Clinical Medicine

April 17, 2024

ChatGPT Provides Inconsistent Risk Stratification for Patients with Atraumatic Chest Pain

A recent study investigated ChatGPT-4’s ability to risk-stratify patients with atraumatic chest pain. The researchers found that while ChatGPT-4’s mean risk scores correlated well with established tools like TIMI and HEART, the AI model provided inconsistent results when presented with identical patient data on multiple occasions. This variability raises concerns about the reliability of using…

January 5, 2024

How I Came to See Value in Defiance

I was walking past youth skateboarders, I noticed they were ignoring social distancing rules during the pandemic. My immediate reaction was critical. However, I reconsided as research shows children to be highly resistant, how Sweden succeeded without lockdowns, and as I remembered my own rebellious youth. Although unintentional, the skaters’ mass gatherings may have safely…

December 18, 2023

Large language models may inadequately address mental health crises

This study evaluated the safety of AI chatbots built on ChatGPT for handling mental health risk scenarios. I gave the chatbots simulated conversations indicating escalating depression and suicide risk. The chatbots frequently postponed referring users to human support until dangerously high-risk levels. Most failed to provide crisis resources. The findings suggest overly optimistic views of…

December 1, 2023

The Beholder: A Symphony of Life in Medicine Explores Interconnections Between Music and Healing

A new article titled “The Beholder – A Symphony of Life in Medicine” explores the interconnections between music, art, physics, and medicine. It reveals symmetries between sound, visual art, and quantum phenomena, hinting at a unifying framework tying together sciences and humanities. The author traces his journey toward integrating artistic, scientific, and humanistic viewpoints, illuminating…

November 30, 2023

Coronary calcium scores in patients with normal myocardial perfusion

This study examined coronary calcium scores (CCS) in patients with normal myocardial perfusion imaging to assess cardiac risk factors. 2351 patients were evaluated. 55% had a CCS of 0, 36% had a CCS of 1-400, and 9% had a CCS over 400. Older age and hyperlipidemia were the strongest risk factors for higher CCS among…

November 13, 2023

The Efficacy of Smoking Cessation Strategies: A Meta-Analysis

A 1993 meta-analysis reviewed research on the efficacy of different smoking cessation strategies. The analysis found that office-based approaches were more effective than community-based approaches. Effective strategies included brief counseling, nicotine replacement, workplace bans, and increasing the excise tax. More research is still needed to understand the long-term outcomes of different approaches. The analysis highlights…

November 10, 2023

Gender Bias in the Treatment of Acute Myocardial Infarction

More evidence back in 1997 that gender bias in the management of acute coronary syndrome existed. Women experienced delays in ECG and physician evaluation in emergency departments. Women were also less likely to be admitted to intensive care units compared to men. More needs to be done to eliminate this gender gap in heart attack…

November 7, 2023

Predictors of Weight Loss in Hypertension Prevention

This study highlights the significance of food records as predictors of weight loss in a hypertension prevention program. Thirty-two individuals, overweight by 10-60%, participated in a 14-week intervention involving diet and exercise modifications. The program, led by health professionals, recommended a daily caloric reduction and regular walking. Results showed an average weight loss, with initial…

October 13, 2023

BMI and Chest Imaging Accuracy

A recent medical imaging study has produced some surprising results that challenge conventional wisdom. The researchers evaluated 50 patients who underwent both chest x-rays and CT scans. They compared the imaging findings to the final clinical diagnosis in each patient. Unexpectedly, the study found no correlation between a patient’s body mass index (BMI) and the…

September 26, 2023

Normalizing Predictive Values for Appropriate Interpretation of Diagnostic Test Results

As clinicians, we often evaluate diagnostic test results like imaging studies to guide patient care. An important consideration is how disease prevalence in the tested population impacts the meaning of positive and negative predictive values. For example, a recent study using cardiac CT angiography (CTA) to diagnose coronary artery disease reported an excellent 99% negative…