RESUMO
PURPOSE: This systematic review and meta-analysis aimed to systematically evaluate and enhance the understanding of optimal management strategies for serpentine aneurysms. METHODS: A systematic search was conducted in Medline, Scopus, and Cochrane databases up to July 8, 2024, using relevant keywords. Studies included were case series, prospective or retrospective cohorts, or randomized controlled trials with data on clinical and angiographic outcomes of intracranial serpentine aneurysms. Data extraction and quality assessment were performed independently by two authors. Statistical analysis was conducted using R, with pooled estimates under a random-effects model. RESULTS: Ten studies comprising 70 patients with 71 serpentine aneurysms were included. The majority (92.9%) were giant aneurysms. The overall rate of procedure-related complications was 33%, morbidity was 13%, and mortality was 13%. Good neurological outcomes were achieved in 76% of cases. For unruptured aneurysms, the complication rate was 34%, while no complications were observed in ruptured aneurysms. Comparative analysis between ruptured and unruptured aneurysms showed no significant differences in outcomes or complications. The technical success rate was 91%. Reconstructive methods showed a slightly higher rate of good neurological outcomes (77%) compared to deconstructive methods (70%), though complication rates were similar. CONCLUSION: Both reconstructive and deconstructive endovascular treatments for serpentine aneurysms are effective, with high rates of good neurological outcomes and acceptable complication rates.
RESUMO
PURPOSE: The usage of Chatbots as a kind of Artificial Intelligence in medicine is getting to increase in recent years. UpToDate® is another well-known search tool established on evidence-based knowledge and is used daily by doctors worldwide. In this study, we aimed to investigate the usefulness and reliability of ChatGPT compared to UpToDate in Otorhinolaryngology and Head and Neck Surgery (ORL-HNS). MATERIALS AND METHODS: ChatGPT-3.5 and UpToDate were interrogated for the management of 25 common clinical case scenarios (13 males/12 females) recruited from literature considering the daily observation at the Department of Otorhinolaryngology of Ege University Faculty of Medicine. Scientific references for the management were requested for each clinical case. The accuracy of the references in the ChatGPT answers was assessed on a 0-2 scale and the usefulness of the ChatGPT and UpToDate answers was assessed with 1-3 scores by reviewers. UpToDate and ChatGPT 3.5 responses were compared. RESULTS: ChatGPT did not give references in some questions in contrast to UpToDate. Information on the ChatGPT was limited to 2021. UpToDate supported the paper with subheadings, tables, figures, and algorithms. The mean accuracy score of references in ChatGPT answers was 0.25-weak/unrelated. The median (Q1-Q3) was 1.00 (1.25-2.00) for ChatGPT and 2.63 (2.75-3.00) for UpToDate, the difference was statistically significant (p < 0.001). UpToDate was observed more useful and reliable than ChatGPT. CONCLUSIONS: ChatGPT has the potential to support the physicians to find out the information but our results suggest that ChatGPT needs to be improved to increase the usefulness and reliability of medical evidence-based knowledge.
