ChatGPT's adherence to otolaryngology clinical practice guidelines.

OBJECTIVES: Large language models, including ChatGPT, has the potential to transform the way we approach medical knowledge, yet accuracy in clinical topics is critical. Here we assessed ChatGPT's performance in adhering to the American Academy of Otolaryngology-Head and Neck Surgery guidelines. METHODS: We presented ChatGPT with 24 clinical otolaryngology questions based on the guidelines of the American Academy of Otolaryngology. This was done three times (N = 72) to test the model's consistency. Two otolaryngologists evaluated the responses for accuracy and relevance to the guidelines. Cohen's Kappa was used to measure evaluator agreement, and Cronbach's alpha assessed the consistency of ChatGPT's responses. RESULTS: The study revealed mixed results; 59.7% (43/72) of ChatGPT's responses were highly accurate, while only 2.8% (2/72) directly contradicted the guidelines. The model showed 100% accuracy in Head and Neck, but lower accuracy in Rhinology and Otology/Neurotology (66%), Laryngology (50%), and Pediatrics (8%). The model's responses were consistent in 17/24 (70.8%), with a Cronbach's alpha value of 0.87, indicating a reasonable consistency across tests. CONCLUSIONS: Using a guideline-based set of structured questions, ChatGPT demonstrates consistency but variable accuracy in otolaryngology. Its lower performance in some areas, especially Pediatrics, suggests that further rigorous evaluation is needed before considering real-world clinical use.

Stellungnahme der Wissenschaftlichen Fachgesellschaft und des Berufsverbandes zur Notfallversorgung in der Hals-Nasen-Ohren-Heilkunde.

Clinics and practices in the field of ear, nose and throat medicine (ENT) are experiencing a significant increase in the number of emergency patients, which has multiple reasons. There is broad consent that a reform of emergency structures is necessary.The government commission for modern and needs-based hospital care has made recommendations with statements on the reform of emergency and acute care in the areas of "emergency services and financing" and "integrated emergency centers and integrated control centers". For this purpose a reliable foundation will be created with participation of specialist societies and professional associations, also linked to the hope of initiating the urgently needed relief of medical staff in clinics and practices.The present manuscript describes the health policy history and current problems in emergency care, focusing on proposed solutions with reference to the special features of ENT medicine. This position paper is linked to an appeal to self-administration and politicians to quickly implement a sustainable concept for emergency care, as financing and staff availability are becoming increasingly critical and the unregulated wave of emergency patients must be given a helping hand.

Does ChatGPT Answer Otolaryngology Questions Accurately?

OBJECTIVE: Investigate the accuracy of ChatGPT in the manner of medical questions related to otolaryngology. METHODS: A ChatGPT session was opened within which 93 questions were asked related to otolaryngology topics. Questions were drawn from all major domains within otolaryngology and based upon key action statements (KAS) from clinical practice guidelines (CPGs). Twenty-one "patient-level" questions were also asked of the program. Answers were graded as either "correct," "partially correct," "incorrect," or "non-answer." RESULTS: Correct answers were given at a rate of 45.5% (71.4% correct in patient-level, 37.3% CPG); partially correct answers at 31.8% (28.6% patient-level, 32.8% CPG); incorrect at 21.6% (0% patient-level, 28.4% CPG); and 1.1% non-answers (% patient-level, 1.5% CPG). There was no difference in the rate of correct answers between CPGs published before or after the period of data collection cited by ChatGPT. CPG-based questions were less likely to be correct than patient-level questions (p = 0.003). CONCLUSION: Publicly available artificial intelligence software has become increasingly popular with consumers for everything from story-telling to data collection. In this study, we examined the accuracy of ChatGPT responses to questions related to otolaryngology over 7 domains and 21 published CPGs. Physicians and patients should understand the limitations of this software as it applies to otolaryngology, and programmers in future iterations should consider giving greater weight to information published by well-established journals and written by national content experts. LEVEL OF EVIDENCE: N/A Laryngoscope, 134:4011-4015, 2024.

Adherence to Reporting Guidelines in Major Otolaryngology Publications.

The aim of this study is to determine the adherence rate to reporting guidelines in published otolaryngology research. We performed an evidence-based review of all original clinical research published in 2021 in five otolaryngology journals for adherence to the appropriate guideline for the study type by evaluating whether the corresponding reporting guideline was mentioned in the body of the published manuscript. There were 1140 original research articles included in this study. Most studies were observational, for which the STROBE reporting guidelines are recommended (n = 791, 70.3%). All studies had an average adherence rate of 16.8% (n = 192/1140). The STROBE adherence rate was 4.9%, with JAMA Otolaryngology having the highest proportion of observation studies using the STROBE guidelines (23/49, 46.9%). Reporting guidelines are important tools to use in presenting original research. The use of these guidelines varies in the otolaryngology literature and highlights the ongoing need to support research reproducibility and usefulness.

Medical record prompts improve the frequency and documentation of dizziness and driving conversations in the ENT balance clinic.

BACKGROUND: Driving capacity is affected by vestibular disorders and the medications used to treat them. Driving is not considered during medical consultations, with 92 per cent of patients attending a centre for dizziness not discussing it with the doctor. OBJECTIVE: To investigate if medical record prompts facilitate dizziness and driving conversations in ENT balance clinics. METHODS: A questionnaire was designed to reflect the current standards of practice and advice given regarding driving and dizziness during balance clinic consultations. RESULTS: Medical record prompts facilitated the improved frequency and recording of shared decision-making conversations about driving and dizziness in 98 per cent of consultations. CONCLUSION: This study highlights the benefits of medical record prompts for documented and accurate shared decision-making conversations surrounding dizziness, vertigo, vestibular conditions and driving. This potentially improves safety for all road users, and protects the patient and clinician in the event of road traffic accidents and medico-legal investigations.

An update on COVID-19 for the otorhinolaryngologist - a Brazilian Association of Otolaryngology and Cervicofacial Surgery (ABORL-CCF) Position Statement / Atualização sobre o COVID-19 para o otorrinolaringologista - um documento sobre a posição da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF)

Abstract Introduction: We are facing a pandemic with a great impact worldwide, as a result of the rapid spread of the novel coronavirus (COVID-19). The medical community is still getting to know behavior of this virus and the consequences from a population point of view. All this knowledge is extremely dynamic, so some behaviors are still not well established. Otorhinolaryngologists have a central role in the management of this situation, in which they must assess the patient, avoid contamination to and by health professionals and other patients. Thus, the recommendations of the Brazilian Association of Otorhinolaryngology and Cervical-Facial Surgery (ABORL-CCF) have the main objective of reducing the spread of the new coronavirus during otorhinolaryngological care and assisting in the management of these patients. Methods: Review of the main recommendations of national and international scientific societies, decisions by government agencies and class councils. The topics will be related to the general aspects of COVID-19, personal protective equipment, care in patient assistance, endoscopic exam routines and the management of sinonasal, otological and pediatric evaluations related to COVID-19. Results: The use of personal protective equipment is considered crucial in routine ENT care. We recommend postponing appointments, exams and elective surgeries to reduce the spread of COVID-19. Similarly, we recommend changing routines in several areas of otolaryngology. Additionally, guidance is provided on the use of telemedicine resources during the pandemic period. Conclusions: We are still at the beginning of the COVID-19 pandemic and scientific evidence is still scarce and incomplete, so these ABORL-CCF recommendations for otorhinolaryngologists may be updated based on new knowledge and the pattern of the new coronavirus spread.

Resumo: Introdução: Estamos diante de uma pandemia de grande impacto mundial como resultado da rápida propagação do novo coronavírus, COVID-19. A comunidade médica está ainda conhecendo o comportamento desse vírus e as repercussões do ponto de vista populacional. Todo esse conhecimento é extremamente dinâmico, por isso algumas condutas ainda não estão bem estabelecidas. O otorrinolaringologista tem um papel central no manejo dessa situação em que deve avaliar o paciente e evitar a contaminação dos profissionais da saúde e dos demais pacientes. Dessa forma, as recomendações da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF) têm por objetivo principal reduzir a propagação do novo coronavírus durante o atendimento otorrinolaringológico e auxiliar no manejo desses pacientes. Método: Revisão das principais recomendações das sociedades científicas nacionais, internacionais, decisões de órgãos governamentais e de conselhos de classe. Os tópicos serão relativos aos aspectos gerais do COVID-19, equipamentos de proteção individual, cuidados no atendimento ao paciente, as rotinas dos exames endoscópicos e o manejo de aspectos nasossinusais, otológicos e pediátricos relacionados ao COVID-19. Resultados: É considerado crucial o uso de equipamento de proteção individual no atendimento otorrinolaringológico de rotina. Recomendamos postergar atendimentos, exames e cirurgias eletivas para diminuir a propagação do COVID-19. Da mesma forma, recomendamos mudança de rotinas em diversas áreas da otorrinolaringologia. Além disso, orientações sobre o uso do recurso da telemedicina durante o período de vigência da pandemia. Conclusões: Estamos ainda no início da pandemia do COVID-19 e as evidências científicas são ainda escassas, por isso essas recomendações da ABORL-CCF para os otorrinolaringologistas podem sofrer atualizações baseadas nos novos conhecimentos e no padrão de disseminação do novo coronavírus.

Faringotonsilites em crianças: visão de uma amostra de pediatras e otorrinolaringologistas / Pharyngotonsillitis in children: view from a sample of pediatricians and otorhinolaryngologists

As faringotonsilites agudas são infecções das vias aéreas superiores comuns na infância. Objetivo: Analisar opiniões e condutas de pediatras e otorrinolaringologistas do Estado de São Paulo em relação ao diagnóstico, tratamento e prevenção das faringotonsilites e suas complicações em crianças. Material e Métodos: Selecionamos aleatoriamente 1370 pediatras e 1000 otorrinolaringologistas do Estado de São Paulo. Aos especialistas foi enviado questionário por correio. Desenho do Estudo: Estudo transversal. Resultados: 95,8% dos pediatras e 91,5% dos otorrinos não solicitam rotineiramente exames para diagnóstico laboratorial das faringotonsilites agudas na criança. Os antimicrobianos mais prescritos pelos pediatras nas faringotonsilites bacterianas foram: penicilina por via oral durante 10 dias (33,6%) e penicilina benzatina em dose única (19,7%). Os antimicrobianos mais prescritos pelos otorrinos para tratamento foram: penicilina por via oral durante 10 dias (35,4%) e penicilina por via oral durante 7 dias (25,7%). A medida de prevenção das faringotonsilites bacterianas considerada muito eficaz por mais da metade dos pediatras e otorrinos foi a cirurgia de tonsilectomia. A faringotonsilite de repetição foi o principal motivo para os otorrinos indicarem cirurgia de tonsilectomia aos escolares e adolescentes (49,3% e 53,4%, respectivamente). Conclusões:É necessário uniformizar condutas de pediatras e otorrinos para diagnóstico e tratamento das faringotonsilites em crianças.

Acute pharyngotonsillitis is a common upper airway infection in children. Aim: To analyze opinions and practices of pediatricians and otorhinolaryngologists from Sao Paulo State, Brazil, concerning diagnosis, treatment and prevention of pharyngotonsillitis and their complications in children. Methods: We randomly selected 1,370 pediatricians and 1,000 otolaryngologists from Sao Paulo State, Brazil. A questionnaire was mailed to the specialists. Study design: Cross-sectional. Results: 95.8% of the pediatricians and 91.5% of the otolaryngologists do not perform routine laboratory diagnosis for acute pharyngotonsillitis in children. The antimicrobials more commonly prescribed by pediatricians for treatment of bacterial pharyngotonsillitis were: oral penicillin for 10 days (33.6%) and s single injection of benzathine penicillin G (19.7%). The antimicrobials prescribed more often by otorhinolaryngologists for treatment were: oral penicillin for 10 days (35.4%) and oral penicillin for 7 days (25.7%). Tonsillectomy was considered the most effective measure for prevention of bacterial pharyngotonsillitis by more than half of pediatricians and otolaryngologists. Repeated pharyngotonsillitis was the main reason for otolaryngologists to indicate tonsillectomy for school-aged children and adolescents (49.3% and 53.4% respectively). Conclusions: It is necessary to standardize the practices of pediatricians and otolaryngologists regarding diagnosis and treatment of pharyngotonsillitis in children.

Tabagismo, abandono do fumo e os otorrinolaringologistas do estado de São Paulo / Smoking, smoking cessation and otorhinolaryngologists in the state of Sao Paulo, Brazil

Os otorrinolaringologistas estão diretamente envolvidos no diagnóstico e tratamento de doenças provocadas pelo cigarro, incluindo o câncer das vias aéreas superiores. É importante que os especialistas estejam capacitados a tratar o tabagismo e a dependência da nicotina. Também se sabe que há fumantes entre os próprios médicos. OBJETIVO: Pesquisar as opiniões e condutas de otorrinolaringologistas do Estado de São Paulo frente ao tabagismo e à dependência química da nicotina, e avaliar o hábito tabagístico dos especialistas. FORMA DE ESTUDO: Corte transversal. MATERIAL E MÉTODOS: Foram selecionados aleatoriamente 600 otorrinolaringologistas do Estado de São Paulo. A esses especialistas foi enviado, em março de 2005, por correio, um questionário padrão. Foram analisadas as respostas recebidas no período de março a maio de 2005. RESULTADOS: Foram recebidas 209 respostas. Nestas, 97 profissionais (46,4 por cento) avaliaram sua familiaridade com os meios de tratamento da dependência de nicotina como regular e 60 (28,7 por cento) como insatisfatória. Dos participantes do estudo, 144 (68,9 por cento) nunca fumaram, 50 (23,9 por cento) são ex-fumantes, nove (4,3 por cento) são fumantes ocasionais e seis (2,9 por cento) são fumantes. CONCLUSÃO: A prevalência de tabagistas na amostra de 209 otorrinolaringologistas do Estado de São Paulo foi de 7,1 por cento.

Otorhinolaryngologists are directly involved in the diagnosis and management of smoking related diseases, including upper airway malignancy. It is important that the specialists have skills to treat smoking and nicotine dependence. It is also known that there are smokers amongst doctors. AIM: To assess the opinions and practices of the otorhinolaryngologists of the state of Sao Paulo, Brazil, concerning smoking and nicotine dependence, and evaluation of smoking habits of the specialists. STUDY DESIGN: Cross-sectional. MATERIAL AND METHODS: We randomly selected 600 otorhinolaryngologists of Sao Paulo State, Brazil. A survey was mailed to the specialists in March 2005. We gathered data received from March to May 2005. RESULTS: There were 209 respondents. Forty-seven specialists (46.4 percent) rated themselves as moderately familiar with the methods for treatment of nicotine dependence, and 60 (28.7 percent) as unsatisfactorily familiar. One hundred and forty-four respondents (68.9 percent) have never smoked, 50 (23.9 percent) were former-smokers, nine (4.3 percent) were occasional smokers and six (2.9 percent) were regular smokers. CONCLUSION: The prevalence of smoking in the sample of 209 otorhinolaryngologists of Sao Paulo State, Brazil, was 7.1 percent.

Placa estabilizadora de Michigan e a sensação do zumbido / Full coverage maxillary splint (of Michigan design) and the tinnitus sensation

O autor faz um estudo em 44 pacientes com zumbido, com o objetivo de avaliar, por um período de 8 semanas, a influência do tratamento da síndrome da disfunção muscular e da ATM, através do uso da placa estabilizadora (modelo de Michigan), na evolução da sensação desse sintoma. Os resultados mostraram que os pacientes tiveram melhora significativa na sensação do zumbido, mesmo em casos em que os testes iniciais de limiar auditivo tonal foram positivos. O autor sugere que deve haver uma atenção maior no diagnóstico otorrinolaringológico para com os sintomas da disfunção da ATM e maior cooperação interdisciplinar