the intervention group received education via a form that described the OR environment, the surgical process, and intraoperative care. The patients' surgical fear levels were assessed in the patients' rooms, in the clinic before education, and on arrival to the OR after education. The results showed that preoperative education about the OR environment and intraoperative processes significantly reduced patients' surgical fears.
Collapse
|
5
|
Cordray H, Wright EA, Patel C, Raol N, Prickett KK. A Mobile Application for Child-Focused Tonsillectomy Education: Development and User-Testing. Laryngoscope 2024; 134:2455-2463. [PMID: 37983833 DOI: 10.1002/lary.31198] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/17/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE Patient education is central to Enhanced Recovery After Surgery protocols, but child-focused materials are lacking. We developed and piloted a mobile application to support accessible, interactive patient and caregiver education about pediatric tonsillectomy. METHODS Thirty children ages 5-12 who were preparing for tonsillectomy, their caregivers, and six attending otolaryngologists participated in a user-testing trial of a web-based prototype. The trial measured feasibility, fidelity, and patient-centered outcomes. Patients and caregivers rated usability/likeability on the mHealth App Usability Questionnaire. Otolaryngologists rated quality on the Mobile App Rating Scale. The full mobile application, "Ready for Tonsillectomy," was then developed for iOS and Android. RESULTS Enrollment was 88.2%, retention was 90.0%, and use was 96.3%. Mean (SD) patient ratings for usability/likeability were 6.3 (1.1) out of 7; caregiver ratings were 6.5 (1.1). In common themes from open-ended feedback, patients described the application as helpful and appealing, and caregivers described it as informative, easy to understand, calming, and easy to use. Among caregivers who used the application during recovery, 92.3% reported that it helped them manage their child's pain. Providers would recommend the application to many or all of their patients (mean [SD]: 4.7 [0.5] out of 5). Mean provider ratings for domains of engagement, functionality, aesthetics, information quality, subjective quality, and app-specific value ranged from 4.1 to 4.8 out of 5. CONCLUSION Feasibility and fidelity were high. Families and otolaryngologists endorsed the resource as an engaging, informative tool that supports positive coping. Our mobile application offers a patient-centered solution readily scalable to other surgeries. LEVEL OF EVIDENCE NA Laryngoscope, 134:2455-2463, 2024.
Collapse
Affiliation(s)
- Holly Cordray
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Emily A Wright
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Chhaya Patel
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Nikhila Raol
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kara K Prickett
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| |
Collapse
|
6
|
Robinson MA, Belzberg M, Thakker S, Bibee K, Merkel E, MacFarlane DF, Lim J, Scott JF, Deng M, Lewin J, Soleymani D, Rosenfeld D, Liu R, Liu TYA, Ng E. Assessing the accuracy, usefulness, and readability of artificial-intelligence-generated responses to common dermatologic surgery questions for patient education: A double-blinded comparative study of ChatGPT and Google Bard. J Am Acad Dermatol 2024; 90:1078-1080. [PMID: 38296195 DOI: 10.1016/j.jaad.2024.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/26/2023] [Accepted: 01/14/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Michelle A Robinson
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Micah Belzberg
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Sach Thakker
- Georgetown University School of Medicine, Washington, DC
| | - Kristin Bibee
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Emily Merkel
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Deborah F MacFarlane
- Department of Dermatology, the University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jordan Lim
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Jeffrey F Scott
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Min Deng
- Department of Dermatology, MedStar Washington Hospital Center, Georgetown University Hospital, Washington, DC
| | - Jesse Lewin
- Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | | | - Tin Yan Alvin Liu
- Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Elise Ng
- Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland
| |
Collapse
|
7
|
Ravenstijn M, Jansen RC, du Bois G, Yzer S, Klaver CCW. Empowering patients with high myopia: The significance of education. Acta Ophthalmol 2024; 102:357-363. [PMID: 37899508 DOI: 10.1111/aos.15779] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/01/2023] [Accepted: 09/18/2023] [Indexed: 10/31/2023]
Abstract
PURPOSE To investigate the status of patient education among highly myopic individuals focusing on the presence, sources, content, timing of the education and impact on patients. METHODS Self-reported data were collected through an online 13-item questionnaire consisting of open and multiple-choice questions. The questionnaire was sent to 250 highly myopic members of a patient organization in the Netherlands, of whom 128 (51%) responded. RESULTS At least one acute event had occurred in 66% (84/128) of participants at the time of the questionnaire. Among all participants, 25% (32/128) had not received patient education regarding alarm symptoms for any of these events. Among those who had been informed, the ophthalmologist was the most frequent (57%, 73/128) source of information. Participants who visited the ophthalmologist annually were more frequently informed than participants without annual visits (53%, 26/49 versus 26%, 9/35, p = 0.002). Those not informed were more likely to have a more than 3 days patient delay (92%, 12/13). Doctors delay was also present; 26% (22/84) of the participants with alarm symptoms had to wait 2 or more days before the first appointment. Long-term consequences of myopia had been discussed with 102 participants (80%, 102/128), again with the ophthalmologist as the most frequent source (59%, 76/128). PERSPECTIVES Many myopic individuals have not been educated about their increased risk of acute events, which can result in patient delay and serious consequences with respect to visual prognosis. These findings underscore the critical importance of integrating patient education across the entire ophthalmic care chain for myopia.
Collapse
Affiliation(s)
- M Ravenstijn
- Rotterdam Ophthalmic Institute, Rotterdam Eye Hospital, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - R C Jansen
- Oogvereniging, Utrecht, The Netherlands
- Groningen Bioinformatics Centre, University of Groningen, Groningen, The Netherlands
| | - G du Bois
- Oogvereniging, Utrecht, The Netherlands
| | - S Yzer
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - C C W Klaver
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Institute of Molecular and Clinical Ophthalmology, University of Basel, Basel, Switzerland
| |
Collapse
|
8
|
Chen L, Orosa D, Ahn G, Putnam J, Layoun H, Saddiqui HU, Hammoud MS, Mahboubi R, Schraufnagel D, Bribriesco A. Are adult thoracic patient education materials designed with patients in mind? J Thorac Cardiovasc Surg 2024; 167:1654-1656.e5. [PMID: 38199291 DOI: 10.1016/j.jtcvs.2023.12.029] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/16/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE Patients are increasingly using the internet to obtain health care information. US News and World Report Best Hospital rankings received more than 103 million views in 2021. Considering 21% of thoracic surgery patients are minorities, 27.9% are in the bottom quartile of household income, and 70% have Medicare/Medicaid or no insurance, online patient educational materials (PEMs) should be accessible and written at a level easily understood by majority of patients. We performed a comprehensive analysis of readability of websites containing patient-centered resources across all adult thoracic surgery areas. METHODS Online PEMs on thoracic surgical procedures were collected from top 50 hospitals for pulmonology and lung surgery ranked by US News and World Report Best Hospital as of December 1, 2021. Text pertaining to thoracic surgical procedures was collected and divided into 4 procedural genres: esophageal, lung, transplant procedures, and other. Texts were analyzed using OleanderSoftware's Readability Suite through the Raygor readability test. RESULTS Three hundred seventy-two articles met criteria for analysis. Websites were difficult to read; mean (standard deviation) readability score for all content required a 13.9 (3.6) grade level for comprehension. The mean (standard deviation) readability for esophageal, lung, lung transplant, and other surgeries were 14.5 (3.6), 13.1 (3.6), 11.5 (3.9), and 13.4 (3.7), respectively. CONCLUSIONS Online PEMs required at least a college reading level to comprehend, well exceeding the sixth-grade level recommended by the American Medical Association. As digital health becomes increasingly relevant, improving the readability of online PEMs in adult cardiac surgery will facilitate equitable access to high-quality care.
Collapse
Affiliation(s)
- Lin Chen
- Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
| | - Dominic Orosa
- Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Gaeun Ahn
- Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jonathan Putnam
- Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Habib Layoun
- Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Hafiz Umair Saddiqui
- Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Miza Salim Hammoud
- Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Rashed Mahboubi
- Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Dean Schraufnagel
- Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Alejandro Bribriesco
- Department of Thoracic and Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
9
|
Pockros B, Cortese BD, Michel K, Ellis TA, Talwar R. Online Tools to Decrease Out-of-Pocket Prescription Costs for Patients: A Practical Guide for Urologists. Urol Pract 2024; 11:454-460. [PMID: 38640418 DOI: 10.1097/upj.0000000000000544] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/30/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION Patients who seek urologic care have recently reported a high degree of financial toxicity from prescription medications, including management for nephrolithiasis, urinary incontinence, and urological oncology. Estimating out-of-pocket costs can be challenging for urologists in the US because of variable insurance coverage, local pharmacy distributions, and complicated prescription pricing schemes. This article discusses resources that urologists can adopt into their practice and share with patients to help lower out-of-pocket spending for prescription medications. METHODS We identify 4 online tools that are designed to direct patients toward more affordable prescription medication options: the Medicare Part D Plan Finder, GoodRx, Amazon, and the Mark Cuban Cost Plus Drug Company. A brief historical overview and summary for patients and clinicians are provided for each online resource. A patient-centered framework is provided to help navigate these 4 available tools in clinic. RESULTS Among the 4 tools we identify, there are multiples tradeoffs to consider as financial savings and features can vary. First, patients insured by Medicare should explore the Part D Plan Finder each year to compare drug plans. Second, patients who need to urgently refill a prescription at a local pharmacy should visit GoodRx. Third, patients who are prescribed recurrent generic prescriptions for chronic conditions can utilize the Mark Cuban Cost Plus Drug Company. Finally, patients who are prescribed 3 or more chronic medications can benefit from subscribing to Amazon RxPass. CONCLUSIONS Prescription medications for urologic conditions can be expensive. This article includes 4 online resources that can help patients access medications at their most affordable costs. Urologists can provide this framework to their patients to help support lowering out-of-pocket drug costs.
Collapse
Affiliation(s)
- Benjamin Pockros
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Brian D Cortese
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Katharine Michel
- Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Taryn A Ellis
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ruchika Talwar
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| |
Collapse
|
10
|
Liu Z, Sun X, Guo ZN, Sun Y, Yang Y, Yan X. Effects of a Planned Web-Based Educational Intervention Based on the Health Belief Model for Patients With Ischemic Stroke in Promoting Secondary Prevention During the COVID-19 Lockdown in China: Quasi-Experimental Study. JMIR Mhealth Uhealth 2024; 12:e44463. [PMID: 38659156 DOI: 10.2196/44463] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/29/2024] [Accepted: 02/26/2024] [Indexed: 04/26/2024] Open
Abstract
Background Some common modified vascular risk factors remain poorly controlled among stroke survivors, and educational programs may help improve these conditions. Objective This study aimed to evaluate the effect of a planned web-based educational intervention based on the health belief model (HBM) in promoting secondary prevention among patients with ischemic stroke. Methods An evaluation-blinded quasi-experimental trial with a historical control group was conducted. Patients admitted from March to June 2020 were assigned to the historical control group, and patients admitted from July to October 2020 were assigned to the intervention group. The control group received routine health management. The intervention group received 6 additional sessions based on the HBM via Tencent Meeting, an audio and video conferencing application, within 3 months after discharge. Sessions were held every 2 weeks, with each session lasting approximately 40 minutes. These sessions were conducted in small groups, with about 8 to 10 people in each group. The primary outcomes were changes in blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), hemoglobin A1c (HbA1c), and the proportion of patients achieving the treatment target. The secondary outcomes were medication adherence, assessed with the Morisky Medicine Adherence Scale (MMAS), and disability, assessed with the modified Rankin scale. Results In total, 315 patients experiencing their first-ever stroke were analyzed. More patients in the intervention group had controlled BP (41.9% vs 28.4%; adjusted odds ratio [aOR] 1.93; P=.01), LDL-C (83.1% vs 67.7%; aOR 2.66; P=.001), and HbA1c (91.9% vs 83.9%; aOR: 3.37; P=.04) levels as well as a significant postintervention decrease in the systolic BP (adjusted β -3.94; P=.02), LDL-C (adjusted β -0.21; P=.008), and HbA1c (adjusted β -0.27; P<.001), compared with control groups. Significant between-group differences were observed in medication adherence (79.4% vs 63.2%; aOR 2.31; P=.002) but not in favorable functional outcomes. Conclusions A web-based education program based on the HBM may be more effective than current methods used to educate patients having strokes on optimal vascular risk factors and medication adherence.
Collapse
Affiliation(s)
- Zhuo Liu
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Xin Sun
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Zhen-Ni Guo
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Changchun, China
- Neuroscience Research Center, Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Ye Sun
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Yi Yang
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Xiuli Yan
- Stroke Center, Department of Neurology, The First Hospital of Jilin University, Changchun, China
| |
Collapse
|
11
|
King RC, Samaan JS, Yeo YH, Peng Y, Kunkel DC, Habib AA, Ghashghaei R. A Multidisciplinary Assessment of ChatGPT's Knowledge of Amyloidosis: Observational Study. JMIR Cardio 2024; 8:e53421. [PMID: 38640472 DOI: 10.2196/53421] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/31/2024] [Accepted: 02/22/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Amyloidosis, a rare multisystem condition, often requires complex, multidisciplinary care. Its low prevalence underscores the importance of efforts to ensure the availability of high-quality patient education materials for better outcomes. ChatGPT (OpenAI) is a large language model powered by artificial intelligence that offers a potential avenue for disseminating accurate, reliable, and accessible educational resources for both patients and providers. Its user-friendly interface, engaging conversational responses, and the capability for users to ask follow-up questions make it a promising future tool in delivering accurate and tailored information to patients. OBJECTIVE We performed a multidisciplinary assessment of the accuracy, reproducibility, and readability of ChatGPT in answering questions related to amyloidosis. METHODS In total, 98 amyloidosis questions related to cardiology, gastroenterology, and neurology were curated from medical societies, institutions, and amyloidosis Facebook support groups and inputted into ChatGPT-3.5 and ChatGPT-4. Cardiology- and gastroenterology-related responses were independently graded by a board-certified cardiologist and gastroenterologist, respectively, who specialize in amyloidosis. These 2 reviewers (RG and DCK) also graded general questions for which disagreements were resolved with discussion. Neurology-related responses were graded by a board-certified neurologist (AAH) who specializes in amyloidosis. Reviewers used the following grading scale: (1) comprehensive, (2) correct but inadequate, (3) some correct and some incorrect, and (4) completely incorrect. Questions were stratified by categories for further analysis. Reproducibility was assessed by inputting each question twice into each model. The readability of ChatGPT-4 responses was also evaluated using the Textstat library in Python (Python Software Foundation) and the Textstat readability package in R software (R Foundation for Statistical Computing). RESULTS ChatGPT-4 (n=98) provided 93 (95%) responses with accurate information, and 82 (84%) were comprehensive. ChatGPT-3.5 (n=83) provided 74 (89%) responses with accurate information, and 66 (79%) were comprehensive. When examined by question category, ChatGTP-4 and ChatGPT-3.5 provided 53 (95%) and 48 (86%) comprehensive responses, respectively, to "general questions" (n=56). When examined by subject, ChatGPT-4 and ChatGPT-3.5 performed best in response to cardiology questions (n=12) with both models producing 10 (83%) comprehensive responses. For gastroenterology (n=15), ChatGPT-4 received comprehensive grades for 9 (60%) responses, and ChatGPT-3.5 provided 8 (53%) responses. Overall, 96 of 98 (98%) responses for ChatGPT-4 and 73 of 83 (88%) for ChatGPT-3.5 were reproducible. The readability of ChatGPT-4's responses ranged from 10th to beyond graduate US grade levels with an average of 15.5 (SD 1.9). CONCLUSIONS Large language models are a promising tool for accurate and reliable health information for patients living with amyloidosis. However, ChatGPT's responses exceeded the American Medical Association's recommended fifth- to sixth-grade reading level. Future studies focusing on improving response accuracy and readability are warranted. Prior to widespread implementation, the technology's limitations and ethical implications must be further explored to ensure patient safety and equitable implementation.
Collapse
Affiliation(s)
- Ryan C King
- Division of Cardiology, Department of Medicine, University of California, Irvine Medical Center, Orange, CA, United States
| | - Jamil S Samaan
- Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Yee Hui Yeo
- Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Yuxin Peng
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, China
| | - David C Kunkel
- GI Motility and Physiology Program, Division of Gastroenterology, University of California, San Diego, La Jolla, CA, United States
| | - Ali A Habib
- Division of Neurology, University of California, Irvine Medical Center, Orange, CA, United States
| | - Roxana Ghashghaei
- Division of Cardiology, Department of Medicine, University of California, Irvine Medical Center, Orange, CA, United States
| |
Collapse
|
12
|
He Z, Bhasuran B, Jin Q, Tian S, Hanna K, Shavor C, Arguello LG, Murray P, Lu Z. Quality of Answers of Generative Large Language Models Versus Peer Users for Interpreting Laboratory Test Results for Lay Patients: Evaluation Study. J Med Internet Res 2024; 26:e56655. [PMID: 38630520 DOI: 10.2196/56655] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/17/2024] [Accepted: 03/06/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Although patients have easy access to their electronic health records and laboratory test result data through patient portals, laboratory test results are often confusing and hard to understand. Many patients turn to web-based forums or question-and-answer (Q&A) sites to seek advice from their peers. The quality of answers from social Q&A sites on health-related questions varies significantly, and not all responses are accurate or reliable. Large language models (LLMs) such as ChatGPT have opened a promising avenue for patients to have their questions answered. OBJECTIVE We aimed to assess the feasibility of using LLMs to generate relevant, accurate, helpful, and unharmful responses to laboratory test-related questions asked by patients and identify potential issues that can be mitigated using augmentation approaches. METHODS We collected laboratory test result-related Q&A data from Yahoo! Answers and selected 53 Q&A pairs for this study. Using the LangChain framework and ChatGPT web portal, we generated responses to the 53 questions from 5 LLMs: GPT-4, GPT-3.5, LLaMA 2, MedAlpaca, and ORCA_mini. We assessed the similarity of their answers using standard Q&A similarity-based evaluation metrics, including Recall-Oriented Understudy for Gisting Evaluation, Bilingual Evaluation Understudy, Metric for Evaluation of Translation With Explicit Ordering, and Bidirectional Encoder Representations from Transformers Score. We used an LLM-based evaluator to judge whether a target model had higher quality in terms of relevance, correctness, helpfulness, and safety than the baseline model. We performed a manual evaluation with medical experts for all the responses to 7 selected questions on the same 4 aspects. RESULTS Regarding the similarity of the responses from 4 LLMs; the GPT-4 output was used as the reference answer, the responses from GPT-3.5 were the most similar, followed by those from LLaMA 2, ORCA_mini, and MedAlpaca. Human answers from Yahoo data were scored the lowest and, thus, as the least similar to GPT-4-generated answers. The results of the win rate and medical expert evaluation both showed that GPT-4's responses achieved better scores than all the other LLM responses and human responses on all 4 aspects (relevance, correctness, helpfulness, and safety). LLM responses occasionally also suffered from lack of interpretation in one's medical context, incorrect statements, and lack of references. CONCLUSIONS By evaluating LLMs in generating responses to patients' laboratory test result-related questions, we found that, compared to other 4 LLMs and human answers from a Q&A website, GPT-4's responses were more accurate, helpful, relevant, and safer. There were cases in which GPT-4 responses were inaccurate and not individualized. We identified a number of ways to improve the quality of LLM responses, including prompt engineering, prompt augmentation, retrieval-augmented generation, and response evaluation.
Collapse
Affiliation(s)
- Zhe He
- School of Information, Florida State University, Tallahassee, FL, United States
| | - Balu Bhasuran
- School of Information, Florida State University, Tallahassee, FL, United States
| | - Qiao Jin
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD, United States
| | - Shubo Tian
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD, United States
| | - Karim Hanna
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Cindy Shavor
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | | | - Patrick Murray
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Zhiyong Lu
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD, United States
| |
Collapse
|
13
|
Laidsaar-Powell R, Giunta S, Butow P, Keast R, Koczwara B, Kay J, Jefford M, Turner S, Saunders C, Schofield P, Boyle F, Yates P, White K, Miller A, Butt Z, Bonnaudet M, Juraskova I. Development of Web-Based Education Modules to Improve Carer Engagement in Cancer Care: Design and User Experience Evaluation of the e-Triadic Oncology (eTRIO) Modules for Clinicians, Patients, and Carers. JMIR Med Educ 2024; 10:e50118. [PMID: 38630531 DOI: 10.2196/50118] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/27/2023] [Accepted: 01/31/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Carers often assume key roles in cancer care. However, many carers report feeling disempowered and ill-equipped to support patients. Our group published evidence-based guidelines (the Triadic Oncology [TRIO] Guidelines) to improve oncology clinician engagement with carers and the management of challenging situations involving carers. OBJECTIVE To facilitate implementation of the TRIO Guidelines in clinical practice, we aimed to develop, iteratively refine, and conduct user testing of a suite of evidence-based and interactive web-based education modules for oncology clinicians (e-Triadic Oncology [eTRIO]), patients with cancer, and carers (eTRIO for Patients and Carers [eTRIO-pc]). These were designed to improve carer involvement, communication, and shared decision-making in the cancer management setting. METHODS The eTRIO education modules were based on extensive research, including systematic reviews, qualitative interviews, and consultation analyses. Guided by the person-based approach, module content and design were reviewed by an expert advisory group comprising academic and clinical experts (n=13) and consumers (n=5); content and design were continuously and iteratively refined. User experience testing (including "think-aloud" interviews and administration of the System Usability Scale [SUS]) of the modules was completed by additional clinicians (n=5), patients (n=3), and carers (n=3). RESULTS The final clinician module comprises 14 sections, requires approximately 1.5 to 2 hours to complete, and covers topics such as carer-inclusive communication and practices; supporting carer needs; and managing carer dominance, anger, and conflicting patient-carer wishes. The usability of the module was rated by 5 clinicians, with a mean SUS score of 75 (SD 5.3), which is interpreted as good. Clinicians often desired information in a concise format, divided into small "snackable" sections that could be easily recommenced if they were interrupted. The carer module features 11 sections; requires approximately 1.5 hours to complete; and includes topics such as the importance of carers, carer roles during consultations, and advocating for the patient. The patient module is an adaptation of the relevant carer module sections, comprising 7 sections and requiring 1 hour to complete. The average SUS score as rated by 6 patients and carers was 78 (SD 16.2), which is interpreted as good. Interactive activities, clinical vignette videos, and reflective learning exercises are incorporated into all modules. Patient and carer consumer advisers advocated for empathetic content and tone throughout their modules, with an easy-to-read and navigable module interface. CONCLUSIONS The eTRIO suite of modules were rigorously developed using a person-based design methodology to meet the unique information needs and learning requirements of clinicians, patients, and carers, with the goal of improving effective and supportive carer involvement in cancer consultations and cancer care.
Collapse
Affiliation(s)
- Rebekah Laidsaar-Powell
- Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, The University of Sydney, Sydney, Australia
- Psycho-Oncology Co-operative Research Group, The University of Sydney, Sydney, Australia
| | - Sarah Giunta
- Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, The University of Sydney, Sydney, Australia
| | - Phyllis Butow
- Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, The University of Sydney, Sydney, Australia
- Psycho-Oncology Co-operative Research Group, The University of Sydney, Sydney, Australia
| | - Rachael Keast
- Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, The University of Sydney, Sydney, Australia
| | - Bogda Koczwara
- Flinders Medical Centre, Adelaide, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Judy Kay
- School of Computer Science, The University of Sydney, Sydney, Australia
| | - Michael Jefford
- Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Sandra Turner
- Department of Radiation Oncology, Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Christobel Saunders
- Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
| | - Penelope Schofield
- Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Psychology and Iverson Health Innovation Research Institute, Swinburne University, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - Frances Boyle
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Patricia Ritchie Centre for Cancer Care & Research, Mater Hospital, Sydney, Australia
| | - Patsy Yates
- Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Kate White
- Susan Wakil School of Nursing, The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council New South Wales, Sydney, Australia
| | - Annie Miller
- Cancer Council New South Wales, Sydney, Australia
| | - Zoe Butt
- Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, The University of Sydney, Sydney, Australia
| | - Melanie Bonnaudet
- School of Computer Science, The University of Sydney, Sydney, Australia
- School of Electrical Engineering and Computer Science, Kungliga Tekniska högskolan Royal Institute of Technology, Stockholm, Sweden
| | - Ilona Juraskova
- Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, The University of Sydney, Sydney, Australia
- Psycho-Oncology Co-operative Research Group, The University of Sydney, Sydney, Australia
| |
Collapse
|
14
|
Manasyan A, Ross E, Cannata B, Malkoff N, Flores E, Yenikomshian HA, Gillenwater TJ. Navigating Scar Care: An Evaluation of Scar Treatment Patient Education Materials. J Burn Care Res 2024:irae039. [PMID: 38623992 DOI: 10.1093/jbcr/irae039] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Indexed: 04/17/2024]
Abstract
While patient education materials (PEMs) across various specialties have been reported as being too difficult to read, the quality and understandability of PEMs related to scar management have not been assessed. In this study, we report the breadth of scar management interventions and readability of online PEMs authored by academic societies and university hospitals. Websites of academic medical societies and university hospitals with scar revision PEMs were assessed for relevance. PEM readability was assessed via Flesch Reading Ease, Flesch-Kincaid Grade Level, and Gunning-Fox Index scores. Understandability and actionability were evaluated using the Patient Education Material Assessment Tool (PEMAT). A total of 26 scar revision PEMs met the inclusion criteria. The most commonly mentioned scar management interventions were scar revision surgery (73%) and laser scar revision (70%), with minimal emphasis on non-invasive methods like scar massage or sun protection. Readability analysis yielded a mean Flesch reading level of 8.8. Overall PEMAT understandability of online scar treatment PEMs was moderate, with a median of 76.0% (IQR 71.5 - 80.5%). PEMs from all specialties and institution types were lacking in actionability, with median actionability of 40.8% (IQR 38.1-60.0%). Online scar revision PEMs included a wide breadth of scar management interventions, however the least costly interventions of sun protection and scar massage were not commonly included. PEMs for scar management could be improved by simplifying language, including visual aids, and including checklists or specific steps patients can take to take action on scar management interventions.
Collapse
Affiliation(s)
- Artur Manasyan
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Erin Ross
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Brigette Cannata
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Nicolas Malkoff
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Elizabeth Flores
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Haig A Yenikomshian
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA 90033, USA
| | - T Justin Gillenwater
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA 90033, USA
| |
Collapse
|
15
|
Bhatt C, Lin E, Ferreira-Legere LE, Jackevicius CA, Ko DT, Lee DS, Schade K, Johnston S, Anderson TJ, Udell JA. Evaluating Readability, Understandability, and Actionability of Online Printable Patient Education Materials for Cholesterol Management: A Systematic Review. J Am Heart Assoc 2024; 13:e030140. [PMID: 38567668 DOI: 10.1161/jaha.123.030140] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 12/01/2023] [Indexed: 04/04/2024]
Abstract
BACKGROUND Dyslipidemia management is a cornerstone in cardiovascular disease prevention and relies heavily on patient adherence to lifestyle modifications and medications. Numerous cholesterol patient education materials are available online, but it remains unclear whether these resources are suitable for the majority of North American adults given the prevalence of low health literacy. This review aimed to (1) identify printable cholesterol patient education materials through an online search, and (2) evaluate the readability, understandability, and actionability of each resource to determine its utility in practice. METHODS AND RESULTS We searched the MEDLINE database for peer-reviewed educational materials and the websites of Canadian and American national health organizations for gray literature. Readability was measured using the Flesch-Kincaid Grade Level, and scores between fifth- and sixth-grade reading levels were considered adequate. Understandability and actionability were scored using the Patient Education Materials Assessment Tool and categorized as superior (>80%), adequate (50%-70%), or inadequate (<50%). Our search yielded 91 results that were screened for eligibility. Among the 22 educational materials included in the study, 15 were identified through MEDLINE, and 7 were from websites. The readability across all materials averaged an 11th-grade reading level (Flesch-Kincaid Grade Level=11.9±2.59). The mean±SD understandability and actionability scores were 82.8±6.58% and 40.9±28.60%, respectively. CONCLUSIONS The readability of online cholesterol patient education materials consistently exceeds the health literacy level of the average North American adult. Many resources also inadequately describe action items for individuals to self-manage their cholesterol, representing an implementation gap in cardiovascular disease prevention.
Collapse
Affiliation(s)
- Chaitanya Bhatt
- Department of Medicine University of Toronto Toronto Ontario Canada
- Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada
- ICES Toronto Ontario Canada
| | - Ethan Lin
- Department of Medicine University of Toronto Toronto Ontario Canada
- Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada
- ICES Toronto Ontario Canada
| | | | - Cynthia A Jackevicius
- ICES Toronto Ontario Canada
- Department of Pharmacy Practice and Administration, College of Pharmacy Western University of Health Sciences Pomona CA USA
- Veterans Affairs Greater Los Angeles Healthcare System Los Angeles CA USA
- Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto Toronto Ontario Canada
- University Health Network Toronto Ontario Canada
| | - Dennis T Ko
- Department of Medicine University of Toronto Toronto Ontario Canada
- ICES Toronto Ontario Canada
- Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto Toronto Ontario Canada
- Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre University of Toronto Toronto Ontario Canada
| | - Douglas S Lee
- Department of Medicine University of Toronto Toronto Ontario Canada
- Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada
- ICES Toronto Ontario Canada
- Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto Toronto Ontario Canada
- Division of Cardiology, Peter Munk Cardiac Centre University Health Network Toronto Ontario Canada
- Ted Rogers Centre for Heart Research Toronto Ontario Canada
| | - Kathryn Schade
- Faculty of Arts and Social Science Huron University College London Ontario Canada
| | - Sharon Johnston
- Institut du Savoir Montfort, Department of Family Medicine University of Ottawa Ottawa Ontario Canada
| | - Todd J Anderson
- Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary Alberta Canada
| | - Jacob A Udell
- Department of Medicine University of Toronto Toronto Ontario Canada
- Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada
- ICES Toronto Ontario Canada
- Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto Toronto Ontario Canada
- Division of Cardiology, Peter Munk Cardiac Centre University Health Network Toronto Ontario Canada
- Women's College Hospital Toronto Ontario Canada
| |
Collapse
|
16
|
Green BB. Self-measured Blood Pressure Monitoring: Challenges and Opportunities. Am J Hypertens 2024; 37:318-320. [PMID: 38315757 DOI: 10.1093/ajh/hpae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/07/2024] Open
Affiliation(s)
- Beverly B Green
- Kaiser Permanente Washington Health Research Institute, Washington Permanente Medical Group, Seattle, Washington, USA
- Department of Population Health Sciences, Kaiser Permanente Bernard J. Tyson School of Medicine, Department of Health Systems Science, Pasadena, California, USA
| |
Collapse
|
17
|
Gordon H, Ramirez G, Harwell EL, Bloss JE, Gámez R, LePrevost CE. Exploring the learning preferences of farmworker-serving community health workers. Health Info Libr J 2024. [PMID: 38616382 DOI: 10.1111/hir.12528] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024]
Abstract
Community health workers are responsible for finding, processing, and transferring health information to communities with limited access to health-related resources, including farmworkers. This paper is the culmination of an undergraduate student research project to explore the learning processes and preferences of farmworker-serving community health workers in the USA. The project was designed for students from farmworker or agricultural backgrounds at two North Carolina universities and was supported by a North Carolina Department of Health and Human Services workforce development grant. Semi-structured interviews were conducted, in person and virtually, with a convenience sample of 17 current and former community health workers. The interview data were analysed thematically and identified a preference for a combination of learning styles, with visual and hands-on learning being the most preferred. Community health workers also identified the importance of learning preferences in relation to their responsibilities as health educators. This study provides librarians, along with public health and medical professionals, with useful information about learning preferences to inform the creation of new and varied learning materials for community health workers.
Collapse
Affiliation(s)
- Hannah Gordon
- Department of Applied Ecology, College of Agriculture and Life Sciences, NC State University, Raleigh, North Carolina, USA
| | - Genesis Ramirez
- Department of Applied Ecology, College of Agriculture and Life Sciences, NC State University, Raleigh, North Carolina, USA
| | - Emery L Harwell
- Department of Applied Ecology, College of Agriculture and Life Sciences, NC State University, Raleigh, North Carolina, USA
| | - Jamie E Bloss
- Laupus Health Sciences Library, East Carolina University, Greenville, North Carolina, USA
| | - Raúl Gámez
- Center for the Study of Higher & Postsecondary Education, Marsal Family School of Education, University of Michigan, Ann Arbor, Michigan, USA
| | - Catherine E LePrevost
- Department of Applied Ecology, College of Agriculture and Life Sciences, NC State University, Raleigh, North Carolina, USA
| |
Collapse
|
18
|
Mastrokostas PG, Mastrokostas LE, Emara AK, Wellington IJ, Ginalis E, Houten JK, Khalsa AS, Saleh A, Razi AE, Ng MK. Modern Internet Search Analytics: Is There a Difference in What Patients are Searching Regarding the Operative and Nonoperative Management of Scoliosis? Global Spine J 2024:21925682241248110. [PMID: 38613478 DOI: 10.1177/21925682241248110] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2024] Open
Abstract
STUDY DESIGN Observational Study. OBJECTIVES This study aimed to investigate the most searched types of questions and online resources implicated in the operative and nonoperative management of scoliosis. METHODS Six terms related to operative and nonoperative scoliosis treatment were searched on Google's People Also Ask section on October 12, 2023. The Rothwell classification was used to sort questions into fact, policy, or value categories, and associated websites were classified by type. Fischer's exact tests compared question type and websites encountered between operative and nonoperative questions. Statistical significance was set at the .05 level. RESULTS The most common questions concerning operative and nonoperative management were fact (53.4%) and value (35.5%) questions, respectively. The most common subcategory pertaining to operative and nonoperative questions were specific activities/restrictions (21.7%) and evaluation of treatment (33.3%), respectively. Questions on indications/management (13.2% vs 31.2%, P < .001) and evaluation of treatment (10.1% vs 33.3%, P < .001) were associated with nonoperative scoliosis management. Medical practice websites were the most common website to which questions concerning operative (31.9%) and nonoperative (51.4%) management were directed to. Operative questions were more likely to be directed to academic websites (21.7% vs 10.0%, P = .037) and less likely to be directed to medical practice websites (31.9% vs 51.4%, P = .007) than nonoperative questions. CONCLUSIONS During scoliosis consultations, spine surgeons should emphasize the postoperative recovery process and efficacy of conservative treatment modalities for the operative and nonoperative management of scoliosis, respectively. Future research should assess the impact of website encounters on patients' decision-making.
Collapse
Affiliation(s)
- Paul G Mastrokostas
- College of Medicine, State University of New York (SUNY) Downstate, Brooklyn, NY, USA
| | | | - Ahmed K Emara
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Ian J Wellington
- Department of Orthopaedic Surgery, University of Connecticut, Hartford, CT, USA
| | | | - John K Houten
- Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, USA
| | - Amrit S Khalsa
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Ahmed Saleh
- Maimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, NY, USA
| | - Afshin E Razi
- Maimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, NY, USA
| | - Mitchell K Ng
- Maimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, NY, USA
| |
Collapse
|
19
|
Sear C. Peripheral neuropathic pain: supporting patients with self-management. Nurs Stand 2024; 39:71-75. [PMID: 38495010 DOI: 10.7748/ns.2024.e12318] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 03/19/2024]
Abstract
Peripheral neuropathic pain is a complex condition that can adversely affect people's quality of life. Alongside pharmacological interventions, nurses can support patients to self-manage their pain using non-pharmacological interventions such as lifestyle changes and exercise. To do this effectively, nurses should be able to recognise the signs and symptoms of peripheral neuropathic pain and be able to educate patients on appropriate self-management approaches. It is important that nurses provide education, advice and information in a way that patients can understand and check this understanding. This article provides an overview of how nurses can support patients to self-manage peripheral neuropathic pain by using various non-pharmacological interventions.
Collapse
Affiliation(s)
- Charlotte Sear
- Harefield Hospital, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, Harefield, England
| |
Collapse
|
20
|
DeMik DE, Lonner JH, Cholewa JM, Anderson MB, Kamath AF, Tripuraneni KR. Association Between Digitally Provided Education and 90-Day Return to Sexual Activity Following Total Knee Arthroplasty: A Randomized Controlled Trial. J Arthroplasty 2024; 39:916-920. [PMID: 37852452 DOI: 10.1016/j.arth.2023.10.014] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/26/2023] [Accepted: 10/02/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Contemporary total knee arthroplasty patients have increased expectations of returning to predisease function, including sexual activity (SA). The purpose of this study was to determine whether patients using a digital care management platform (DCMP) were more likely to have a higher rate and frequency of return to SA. METHODS We conducted an exploratory analysis of a prospective, multicenter, randomized controlled trial that enrolled patients undergoing total knee arthroplasty. A total of 304 patients were randomized to a DCMP (n = 119) providing preoperative and postoperative education regarding return to SA or standard postoperative care (control group; n = 185). Return to SA, assessed via questionnaire, patient-reported outcome measures, Timed Up and Go test, single leg stance, active range of motion and need for manipulation under anesthesia were assessed at 90 days postoperatively. RESULTS More patients in the DCMP group returned to SA compared to control at 90 days (58.4 versus 39.6%, P = .018); however, the control group resumed SA sooner (33.1 versus 42.0 days, P = .023). Patients who returned to SA were younger (61.6 versus 65.9 year), more often men (56 versus 35%) (P < .001), higher performing on the Timed Up and Go and single leg stance tests (P < .001), and had greater active range of motion (P = .007). There were no differences in patient-reported outcome measures or need for manipulation under anesthesia between patients that returned to SA and those who did not. CONCLUSIONS More patients using a DCMP resumed SA at 90 days; however, patients in the control group returned to SA sooner. Those who returned to SA were younger, possessed greater physical function, and were more often men.
Collapse
Affiliation(s)
- David E DeMik
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania
| | - Jess H Lonner
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania
| | | | | | - Atul F Kamath
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
| | | |
Collapse
|
21
|
Tempany J, Collier A, Ali A. The impact of a preoperative evaluation process on weight reduction and glycemic control in patients undergoing bariatric and metabolic surgery. Obes Sci Pract 2024; 10:e735. [PMID: 38465290 PMCID: PMC10924108 DOI: 10.1002/osp4.735] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction Metabolic surgery is a sustainable intervention for obesity and type 2 diabetes. Preoperative education optimizes weight loss and glycemic control outcomes. Objective This study aimed to determine the effect of a generalized preoperative evaluation process (PEP) in patients who underwent bariatric surgery on weight loss and glycemic control pre- and post-surgery. Methods Data were retrospectively collected and analyzed for patients with type 2 diabetes who underwent bariatric surgery between 2010 and 2016. Patients were categorized into two groups determined by participation in the PEP. The groups were named the PEP group and non-PEP group. The correlation among engagement in the PEP was determined using the chi-square test and t-test. Statistical analysis with p < 0.05 was deemed significant. Results 129 patients were included in the study; 86 females (67%) and 43 males (33%). Fifty-nine patients (46%) engaged in the PEP and 70 (54%) patients did not engage in the PEP. A greater reduction in weight loss was observed in the PEP group versus the non-PEP group from initial enrollment to pre-surgery (14.3 ± 9.2 kg vs. 11.6 ± 9.2 kg; p = 0.11), and from pre-surgery to 2-years post-surgery (20.6 ± 14.8 kg vs. 16.9 ± 15.6 kg; p = 0.17). A greater reduction in HbA1c from initial enrollment to pre-surgery was seen in the PEP group versus the non-PEP group (0.90 ± 1.28% vs. 0.63 ± 1.07%); however, this was not maintained from pre-surgery to 2-year post-surgery (0.51 ± 1.18% vs. 0.70 ± 1.73%). In both cases, the statistical difference was insignificant. Conclusion The PEP was not associated with improvements in short-term weight loss or glycemic control pre-surgery and a 2-years post-surgery. Patients may benefit from individually tailored preoperative weight management strategies.
Collapse
Affiliation(s)
| | - Andrew Collier
- School of Health & Life SciencesGlasgow Caledonian UniversityGlasgowUK
| | - Abdulmajid Ali
- Bariatric Surgery UnitUniversity Hospital AyrAyrUK
- University of the West of ScotlandGlasgowUK
| |
Collapse
|
22
|
Hogan A, Hughes L, Coyne E. Nurses' assessment of health literacy requirements for adult inpatients: An integrative review. Health Promot J Austr 2024; 35:504-517. [PMID: 37443427 DOI: 10.1002/hpja.780] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 05/16/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
ISSUE ADDRESSED This paper reviews current research which examines nurses' assessment of patient's health literacy in the acute hospital setting. Research highlights, that patients with low health literacy have more frequent hospitalisations and are more likely to be re-admitted. Within the healthcare team, nurses are primarily responsible for teaching patients and deciphering health communication, to enhance understanding. Within the acute care setting, there remains a disparity in patient understanding of information, despite nurse-led education. The health literacy assessment and tailoring of information by nurses, is becoming more important with shorter stays, plus limited family visits and the wearing of masks with COVID-19 related changes. METHODS An integrative review across four nursing databases, from 2010 and June 2022 was conducted. The integrative framework included problem identification, literature search, data evaluation, data analysis with thematic analysis, and results presentation. RESULTS Nine studies were included. Common themes were nurses' overestimation of patients' health literacy, the use of universal precautions, and adapting communication techniques to improve education moments. CONCLUSION The findings of this review indicate a tendency among nurses to overestimate their patients' health literacy levels, which can result in ineffective health education and inadequate discharge planning. SO WHAT Nurses decipher health communication for their patients. Designing tailored patient communication and education could potentially be a cost saving measure for hospitals by reducing length of stay and reducing readmissions. Health literacy training should be incorporated into nursing practice.
Collapse
Affiliation(s)
- Alana Hogan
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- Caboolture Hospital, Caboolture, Queensland, Australia
| | - Lynda Hughes
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
| | - Elisabeth Coyne
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- School of Nursing and Midwifery, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
23
|
Lambert C, Maitland H, Ghanima W. Risk-based and individualised management of bleeding and thrombotic events in adults with primary immune thrombocytopenia (ITP). Eur J Haematol 2024; 112:504-515. [PMID: 38088207 DOI: 10.1111/ejh.14154] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 03/19/2024]
Abstract
Although bleeding is one of the main symptoms of primary immune thrombocytopenia (ITP), risk factors for bleeding have yet to be fully established. Low platelet count (PC; <20-30 × 109 /L) is generally indicative of increased risk of bleeding. However, PC and bleeding events cannot be fully correlated; many other patient- and disease-related factors are thought to contribute to increased bleeding risk. Furthermore, even though ITP patients have thrombocytopenia and are at increased risk of bleeding, ITP also carries higher risk of thrombotic events. Factors like older age and certain ITP treatments are associated with increased thrombotic risk. Women's health in ITP requires particular attention concerning haemorrhagic and thrombotic complications. Management of bleeding/thrombotic risk, and eventually antithrombotic therapies in ITP patients, should be based on individual risk profiles, using a tailored, patient-centric approach. Currently, evidence-based recommendations and validated tools are lacking to support decision-making and help clinicians weigh risk of bleeding against thrombosis. Moreover, evidence is lacking about optimal PC for achieving haemostasis in invasive procedures settings. Further research is needed to fully define risk factors for each event, enabling development of comprehensive risk stratification approaches. This review discusses risk-based and individualised management of bleeding and thrombosis risk in adults with primary ITP.
Collapse
Affiliation(s)
- Catherine Lambert
- Hemostasis and Thrombosis Unit, Division of Hematology, Cliniques universitaires Saint-Luc, UCLouvain, Brussels, Belgium
| | - Hillary Maitland
- Division of Hematology and Oncology, University of Virginia Medical Center, Charlottesville, Virginia, USA
| | - Waleed Ghanima
- Department of Hemato-oncology, Østfold Hospital, Oslo University, Oslo, Norway
- Department of Hematology, Institute of Clinical Medicine, Oslo University, Oslo, Norway
| |
Collapse
|
24
|
Morse E, Odigie E, Gillespie H, Rameau A. The Readability of Patient-Facing Social Media Posts on Common Otolaryngologic Diagnoses. Otolaryngol Head Neck Surg 2024; 170:1051-1058. [PMID: 38018504 DOI: 10.1002/ohn.584] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/09/2023] [Accepted: 10/28/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To assess the readability of patient-facing educational information about the most common otolaryngology diagnoses on popular social media platforms. STUDY DESIGN Cross-sectional study. SETTING Social media platforms. METHODS The top 5 otolaryngologic diagnoses were identified from the National Ambulatory Medical Care Survey Database. Facebook, Twitter, TikTok, and Instagram were searched using these terms, and the top 25 patient-facing posts from unique accounts for each search term and poster type (otolaryngologist, other medical professional, layperson) were identified. Captions, text, and audio from images and video, and linked articles were extracted. The readability of each post element was calculated with multiple readability formulae. Readability was summarized and was compared between poster types, platforms, and search terms via Kruskal-Wallis testing. RESULTS Median readability, by grade level, by grade level, was greater than 10 for captions, 5 for image-associated text, and 9 for linked articles. Captions and images in posts by laypeople were significantly more readable than captions by otolaryngologists or other medical professionals, but there was no difference for linked articles. All post components were more readable in posts about cerumen than those about other search terms. CONCLUSIONS When examining the readability of posts on social media regarding the most common otolaryngology diagnoses, we found that many posts are less readable than recommended for patients, and found that posts by laypeople were significantly more readable than those by medical professionals. Medical professionals should work to make educational social media posts more readable to facilitate patient comprehension.
Collapse
Affiliation(s)
- Elliot Morse
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Eseosa Odigie
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, USA
- Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, USA
| | - Helen Gillespie
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, USA
- Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, USA
| | - Anaïs Rameau
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, USA
- Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, USA
| |
Collapse
|
25
|
Roeser J, Bayliss N, Blom M, Croney R, Lanman L, Laks J, Lyons M, Proulx L, Tsatali M, Westerlund K, Georges J. Insights and recommendations for working collaboratively and improving care in Alzheimer's disease: Learnings from the Finding Alzheimer's Solutions Together (F.A.S.T.) Council. Health Expect 2024; 27:e14040. [PMID: 38629481 PMCID: PMC11022292 DOI: 10.1111/hex.14040] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/07/2024] [Accepted: 03/19/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Collaborations between patient organisations (POs) and the pharmaceutical industry can help identify and address the unmet needs of people living with a disease. In Alzheimer's disease (AD), the scale and complexity of the current unmet needs call for a broad and cross-sectoral collaboration, including people living with Alzheimer's (PLWA), their care partners and the wider research community. OBJECTIVE This study aimed to describe learnings from the Finding Alzheimer's Solutions Together (F.A.S.T.) Council, a collaboration between POs and Roche, convened to better understand the unmet needs of PLWA and their care partners. RESULTS 1. Learnings from the collaboration, including clarifying objectives and members' expectations upfront, and establishing a set of guiding values and engagement principles. 2. Insights and recommendations for improving care in AD, including a wide range of unmet needs and potential solutions, systematically captured throughout the PLWA journey. These have resulted in several published reports and other outcomes, including (1) 'Portraits of care', highlighting the role of care partners, and the impact of coronavirus disease 2019 on care; (2) Clinical trial guidebook, recommending how PLWA and care partner experience can be incorporated into trial design; (3) 'Commitments Catalogue', highlighting progress by governmental organisations in achieving their commitments; and (4) a report to guide policy on improving diversity, equity and inclusion in clinical trials. CONCLUSIONS Close collaboration between POs and the pharmaceutical industry in AD can enable effective research, in which PLWA and care partners are engaged as 'experts through experience' to help identify key unmet needs and co-create solutions with the wider AD research community. This paper and the work undertaken by the F.A.S.T. Council may act as a blueprint for meaningful collaboration between POs and the pharmaceutical industry. PATIENT OR PUBLIC CONTRIBUTION The paper reports the collaboration between POs, the F.A.S.T. Council and Roche to progress towards a future in which PLWA can live fulfilling lives with their disease managed well. CLINICAL TRIAL REGISTRATION Not applicable.
Collapse
Affiliation(s)
| | | | - Marco Blom
- Alzheimer NetherlandsAmersfoortThe Netherlands
| | | | | | - Jerson Laks
- Federação Brasileira das Associações de AlzheimerRio de JaneiroBrazil
| | | | - Lea Proulx
- Roche Innovation CenterF. Hoffmann‐La Roche LtdBaselSwitzerland
| | | | | | | |
Collapse
|
26
|
Arif HA, LeBrun G, Moore ST, Friscia DA. Analysis of the Most Popular Online Ankle Fracture-Related Patient Education Materials. Foot Ankle Orthop 2024; 9:24730114241241310. [PMID: 38577700 PMCID: PMC10989055 DOI: 10.1177/24730114241241310] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
Background Given the increasing accessibility of Internet access, it is critical to ensure that the informational material available online for patient education is both accurate and readable to promote a greater degree of health literacy. This study sought to investigate the quality and readability of the most popular online resources for ankle fractures. Methods After conducting a Google search using 6 terms related to ankle fractures, we collected the first 20 nonsponsored results for each term. Readability was evaluated using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Gunning Fog Index (GFI) instruments. Quality was evaluated using custom created Ankle Fracture Index (AFI). Results A total of 46 of 120 articles met the inclusion criteria. The mean FKGL, FRE, and GFI scores were 8.4 ± 0.5, 57.5 ± 3.2, and 10.5 ± 0.5, respectively. The average AFI score was 15.4 ± 1.4, corresponding to an "acceptable" quality rating. Almost 70% of articles (n = 32) were written at or below the recommended eighth-grade reading level. Most articles discussed the need for imaging in diagnosis and treatment planning while neglecting to discuss the risks of surgery or potential future operations. Conclusion We found that online patient-facing materials on ankle fractures demonstrated an eighth-grade average reading grade level and an acceptable quality on content analysis. Further work should surround increasing information regarding risk factors, complications for surgery, and long-term recovery while ensuring that readability levels remain below at least the eighth-grade level.
Collapse
Affiliation(s)
- Haad A. Arif
- School of Medicine, University of California Riverside, Riverside, CA, USA
| | | | - Simon T. Moore
- School of Medicine, University of California Riverside, Riverside, CA, USA
| | - David A. Friscia
- School of Medicine, University of California Riverside, Riverside, CA, USA
- Eisenhower Desert Orthopedic Center, Rancho Mirage, CA, USA
| |
Collapse
|
27
|
Tecce N, de Alteriis G, de Alteriis G, Verde L, Tecce MF, Colao A, Muscogiuri G. Harnessing the Synergy of SGLT2 Inhibitors and Continuous Ketone Monitoring (CKM) in Managing Heart Failure among Patients with Type 1 Diabetes. Healthcare (Basel) 2024; 12:753. [PMID: 38610175 PMCID: PMC11011472 DOI: 10.3390/healthcare12070753] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Heart failure (HF) management in type 1 diabetes (T1D) is particularly challenging due to its increased prevalence and the associated risks of hospitalization and mortality, driven by diabetic cardiomyopathy. Sodium-glucose cotransporter-2 inhibitors (SGLT2-is) offer a promising avenue for treating HF, specifically the preserved ejection fraction variant most common in T1D, but their utility is hampered by the risk of euglycemic diabetic ketoacidosis (DKA). This review investigates the potential of SGLT2-is in T1D HF management alongside emergent Continuous Ketone Monitoring (CKM) technology as a means to mitigate DKA risk through a comprehensive analysis of clinical trials, observational studies, and reviews. The evidence suggests that SGLT2-is significantly reduce HF hospitalization and enhance cardiovascular outcomes. However, their application in T1D patients remains limited due to DKA concerns. CKM technology emerges as a crucial tool in this context, offering real-time monitoring of ketone levels, which enables the safe incorporation of SGLT2-is into treatment regimes by allowing for early detection and intervention in the development of ketosis. The synergy between SGLT2-is and CKM has the potential to revolutionize HF treatment in T1D, promising improved patient safety, quality of life, and reduced HF-related morbidity and mortality. Future research should aim to employ clinical trials directly assessing this integrated approach, potentially guiding new management protocols for HF in T1D.
Collapse
Affiliation(s)
- Nicola Tecce
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Napoli, Italy; (G.d.A.); (A.C.)
| | - Giorgio de Alteriis
- Department of Industrial Engineering, University of Naples Federico II, Piazzale Tecchio 80, 80125 Naples, Italy;
| | - Giulia de Alteriis
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Napoli, Italy; (G.d.A.); (A.C.)
| | - Ludovica Verde
- Centro Italiano per la Cura e il Benessere del Paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Napoli, Italy;
| | - Mario Felice Tecce
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Italy;
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Napoli, Italy; (G.d.A.); (A.C.)
- Cattedra Unesco “Educazione alla Salute e Allo Sviluppo Sostenibile”, University Federico II, 80131 Napoli, Italy
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Napoli, Italy; (G.d.A.); (A.C.)
- Cattedra Unesco “Educazione alla Salute e Allo Sviluppo Sostenibile”, University Federico II, 80131 Napoli, Italy
| |
Collapse
|
28
|
Hill RC, Ho B, Lipner SR. Assuaging patient anxiety about nail biopsies with an animated educational video. J Am Acad Dermatol 2024:S0190-9622(24)00542-5. [PMID: 38556090 DOI: 10.1016/j.jaad.2024.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/08/2024] [Accepted: 03/21/2024] [Indexed: 04/02/2024]
Affiliation(s)
| | - Benedict Ho
- Weill Cornell Medical College, New York, New York
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York.
| |
Collapse
|
29
|
Karadag AS, Kandi B, Sanlı B, Ulusal H, Basusta H, Sener S, Calıka S. Social Media Use in Dermatology in Turkey: Challenges and Tips for Patient Health. JMIR Dermatol 2024; 7:e51267. [PMID: 38546714 PMCID: PMC11009853 DOI: 10.2196/51267] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/25/2024] [Accepted: 01/28/2024] [Indexed: 04/14/2024] Open
Abstract
Social media has established its place in our daily lives, especially with the advent of the COVID-19 pandemic. It has become the leading source of information for dermatological literacy on various topics, ranging from skin diseases to everyday skincare and cosmetic purposes in the present digital era. Accumulated evidence indicates that accurate medical content constitutes only a tiny fraction of the exponentially growing dermatological information on digital platforms, highlighting an unmet patient need for access to evidence-based information on social media. However, there have been no recent local publications from Turkey analyzing and assessing the key elements in raising dermatological literacy and awareness in digital communication for patients. To the best of our knowledge, this study is the first collaborative work between health care professionals and a social media specialist in the medical literature. Furthermore, it represents the first author-initiated implementation science attempt focusing on the use of social media in addressing dermatological problems, with the primary end point of increasing health literacy and patient benefits. The multidisciplinary expert panel was formed by 4 dermatologists with academic credentials and significant influence in public health and among patients on digital platforms. A social media specialist, who serves as a guest lecturer on "How social media works" at Istanbul Technical University, Turkey, was invited to the panel as an expert on digital communication. The panel members had a kickoff meeting to establish the context for the discussion points. The context of the advisory board meeting was outlined under 5 headlines. Two weeks later, the panel members presented their social media account statistics, defined the main characteristics of dermatology patients on social media, and discussed their experiences with patients on digital platforms. These discussions were organized under the predefined headlines and in line with the current literature. We aimed to collect expert opinions on identifying the main characteristics of individuals interested in dermatological topics and to provide recommendations to help dermatologists increase evidence-based dermatological content on social media. Additionally, experts discussed paradigms for dermatological outreach and the role of dermatologists in reducing misleading information on digital platforms in Turkey. The main concluding remark of this study is that dermatologists should enhance their social media presence to increase evidence-based knowledge by applying the principles of patient-physician communication on digital platforms while maintaining a professional stance. To achieve this goal, dermatologists should share targeted scientific content after increasing their knowledge about the operational rules of digital channels. This includes correctly identifying the needs of those seeking information on social media and preparing a sustainable social media communication plan. This viewpoint reflects Turkish dermatologists' experiences with individuals searching for dermatological information on local digital platforms; therefore, the applicability of recommendations may be limited and should be carefully considered.
Collapse
Affiliation(s)
- Ayse Serap Karadag
- Department of Dermatology, Medical School of Istanbul Arel University, Istanbul, Turkey
| | | | - Berna Sanlı
- Department of Dermatology, Medical School of Pamukkale University, Denizli, Turkey
| | - Hande Ulusal
- Department of Dermatology, Medical School of Biruni University, Istanbul, Turkey
| | | | | | | |
Collapse
|
30
|
Finch LA, Levy MS, Thiele A, Jeudin P, Huang M. Barriers to cervical cancer prevention in a safety net clinic: gaps in HPV vaccine provider recommendation and series completion among Ob/Gyn patients. Front Oncol 2024; 14:1359160. [PMID: 38606100 PMCID: PMC11007179 DOI: 10.3389/fonc.2024.1359160] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/13/2024] [Indexed: 04/13/2024] Open
Abstract
Objective The primary objective of this study was to evaluate patients' knowledge regarding HPV vaccination and vaccine uptake in a diverse patient population. The secondary objective was to evaluate factors influencing the decision to vaccinate, potential barriers to vaccination, and to assess whether HPV vaccines were offered to or discussed with eligible patients in a safety net Obstetrics and Gynecology (Ob/Gyn) clinic. Methods A 28-item survey was developed using Likert scale survey questions to assess patient agreement with statements regarding HPV and the vaccine. The surveys were administered to patients in the Ob/Gyn outpatient clinics from May 2021 through September 2022. Additionally, pharmacy data were reviewed and chart review was performed as a quality improvement initiative to assess the impact of expanded HPV vaccine eligibility to patients with private insurance on vaccine uptake. Descriptive statistics were performed. Results 304 patients completed surveys from May 2021 through September 2022. The median age of respondents was 32 (range 18-80). 16 (5%) were Non-Hispanic White, 124 (41%) were Hispanic White, 58 (19%) were Non-Hispanic Black, 6 (2%) were Hispanic Black, 29 (9.5%) were Haitian, 44 (14%) were Hispanic Other, 7 (2%) were Non-Hispanic Other, 20 (6.6%) did not respond. 45 (14%) patients were uninsured. Many patients (62%) reported that a physician had never discussed HPV vaccination with them. Seventy nine percent of patients reported they had never received the HPV vaccine, and 69% of patients reported that lack of a medical provider recommendation was a major barrier. Among patients to whom HPV vaccination had been recommended, 57% reported that the vaccine was not available the same day in clinic. Conclusion Our study demonstrated that many patients never had a provider discuss HPV vaccination with them and never received the HPV vaccine. Additionally, amongst those who did initiate HPV vaccination, completion of the series remains a key barrier. Ensuring that providers discuss HPV vaccination and that patients receive HPV vaccines, along with expanding access to and convenience of HPV vaccination are critical aspects of preventing cervical cancer.
Collapse
Affiliation(s)
- Lindsey A. Finch
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Jackson Memorial Hospital, Miami, FL, United States
| | - Morgan S. Levy
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Amanda Thiele
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Patricia Jeudin
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center/University of Miami Miller School of Medicine, Miami, FL, United States
| | - Marilyn Huang
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center/University of Miami Miller School of Medicine, Miami, FL, United States
| |
Collapse
|
31
|
Byerley CO, Horne D, Gong M, Musgrave S, Valaas LA, Rickard B, Yoon H, Park MS, Mirin A, Joshua S, Lavender H, You S. An effective COVID-19 vaccine hesitancy intervention focused on the relative risks of vaccination and infection. Sci Rep 2024; 14:7419. [PMID: 38548828 PMCID: PMC10978892 DOI: 10.1038/s41598-024-57841-1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 03/22/2024] [Indexed: 04/01/2024] Open
Abstract
We designed the Relative Risk Tool (RRT) to help people assess the relative risks associated with COVID-19 vaccination and infection. In May 2022 (N = 400) and November 2022 (N = 615), U.S. residents participated in a survey that included questions about the risks of vaccination and infection. In both cohorts, we found an association between relative risk perception and vaccine hesitancy. Participants in the May cohort were randomly assigned an intervention: to see information from the RRT or the Centers for Disease Control and Prevention (CDC). After the intervention, participants answered the same questions about risk perception and vaccination intent again. The RRT was more effective than the CDC at changing risk perception and increasing vaccination intent. In November, the survey structure was the same, but the RRT was the only intervention included, and we confirmed that the RRT was effective at changing opinions in this new sample. Importantly, the RRT provided accurate information about the risks of serious adverse outcomes to vaccination and still increased vaccination intent. Our work suggests that the RRT helps people assess relative risk, which can in turn help empower them to make informed decisions and ultimately reduce vaccine hesitancy.
Collapse
Affiliation(s)
- Cameron O'Neill Byerley
- Department of Mathematics, Science, and Social Studies Education, University of Georgia, Athens, 30606, USA.
| | - Dru Horne
- Department of Mathematics, Science, and Social Studies Education, University of Georgia, Athens, 30606, USA
| | - Mina Gong
- Department of Mathematics, Science, and Social Studies Education, University of Georgia, Athens, 30606, USA
| | - Stacy Musgrave
- Department of Mathematics and Statistics, Cal Poly Pomona, Pomona, 91768, USA
| | - Laura A Valaas
- Department of Dermatology, University of Washington, Seattle, 98195, USA
| | - Brian Rickard
- Department of Mathematical Sciences, University of Arkansas, Fayetteville, 72701, USA
| | - Hyunkyoung Yoon
- Department of Mathematics and Statistics, Cal Poly Pomona, Pomona, 91768, USA
| | - Min Sook Park
- Department of Information Studies, University of Wisconsin-Milwaukee, Milwaukee, 53201, USA
| | - Alison Mirin
- Department of Mathematics, University of Arizona, Tucson, 85721, USA
| | | | - Heather Lavender
- Department of Mathematics, Science, and Social Studies Education, University of Georgia, Athens, 30606, USA
| | - Sukjin You
- Department of Information Studies, University of Wisconsin-Milwaukee, Milwaukee, 53201, USA
| |
Collapse
|
32
|
Kumpf VJ, Gray B, Monczka J, Zeraschi S, Klek S. Parenteral nutrition at home/long-term parenteral nutrition. Am J Health Syst Pharm 2024:zxae081. [PMID: 38527076 DOI: 10.1093/ajhp/zxae081] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Indexed: 03/27/2024] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE Some diseases require that patients receive parenteral nutrition (PN) over a prolonged time period. Long-term administration of PN can further complicate an already complex therapy, posing additional risk of potential complications. This article is based on presentations and discussions held at the International Safety and Quality of PN Summit, providing insights into aspects of home PN (HPN) and examples of good HPN practice. SUMMARY One critical step in the HPN process is when patients transition from a hospital to a home setting, and vice versa. Generally, electronic PN ordering is not feasible in an HPN setting, leading to potential difficulties in communication and coordination. HPN requires that patients (or their home caregivers) administer PN, and thus their education and competency are crucial. Likewise, the choice of PN formulation is of great importance. For example, using more modern intravenous lipid emulsions containing medium-chain triglycerides, olive oil, and/or fish oil can provide benefits in terms of liver function during long-term HPN. Internationally, there are wide variations in delivery of HPN, with compounded PN dominating in some countries while others make greater use of market-authorized multichamber bags (MCBs). Patient-related factors, institutional considerations, and the availability of different MCB formulations, are also contributing factors guiding formulation and delivery system preferences. CONCLUSION Education and communication remain key components of a successful HPN process. The information shared here may help to motivate efforts to improve HPN processes and to consider the often-differing perspectives of patients and their healthcare professionals.
Collapse
Affiliation(s)
- Vanessa J Kumpf
- Center for Human Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Sarah Zeraschi
- Pharmacy Department and Nutrition and Intestinal Failure Services, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Stanislaw Klek
- Surgical Oncology Clinic, The Maria Sklodowska-Curie National Cancer Institute, Krakow, Poland
| |
Collapse
|
33
|
Wan Mohamad Darani WNS, Mat Ruzlin AN, Azhar ZI, Chen XW. Development and validation of the information-motivation-behavioural skills model-based human immunodeficiency virus education kit for adolescents in Malaysia. Sci Rep 2024; 14:6890. [PMID: 38519534 PMCID: PMC10959928 DOI: 10.1038/s41598-024-57593-y] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024] Open
Abstract
The growing Human Immunodeficiency Virus (HIV) incidences and insufficient HIV knowledge among Malaysian late adolescents necessitate immediate attention to HIV prevention via education. This study aims to develop and validate an Information-Motivation-Behavioural skills (IMB) model-based education kit for adolescents, PREM-Kit, to educate on HIV prevention among Malaysian late adolescents. Utilizing the Analysis, Design, Development, Implementation, and Evaluation model, we conducted the study in three phases: needs assessment, development of PREM-Kit, and validation of PREM-Kit by applying the IMB model to map the PREM-Kit's contents. PREM-Kit, developed in Malay language, consisted of an infographic flip chart and videos. Five multi-disciplinary experts validated the PREM-Kit using the content validity index (CVI), and 13 end-users validated the PREM-Kit using the Malay version of the Patient Education Materials Assessment Tool for Printable and Audiovisual Materials. The infographic flip chart comprised three modules covering 15 topics, and an animated video accompanied each module. PREM-Kit achieved CVI scores of 1.0 and median scores of over 80% for understandability and actionability. Overall, the newly developed IMB model-based HIV education kit has good content validity, is simple to comprehend and apply, and is ready for testing its effectiveness in improving adolescents' knowledge, attitudes, and practices for HIV prevention.
Collapse
Affiliation(s)
- Wan Nur Syamimi Wan Mohamad Darani
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
- Training Management Division, Ministry of Health, Putrajaya, Malaysia
| | - Aimi Nadira Mat Ruzlin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Zahir Izuan Azhar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Xin Wee Chen
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia.
- Institute of Medical Molecular Biotechnology (IMMB), Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia.
| |
Collapse
|
34
|
Cohen SA, Brant A, Fisher AC, Pershing S, Do D, Pan C. Dr. Google vs. Dr. ChatGPT: Exploring the Use of Artificial Intelligence in Ophthalmology by Comparing the Accuracy, Safety, and Readability of Responses to Frequently Asked Patient Questions Regarding Cataracts and Cataract Surgery. Semin Ophthalmol 2024:1-8. [PMID: 38516983 DOI: 10.1080/08820538.2024.2326058] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/27/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE Patients are using online search modalities to learn about their eye health. While Google remains the most popular search engine, the use of large language models (LLMs) like ChatGPT has increased. Cataract surgery is the most common surgical procedure in the US, and there is limited data on the quality of online information that populates after searches related to cataract surgery on search engines such as Google and LLM platforms such as ChatGPT. We identified the most common patient frequently asked questions (FAQs) about cataracts and cataract surgery and evaluated the accuracy, safety, and readability of the answers to these questions provided by both Google and ChatGPT. We demonstrated the utility of ChatGPT in writing notes and creating patient education materials. METHODS The top 20 FAQs related to cataracts and cataract surgery were recorded from Google. Responses to the questions provided by Google and ChatGPT were evaluated by a panel of ophthalmologists for accuracy and safety. Evaluators were also asked to distinguish between Google and LLM chatbot answers. Five validated readability indices were used to assess the readability of responses. ChatGPT was instructed to generate operative notes, post-operative instructions, and customizable patient education materials according to specific readability criteria. RESULTS Responses to 20 patient FAQs generated by ChatGPT were significantly longer and written at a higher reading level than responses provided by Google (p < .001), with an average grade level of 14.8 (college level). Expert reviewers were correctly able to distinguish between a human-reviewed and chatbot generated response an average of 31% of the time. Google answers contained incorrect or inappropriate material 27% of the time, compared with 6% of LLM generated answers (p < .001). When expert reviewers were asked to compare the responses directly, chatbot responses were favored (66%). CONCLUSIONS When comparing the responses to patients' cataract FAQs provided by ChatGPT and Google, practicing ophthalmologists overwhelming preferred ChatGPT responses. LLM chatbot responses were less likely to contain inaccurate information. ChatGPT represents a viable information source for eye health for patients with higher health literacy. ChatGPT may also be used by ophthalmologists to create customizable patient education materials for patients with varying health literacy.
Collapse
Affiliation(s)
- Samuel A Cohen
- Byers Eye Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Arthur Brant
- Byers Eye Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Ann Caroline Fisher
- Byers Eye Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Suzann Pershing
- Byers Eye Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Diana Do
- Byers Eye Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Carolyn Pan
- Byers Eye Institute, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
35
|
Mastrokostas PG, Mastrokostas LE, Emara AK, Wellington IJ, Ginalis E, Houten JK, Khalsa AS, Saleh A, Razi AE, Ng MK. GPT-4 as a Source of Patient Information for Anterior Cervical Discectomy and Fusion: A Comparative Analysis Against Google Web Search. Global Spine J 2024:21925682241241241. [PMID: 38513636 DOI: 10.1177/21925682241241241] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
STUDY DESIGN Comparative study. OBJECTIVES This study aims to compare Google and GPT-4 in terms of (1) question types, (2) response readability, (3) source quality, and (4) numerical response accuracy for the top 10 most frequently asked questions (FAQs) about anterior cervical discectomy and fusion (ACDF). METHODS "Anterior cervical discectomy and fusion" was searched on Google and GPT-4 on December 18, 2023. Top 10 FAQs were classified according to the Rothwell system. Source quality was evaluated using JAMA benchmark criteria and readability was assessed using Flesch Reading Ease and Flesch-Kincaid grade level. Differences in JAMA scores, Flesch-Kincaid grade level, Flesch Reading Ease, and word count between platforms were analyzed using Student's t-tests. Statistical significance was set at the .05 level. RESULTS Frequently asked questions from Google were varied, while GPT-4 focused on technical details and indications/management. GPT-4 showed a higher Flesch-Kincaid grade level (12.96 vs 9.28, P = .003), lower Flesch Reading Ease score (37.07 vs 54.85, P = .005), and higher JAMA scores for source quality (3.333 vs 1.800, P = .016). Numerically, 6 out of 10 responses varied between platforms, with GPT-4 providing broader recovery timelines for ACDF. CONCLUSIONS This study demonstrates GPT-4's ability to elevate patient education by providing high-quality, diverse information tailored to those with advanced literacy levels. As AI technology evolves, refining these tools for accuracy and user-friendliness remains crucial, catering to patients' varying literacy levels and information needs in spine surgery.
Collapse
Affiliation(s)
- Paul G Mastrokostas
- College of Medicine, State University of New York (SUNY) Downstate, Brooklyn, NY, USA
| | | | - Ahmed K Emara
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Ian J Wellington
- Department of Orthopaedic Surgery, University of Connecticut, Hartford, CT, USA
| | | | - John K Houten
- Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, USA
| | - Amrit S Khalsa
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Ahmed Saleh
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Afshin E Razi
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Mitchell K Ng
- Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| |
Collapse
|
36
|
Bindhu S, Nattam A, Xu C, Vithala T, Grant T, Dariotis JK, Liu H, Wu DTY. Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review. Online J Public Health Inform 2024; 16:e50898. [PMID: 38506914 PMCID: PMC10993137 DOI: 10.2196/50898] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Health literacy (HL) is the ability to make informed decisions using health information. As health data and information availability increase due to online clinic notes and patient portals, it is important to understand how HL relates to social determinants of health (SDoH) and the place of informatics in mitigating disparities. OBJECTIVE This systematic literature review aims to examine the role of HL in interactions with SDoH and to identify feasible HL-based interventions that address low patient understanding of health information to improve clinic note-sharing efficacy. METHODS The review examined 2 databases, Scopus and PubMed, for English-language articles relating to HL and SDoH. We conducted a quantitative analysis of study characteristics and qualitative synthesis to determine the roles of HL and interventions. RESULTS The results (n=43) were analyzed quantitatively and qualitatively for study characteristics, the role of HL, and interventions. Most articles (n=23) noted that HL was a result of SDoH, but other articles noted that it could also be a mediator for SdoH (n=6) or a modifiable SdoH (n=14) itself. CONCLUSIONS The multivariable nature of HL indicates that it could form the basis for many interventions to combat low patient understandability, including 4 interventions using informatics-based solutions. HL is a crucial, multidimensional skill in supporting patient understanding of health materials. Designing interventions aimed at improving HL or addressing poor HL in patients can help increase comprehension of health information, including the information contained in clinic notes shared with patients.
Collapse
Affiliation(s)
- Shwetha Bindhu
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Anunita Nattam
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Catherine Xu
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Tripura Vithala
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Tiffany Grant
- University of Cincinnati Libraries Research and Data Services, University of Cincinnati, Cincinnati, OH, United States
| | - Jacinda K Dariotis
- Department of Human Development and Family Studies, The University of Illinois at Urbana-Champaign, Urbana, IL, United States
- The Family Resiliency Center, College of Agricultural, Consumer and Environmental Sciences, The University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Department of Biomedical and Translational Sciences, The University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Hexuan Liu
- School of Criminal Justice, University of Cincinnati, Cincinnati, OH, United States
| | - Danny T Y Wu
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| |
Collapse
|
37
|
Parekh AS, McCahon JAS, Nghe A, Pedowitz DI, Daniel JN, Parekh SG. Foot and Ankle Patient Education Materials and Artificial Intelligence Chatbots: A Comparative Analysis. Foot Ankle Spec 2024:19386400241235834. [PMID: 38504411 DOI: 10.1177/19386400241235834] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
BACKGROUND The purpose of this study was to perform a comparative analysis of foot and ankle patient education material generated by the AI chatbots, as they compare to the American Orthopaedic Foot and Ankle Society (AOFAS)-recommended patient education website, FootCareMD.org. METHODS ChatGPT, Google Bard, and Bing AI were used to generate patient educational materials on 10 of the most common foot and ankle conditions. The content from these AI language model platforms was analyzed and compared with that in FootCareMD.org for accuracy of included information. Accuracy was determined for each of the 10 conditions on a basis of included information regarding background, symptoms, causes, diagnosis, treatments, surgical options, recovery procedures, and risks or preventions. RESULTS When compared to the reference standard of the AOFAS website FootCareMD.org, the AI language model platforms consistently scored below 60% in accuracy rates in all categories of the articles analyzed. ChatGPT was found to contain an average of 46.2% of key content across all included conditions when compared to FootCareMD.org. Comparatively, Google Bard and Bing AI contained 36.5% and 28.0% of information included on FootCareMD.org, respectively (P < .005). CONCLUSION Patient education regarding common foot and ankle conditions generated by AI language models provides limited content accuracy across all 3 AI chatbot platforms. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
- Aarav S Parekh
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania
| | | | - Amy Nghe
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania
| | | | | | | |
Collapse
|
38
|
Chervonski E, Harish KB, Rockman CB, Sadek M, Teter KA, Jacobowitz GR, Berland TL, Lohr J, Moore C, Maldonado TS. Generative artificial intelligence chatbots may provide appropriate informational responses to common vascular surgery questions by patients. Vascular 2024:17085381241240550. [PMID: 38500300 DOI: 10.1177/17085381241240550] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
OBJECTIVES Generative artificial intelligence (AI) has emerged as a promising tool to engage with patients. The objective of this study was to assess the quality of AI responses to common patient questions regarding vascular surgery disease processes. METHODS OpenAI's ChatGPT-3.5 and Google Bard were queried with 24 mock patient questions spanning seven vascular surgery disease domains. Six experienced vascular surgery faculty at a tertiary academic center independently graded AI responses on their accuracy (rated 1-4 from completely inaccurate to completely accurate), completeness (rated 1-4 from totally incomplete to totally complete), and appropriateness (binary). Responses were also evaluated with three readability scales. RESULTS ChatGPT responses were rated, on average, more accurate than Bard responses (3.08 ± 0.33 vs 2.82 ± 0.40, p < .01). ChatGPT responses were scored, on average, more complete than Bard responses (2.98 ± 0.34 vs 2.62 ± 0.36, p < .01). Most ChatGPT responses (75.0%, n = 18) and almost half of Bard responses (45.8%, n = 11) were unanimously deemed appropriate. Almost one-third of Bard responses (29.2%, n = 7) were deemed inappropriate by at least two reviewers (29.2%), and two Bard responses (8.4%) were considered inappropriate by the majority. The mean Flesch Reading Ease, Flesch-Kincaid Grade Level, and Gunning Fog Index of ChatGPT responses were 29.4 ± 10.8, 14.5 ± 2.2, and 17.7 ± 3.1, respectively, indicating that responses were readable with a post-secondary education. Bard's mean readability scores were 58.9 ± 10.5, 8.2 ± 1.7, and 11.0 ± 2.0, respectively, indicating that responses were readable with a high-school education (p < .0001 for three metrics). ChatGPT's mean response length (332 ± 79 words) was higher than Bard's mean response length (183 ± 53 words, p < .001). There was no difference in the accuracy, completeness, readability, or response length of ChatGPT or Bard between disease domains (p > .05 for all analyses). CONCLUSIONS AI offers a novel means of educating patients that avoids the inundation of information from "Dr Google" and the time barriers of physician-patient encounters. ChatGPT provides largely valid, though imperfect, responses to myriad patient questions at the expense of readability. While Bard responses are more readable and concise, their quality is poorer. Further research is warranted to better understand failure points for large language models in vascular surgery patient education.
Collapse
Affiliation(s)
- Ethan Chervonski
- New York University Grossman School of Medicine, New York, NY, USA
| | - Keerthi B Harish
- New York University Grossman School of Medicine, New York, NY, USA
| | - Caron B Rockman
- Division of Vascular & Endovascular Surgery, Department of Surgery, New York University Langone Health, New York, NY, USA
| | - Mikel Sadek
- Division of Vascular & Endovascular Surgery, Department of Surgery, New York University Langone Health, New York, NY, USA
| | - Katherine A Teter
- Division of Vascular & Endovascular Surgery, Department of Surgery, New York University Langone Health, New York, NY, USA
| | - Glenn R Jacobowitz
- Division of Vascular & Endovascular Surgery, Department of Surgery, New York University Langone Health, New York, NY, USA
| | - Todd L Berland
- Division of Vascular & Endovascular Surgery, Department of Surgery, New York University Langone Health, New York, NY, USA
| | - Joann Lohr
- Dorn Veterans Affairs Medical Center, Columbia, SC, USA
| | | | - Thomas S Maldonado
- Division of Vascular & Endovascular Surgery, Department of Surgery, New York University Langone Health, New York, NY, USA
| |
Collapse
|
39
|
Cha E, Son NH, Joung KH, Shin YA, Kim HJ, Kim H, Faulkner MS. Differences in patient-reported and clinical characteristics by age group in adults with type 2 diabetes. Worldviews Evid Based Nurs 2024. [PMID: 38500018 DOI: 10.1111/wvn.12715] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 12/06/2023] [Accepted: 01/27/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND The global burden of type 2 diabetes (T2D) is growing, and the age of onset is widening, resulting in increasing numbers of young adults and elderly patients with T2D. Age-specific diabetes care needs have yet to be fully explored. AIMS This study examined (1) differences in patient-reported and clinical characteristics by age group and (2) the effect of age on two proxy measures assessing psychological health and self-care adherence after adjusting for potential mediators. METHODS A cross-sectional, correlational design was used. Adults with type 2 diabetes (T2D) were recruited from a university hospital in Korea between 2019 and 2020. Participants were divided into four groups based on years of age (40s and younger group [n = 27]; 50s group [n = 47]; 60s group [n = 54]; and 70s and older group [n = 48]) to compare patient-reported and clinical characteristics. Chi-square tests, ANOVA, Kruskal-Wallis tests, and logistic regression analysis were performed to assess group differences and effect of age on psychological health and self-care adherence. RESULTS Of 178 participants, two-thirds were men (n = 114; 64.41%). The mean ages in the 40s and younger, 50s, 60s, and 70s and older groups were 39.4, 54.7, 63.9, and 76.0 years, respectively. There were significant differences in patient-reported and clinical characteristics by age group. The youngest group reported the poorest psychological health and self-care behaviors. Although the oldest group showed the poorest physical functioning, this group also showed the highest self-care adherence and the best psychological health. Regarding clinical characteristics, traditional diabetes-related blood test results showed no significant group differences. LINKING EVIDENCE TO ACTION Age-specific diabetes care needs were identified in adults with T2D. Interventions to improve psychological health and priming effects of behavioral adherence need to be developed. Furthermore, meticulous investigation to detect potential complications early is essential in adults with T2D.
Collapse
Affiliation(s)
- EunSeok Cha
- College of Nursing, Chungnam National University, Daejeon, South Korea
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Nak-Hoon Son
- Department of Statistics, College of Natural Science, Keimyung University, Daeggu, South Korea
| | - Kyong Hye Joung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Yun-A Shin
- College of Sport Science, Dankook University, Cheonan, South Korea
| | - Hyun Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, South Korea
| | - Hyukjin Kim
- Department of Statistics, College of Natural Science, Keimyung University, Daeggu, South Korea
| | - Melissa Spezia Faulkner
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
- Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, Atlanta, Georgia, USA
| |
Collapse
|
40
|
Clark C, Komo I. Antibody-Drug Conjugates and Ocular Toxicity: Nursing, Patient, and Organizational Implications for Care. Clin J Oncol Nurs 2024; 28:188-196. [PMID: 38511914 DOI: 10.1188/24.cjon.188-196] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
BACKGROUND Antibody-drug conjugates (ADCs) are a novel class of drugs with rapidly expanding oncology indications across solid and hematologic malignancies. OBJECTIVES This article provides an overview of ADCs with a high risk of ocular reactions and guidance for oncology nurses to help mitigate risk and identify toxicities for prompt management. METHODS This review presents updated evidence, manufacturer recommendations, and clinical guidance about three ADCs with a risk of overall ocular reactions exceeding 40%, as well as strategies to prepare patients for treatment, prevent reactions, and respond to presenting ocular toxicities. FINDINGS ADCs can cause a range of ocular reactions from mild dry eye to severe and dose- limiting corneal adverse reactions and vision loss. Oncology nurses and other members of the interprofessional team can perform focused clinical assessment, provide patient education about self-management and prevention, and coordinate surrounding eye care for patients receiving treatment with ADCs.
Collapse
|
41
|
Wang S, Liu K, Tang S, Wang G, Qi Y, Chen Q. Barriers and facilitators to patient education provided by nurses: A mixed-method systematic review. J Clin Nurs 2024. [PMID: 38476038 DOI: 10.1111/jocn.17111] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/02/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024]
Abstract
AIM To investigate the factors that facilitate or hinder nurses in providing patient education. DESIGN A mixed-method systematic review. DATA SOURCES Six databases (Cochrane Library, PubMed, EMBASE, Web of Science, MEDLINE and ERIC) were systematically searched for relevant publications. METHODS The study was conducted following the JBI for mixed-method systematic reviews, and the reporting followed the PRISMA guideline. Two researchers independently performed literature screening, literature evaluation, data extraction and synthesis. PROSPERO registration number: CRD42023427451. RESULTS Twenty-six eligible articles were included, including 15 quantitative articles, 10 qualitative articles and 2 mixed-methods articles. The resultant synthesis of key findings led to the identification of these barriers and facilitators, categorised into five distinct levels: nurse-related factors, organisational factors, patient-related factors, the nurse-patient relationship and interdisciplinary collaboration. CONCLUSIONS The findings highlight the factors that facilitate or hinder nurses in providing patient education, suggesting that multifaceted interventions can enhance the practice of patient education in nursing and support the development of appropriate patient education guidelines or public policies. RELEVANCE TO CLINICAL PRACTICE This review delineates the facilitators and barriers influencing nurses' provision of patient education, offering an initial framework for nursing managers to craft interventions aimed at enhancing the quality of patient education provided by nurses, consequently elevating the overall quality of nursing.
Collapse
Affiliation(s)
- Shuyi Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Ke Liu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
- Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation: A JBI Centre of Excellence, Changsha, China
| | - Guiyun Wang
- School of Nursing, Shandong Xiehe University, Jinan, China
| | - Yanxia Qi
- School of Nursing, Shandong Xiehe University, Jinan, China
| | - Qirong Chen
- Xiangya School of Nursing, Central South University, Changsha, China
- Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation: A JBI Centre of Excellence, Changsha, China
| |
Collapse
|
42
|
Parodis I, Tsoi A, Gomez A, Chow JW, Girard-Guyonvarc’h C, Stamm T, Boström C. Lifestyle interventions in the management of systemic sclerosis: a systematic review of the literature. Rheumatol Adv Pract 2024; 8:rkae037. [PMID: 38590950 PMCID: PMC11001494 DOI: 10.1093/rap/rkae037] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/25/2024] [Indexed: 04/10/2024] Open
Abstract
Objectives We aimed to investigate the efficacy of lifestyle interventions for the management of SSc. Methods We searched the MEDLINE, Embase, Web of Science and CINAHL databases in June 2021. We included studies conducted on five or more patients with SSc published between 1 January 2000 and the search date evaluating lifestyle interventions, excluding systematic reviews without meta-analyses. Critical appraisal was conducted using critical appraisal tools from the Joanna Briggs Institute. Thirty-six studies were included for full-text evaluation. Results A total of 17 studies evaluated the effect of physical exercise alone, whereas 14 studies evaluated educational interventions for mental health management, often with physical exercise as a central component. At an aggregated level, these studies support patient education and physical exercise for the improvement of physical function, in particular hand and mouth function. Studies on diet and nutrition were few (n = 5) and pertained to gastrointestinal as well as anthropometric outcomes; these studies were insufficient to support any conclusions. Conclusion Physical exercise and patient education should be considered for improving physical function in patients with SSc. These interventions can be provided alongside pharmacotherapy, but there is no evidence supporting that they can be a substitute. Further research should aim at assessing the effects of reductions of harmful exposures, including tobacco smoking and alcohol, improving sleep and enhancing social relations, three hitherto underexplored facets of lifestyle in the context of SSc.
Collapse
Affiliation(s)
- Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
- Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Alexander Tsoi
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Alvaro Gomez
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Jun Weng Chow
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Charlotte Girard-Guyonvarc’h
- Division of Rheumatology, Department of Medicine, University Hospital of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Carina Boström
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
43
|
Dimitriadis F, Alkagiet S, Tsigkriki L, Kleitsioti P, Sidiropoulos G, Efstratiou D, Askalidi T, Tsaousidis A, Siarkos M, Giannakopoulou P, Mavrogianni AD, Zarifis J, Koulaouzidis G. ChatGPT and Patients With Heart Failure. Angiology 2024:33197241238403. [PMID: 38451243 DOI: 10.1177/00033197241238403] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
ChatGPT (Generative Pre-trained Transformer) is a large-scale language processing model, with possibilities for professional patient support in a patient-friendly way. The aim of the study was to examine the accuracy and reproducibility of ChatGPT in answering questions about knowledge and management of heart failure (HF). First, we recorded 47 most frequently asked questions by patients about HF. The answers of ChatGPT to these questions were independently assessed by two researchers. ChatGPT was able to render the definition of the disease in a very simple and explanatory way. It listed a number of the most important causes of HF and the most important risk factors for its occurrence. It provided correct answers about the most important diagnostic tests and why they are recommended. In addition, it answered health and dietary questions, such as the daily fluid and the alcohol intake. ChatGPT listed the most important classes of drugs in HF and their mechanism of action. It also answered with arguments to questions about patient's sex life, whether they could work, drive, or travel by plane. The performance of ChatGPT was described as very good as it was able to adequately answer all questions posed to it.
Collapse
Affiliation(s)
- Fotis Dimitriadis
- Cardiology Department, General Hospital G. Papanikolaou, Thessaloniki, Greece
| | - Stelina Alkagiet
- Cardiology Department, General Hospital G. Papanikolaou, Thessaloniki, Greece
| | - Lamprini Tsigkriki
- Cardiology Department, General Hospital G. Papanikolaou, Thessaloniki, Greece
| | | | - George Sidiropoulos
- Cardiology Department, General Hospital G. Papanikolaou, Thessaloniki, Greece
| | - Dimitris Efstratiou
- Cardiology Department, General Hospital G. Papanikolaou, Thessaloniki, Greece
| | - Taisa Askalidi
- Cardiology Department, General Hospital G. Papanikolaou, Thessaloniki, Greece
| | - Adam Tsaousidis
- Cardiology Department, General Hospital G. Papanikolaou, Thessaloniki, Greece
| | - Michail Siarkos
- Cardiology Department, General Hospital G. Papanikolaou, Thessaloniki, Greece
| | | | | | - John Zarifis
- Cardiology Department, General Hospital G. Papanikolaou, Thessaloniki, Greece
| | - George Koulaouzidis
- Department of Biochemical Sciences, Pomeranian Medical University, Szczecin, Poland
| |
Collapse
|
44
|
Abraham O, Agoke A, Sanuth K, Fapohunda A, Ogunsanya M, Piper M, Trentham-Dietz A. Need for Culturally Competent and Responsive Cancer Education for African Immigrant Families and Youth Living in the United States. JMIR Cancer 2024; 10:e53956. [PMID: 38447129 PMCID: PMC10955401 DOI: 10.2196/53956] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/23/2024] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
Cancer prevalence data for Black Americans is monolithic and fails to consider the diverse cultures and backgrounds within that community. For instance, African immigrants constitute a meaningful proportion of the foreign-born Black immigrants in the United States (42%), but the prevalence of cancer in the African immigrant community itself is unknown. Therefore, without accurate cancer prevalence data, it is impossible to identify trends and other key factors that are needed to support the health of African immigrants and their children. Moreover, it is impossible to understand how the culture and language of subgroups influence their cancer-related health behavior. While research in this area is limited, the existing literature articulates the need for culturally responsive and culturally tailored cancer education for African immigrants and their adolescent children, which is what we advocate for in this viewpoint paper. Existing projects demonstrate the feasibility of culturally responsive programming for adults; however, few projects include or focus on adolescents or children born to African immigrants. To best meet the needs of this understudied community, researchers must use culturally competent interventions alongside familiar, usable media. For adolescents, technology is ubiquitous thus, the creation of a culturally tailored digital intervention has immense potential to improve cancer awareness and prevention for youth and their community. More research is needed to address many of the existing research gaps and develop a rich understanding of the unique experience of cancer among African immigrant families that can be used to inform intervention development. Through this viewpoint, we review the current state of cancer-related research among African immigrant families in the United States. In this paper, we acknowledge the current knowledge gaps and issues surrounding measurement and then discuss the factors relevant to designing an educational intervention targeted at African immigrants and the role of African immigrant youth.
Collapse
Affiliation(s)
- Olufunmilola Abraham
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Adeola Agoke
- African Cultural Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Kazeem Sanuth
- National African Language Resource Center, Indiana University Bloomington, Bloomington, IN, United States
| | - Abimbola Fapohunda
- Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Motolani Ogunsanya
- College of Pharmacy, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, United States
| | - Megan Piper
- Department of Medicine and Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Amy Trentham-Dietz
- Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| |
Collapse
|
45
|
Reynolds K, Tejasvi T. Potential Use of ChatGPT in Responding to Patient Questions and Creating Patient Resources. JMIR Dermatol 2024; 7:e48451. [PMID: 38446541 PMCID: PMC10955382 DOI: 10.2196/48451] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/11/2023] [Accepted: 02/22/2024] [Indexed: 03/07/2024] Open
Abstract
ChatGPT (OpenAI) is an artificial intelligence-based free natural language processing model that generates complex responses to user-generated prompts. The advent of this tool comes at a time when physician burnout is at an all-time high, which is attributed at least in part to time spent outside of the patient encounter within the electronic medical record (documenting the encounter, responding to patient messages, etc). Although ChatGPT is not specifically designed to provide medical information, it can generate preliminary responses to patients' questions about their medical conditions and can precipitately create educational patient resources, which do inevitably require rigorous editing and fact-checking on the part of the health care provider to ensure accuracy. In this way, this assistive technology has the potential to not only enhance a physician's efficiency and work-life balance but also enrich the patient-physician relationship and ultimately improve patient outcomes.
Collapse
Affiliation(s)
- Kelly Reynolds
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Trilokraj Tejasvi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| |
Collapse
|
46
|
Roster K, Kann RB, Farabi B, Gronbeck C, Brownstone N, Lipner SR. Readability and Health Literacy Scores for ChatGPT-Generated Dermatology Public Education Materials: Cross-Sectional Analysis of Sunscreen and Melanoma Questions. JMIR Dermatol 2024; 7:e50163. [PMID: 38446502 PMCID: PMC10955394 DOI: 10.2196/50163] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 01/02/2024] [Accepted: 02/06/2024] [Indexed: 03/07/2024] Open
Affiliation(s)
- Katie Roster
- New York Medical College, New York, NY, United States
| | | | - Banu Farabi
- Dermatology Department, NYC Health + Hospital/Metropolitan, New York, NY, United States
| | - Christian Gronbeck
- Department of Dermatology, University of Connecticut HealthCenter, Framington, CT, United States
| | - Nicholas Brownstone
- Department of Dermatology, Temple University Hospital, Philadelphia, PA, United States
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, NY, United States
| |
Collapse
|
47
|
Robinson CL, D'Souza RS, Yazdi C, Diejomaoh EM, Schatman ME, Emerick T, Orhurhu V. Reviewing the Potential Role of Artificial Intelligence in Delivering Personalized and Interactive Pain Medicine Education for Chronic Pain Patients. J Pain Res 2024; 17:923-929. [PMID: 38464902 PMCID: PMC10924768 DOI: 10.2147/jpr.s439452] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/18/2024] [Indexed: 03/12/2024] Open
Abstract
The integration of artificial intelligence (AI) in patient pain medicine education has the potential to revolutionize pain management. By harnessing the power of AI, patient education becomes more personalized, interactive, and supportive, empowering patients to understand their pain, make informed decisions, and actively participate in their pain management journey. AI tailors the educational content to individual patients' needs, providing personalized recommendations. It introduces interactive elements through chatbots and virtual assistants, enhancing engagement and motivation. AI-powered platforms improve accessibility by providing easy access to educational resources and adapting content to diverse patient populations. Future AI applications in pain management include explaining pain mechanisms, treatment options, predicting outcomes based on individualized patient-specific factors, and supporting monitoring and adherence. Though the literature on AI in pain medicine and its applications are scarce yet growing, we propose avenues where AI may be applied and review the potential applications of AI in pain management education. Additionally, we address ethical considerations, patient empowerment, and accessibility barriers.
Collapse
Affiliation(s)
- Christopher L Robinson
- Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ryan S D'Souza
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Cyrus Yazdi
- Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Efemena M Diejomaoh
- Department of Psychiatry & Behavioral Science, Meharry Medical College, Nashville, TN, USA
| | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Department of Population Health-Division of Medical Ethics, NYU Grossman School of Medicine, New York, NY, USA
| | - Trent Emerick
- Department of Anesthesiology and Perioperative Medicine, Chronic Pain Division, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Vwaire Orhurhu
- University of Pittsburgh Medical Center, Susquehanna, Williamsport, PA, USA
- MVM Health, East Stroudsburg, PA, USA
| |
Collapse
|
48
|
Krontoft ASB, Skov L, Ammitzboell E, Lomborg K. Self-management Support for Patients with Atopic Dermatitis: A Qualitative Interview Study. J Patient Exp 2024; 11:23743735241231696. [PMID: 38464888 PMCID: PMC10921857 DOI: 10.1177/23743735241231696] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
Patients with a chronic skin disease, eg, atopic dermatitis, need self-management skills to increase their quality of life. We explored patients' needs for self-management support from healthcare professionals and how these needs can be met in a dermatology setting. Interpretive description methodology was chosen for iterative data collection and analysis of qualitative interviews with patients with atopic dermatitis. Two mutually dependent themes were found to be supportive of patients' self-management. Personal and disease-related recognition was fundamental to successful support. However, guidance for agenda-setting from healthcare professionals was also needed on the wide range of topics that could be covered in the consultation based on individual needs. Patients need self-management support in addition to what can be found with family, friends, or peers. It is crucial that the support is delivered with an appreciative approach by healthcare professionals with profound knowledge of atopic dermatitis. Equally important is guidance towards agenda-setting, a way to co-construct the consultation with a clear focus on the specific patient's needs.
Collapse
Affiliation(s)
- Anna Sophie Belling Krontoft
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev-Gentofte Hospital, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev-Gentofte Hospital, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | | | - Kirsten Lomborg
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
- Department of Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| |
Collapse
|
49
|
Salinas M, Yazdani U, Oblack A, McDaniels B, Ahmed N, Haque B, Pouratian N, Chitnis S. Know DBS: patient perceptions and knowledge of deep brain stimulation in Parkinson's disease. Ther Adv Neurol Disord 2024; 17:17562864241233038. [PMID: 38455848 PMCID: PMC10919129 DOI: 10.1177/17562864241233038] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/29/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction Deep brain stimulation (DBS) is an established therapy for Parkinson's disease (PD) that can significantly improve motor symptoms and quality of life. Despite its effectiveness, little is known about patient perceptions of DBS. Objectives To evaluate patient perceptions of DBS for PD, focusing on understanding, satisfaction, and factors influencing their outlook. This study aims to enhance patient education and counseling by identifying key determinants of patient perceptions. Design A patient survey. Methods We surveyed 77 PD patients who had undergone DBS at multiple centers using a comprehensive questionnaire. The questionnaire included questions on demographic information, disease history, and detailed understanding about the indications for DBS, side effects, outlook, and other common misconceptions. We summarize data using measures of central tendency and dispersion appropriate to the data type (categorical, continuous, proportional) and model relationships among variables using fractional and linear regression methods. Results Participants had a median age of 66 years, were predominantly male (66%), Caucasian (90%), well-educated (79% with at least college degrees), and had a disease duration of greater than 5 years (97%). They conveyed good understanding of the signs and symptoms addressed by DBS across the motor and non-motor domains and associated side effects. Regression analysis identified age, disease duration, and education level as key determinants of patient understanding and outlook of DBS. Conclusion Our study provides a detailed understanding of patient perceptions of DBS for PD, including the benefits, challenges, and misconceptions. Our findings underscore the importance of identifying the causes of disparities in patient knowledge and perceptions regarding DBS to tailor patient counseling and ensure optimal treatment outcomes.
Collapse
Affiliation(s)
- Meagen Salinas
- Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA
- Neurology Section, VA North Texas Health Care System, Dallas, TX, USA
| | - Umar Yazdani
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Austin Oblack
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bradley McDaniels
- Department of Rehabilitation and Health Services, University of North Texas, Denton, TX, USA
| | - Nida Ahmed
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bilal Haque
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nader Pouratian
- Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shilpa Chitnis
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
50
|
Howick J, de Zulueta P, Gray M. Beyond empathy training for practitioners: Cultivating empathic healthcare systems and leadership. J Eval Clin Pract 2024. [PMID: 38436621 DOI: 10.1111/jep.13970] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/11/2024] [Indexed: 03/05/2024]
Abstract
Empathic care benefits patients and practitioners, and empathy training for practitioners can enhance empathy. However, practitioners do not operate in a vacuum. For empathy to thrive, healthcare consultations must be situated in a nurturing milieu, guided by empathic, compassionate leaders. Empathy will be suppressed, or even reversed if practitioners are burned out and working in an unpleasant, under-resourced environment with increasingly poorly served and dissatisfied patients. Efforts to enhance empathy must therefore go beyond training practitioners to address system-level factors that foster empathy. These include patient education, cultivating empathic leadership, customer service training for reception staff, valuing cleaning and all ancillary staff, creating healing spaces, and using appropriate, efficiency saving technology to reduce the administrative burden on healthcare practitioners. We divide these elements into environmental factors, organisational factors, job factors, and individual characteristics.
Collapse
Affiliation(s)
- Jeremy Howick
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, Leicester, UK
| | - Paquita de Zulueta
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Muir Gray
- Director of the Oxford Value and Stewardship Programme, Oxford, UK
- Faculty of Philosophy, University of Oxford, Oxford, United Kingdom
| |
Collapse
|