Is ChatGPT an Accurate and Reliable Source of Information for Patients with Vaccine and Statin Hesitancy?

Objective: Chat Generative Pre-trained Transformer (ChatGPT) is an artificial intelligence (AI) language model that is trained to respond to questions across a wide range of topics. Our aim is to elucidate whether it would be beneficial for patients who are hesitant about vaccines and statins to use ChatGPT. Methods: This cross-sectional and observational study was conducted from March 2 to March 30, 2023, using OpenAI ChatGPT-3.5. ChatGPT provided responses to 7 questions related to vaccine and statin hesitancy. The same questions were also directed at physicians. Both the answers from ChatGPT and the physicians were assessed for accuracy, clarity, and conciseness by experts in cardiology, internal medicine, and microbiology, who possessed a minimum of 30 years of professional experience. Responses were rated on a scale of 0-4, and the ChatGPT's average score was compared with that of physicians using the Mann-Whitney U test. Results: The mean scores of ChatGPT (3.78±0.36) and physicians (3.65±0.57) were similar (Mann-Whitney U test p=0.33). The mean scores of ChatGPT were 3.85±0.34 for vaccination and 3.68±0.35 for statin use. The mean scores of physicians were 3.73±0.51 for vaccination and 3.58±0.61 for statin use. There was no statistically significant difference between the mean scores of ChatGPT and physicians for both vaccine and statin use (p=0.403 for vaccination, p=0.678 for statin). ChatGPT did not consider sources of conspiratorial information on vaccines and statins. Conclusions: This study suggests that ChatGPT can be a valuable source of information for guiding patients with vaccine and statin hesitancy.

Is Metabolic Score for Visceral Fat (METS-VF) a Better Index Than Other Adiposity Indices for the Prediction of Visceral Adiposity.

Background: Visceral adiposity is an important risk factor for cardiometabolic diseases. Objective: To determine whether the Metabolic Score for Visceral Fat (METS-VF) is more effective than other adiposity indices in predicting visceral fat area (VFA). Methods: In this single-center and cross-sectional study, we included patients aged 20-50 years, without diabetes and coronary artery disease, who underwent computed tomography (CT) including the third lumbar vertebra. Age, blood pressure, waist circumference (WC), hip circumference, fasting lipids, and glucose were assessed. VFA was measured by cross-sectional examination of CT. The correlation of WC, body mass index (BMI), waist-hip ratio (WHR), lipid accumulation product (LAP), visceral adiposity index (VAI), a body shape index (ABSI), body roundness index (BRI), and METS-VF with VFA was analyzed by correlation analysis. The cut-off values and area under the curve (AUC) for identifying increased VFA (>130 cm2) were determined. Results: We included 185 individuals with mean age 38.2 ± 8 and female predominance (58.4%). There was a significant positive correlation between all indices and VFA (p<0.001). ROC analysis revealed that METS-VF and WC demonstrated the highest predictive value for identifying increased VFA. In both men (p=0.001) and women (p<0.001), METS-VF (AUC 0.922 and 0.939, respectively) showed a significant superiority over ABSI (AUC 0.702 and 0.658, respectively), and VAI (AUC 0.731 and 0.725, respectively). Additionally, in women, its superiority over WHR (AUC 0.807) was also statistically significant (p=0.003). We identified a METS-VF cut-off point >6.4 in males >6.5 in females and WC cut-off point >88 cm in males (AUC 0.922), >90.5 cm in females (AUC 0.938). Conclusion: METS-VF is strongly associated with visceral adiposity and better to predict increased VFA. However, its superiority over WC, BMI, BRI, and LAP was not significant. The results emphasize that WC is more appealing as screening indicator for visceral adiposity considering its easy use. Clinical Trial Registry Name: Clinicaltrials.gov (http://www.clinicaltrials.gov). Clinical Trial Registry Url: https://clinicaltrials.gov/ct2/show/NCT05648409. Clinical Trial Registry Number: NCT05648409.

Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio in the Patients with Euthyroid Hashimoto's Thyroiditis.

Objective: This study aimed to compare the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) values in patients with euthyroid Hashimoto's thyroiditis (HT) with healthy control subjects. Methods: This was a single-center, retrospective, cross-sectional study conducted on obese patients aged 18 years and over. The medical records of patients who presented with complaints of being overweight at the obesity clinic between April 2017 and May 2019 were examined. Patients and healthy individuals were included in the study consecutively until the sample sizes reached saturation. Patients with diabetes, cardiovascular disease, chronic inflammatory disease, and malignancy were excluded from the study. The patients' anthropometric measurements, smoking status, blood examination, and thyroid ultrasounds were evaluated. The difference in means between the groups was calculated using the Mann-Whitney U test. Results: The study included 179 participants, consisting of 93 patients and 86 healthy controls. The mean age was 46.6±14.1 years, with most females (91.6%). Although the NLR and PLR values in patients were higher than those in the control group, the difference did not reach statistical significance (p=0.427 and p=0.089, respectively). Furthermore, no significant difference was observed in NLR (p=0.191) and PLR (p=0.668) values between levothyroxine-treated and untreated patients. Correlation analysis revealed weak positive associations between C-reactive protein and thyroid peroxidase antibodies (p<0.05), neutrophils (p<0.01), platelets (p<0.01), and NLR (p<0.05). Conclusions: The findings of this study suggest that NLR and PLR may not serve as effective indicators of systemic inflammation in patients with euthyroid HT, nor do they adequately assess the impact of levothyroxine usage on systemic inflammation.

Comparison of the diagnostic accuracy of the updated Sydney system and single biopsy.

Background: Updated Sydney system (USS) recommends taking biopsies from certain areas of the stomach for the diagnosis of precancerous lesions associated with Helicobacter pylori. Our aim was to evaluate the contribution of each of the biopsy sites to the diagnosis. Methods: This prospective study included 97 patients aged 40 and over with dyspeptic complaints. Biopsies were taken from five regions: the lesser curvature of the antrum (LCA), the lesser curvature of the corpus (LCC), incisura angularis (IA), the greater curvature of the antrum (GCA), and the greater curvature of the corpus (GCC). Biopsy specimens were stained with hematoxylin-eosin stain, periodic acid Schiff-alcian blue, and Giemsa histochemical stain and evaluated according to the Sydney classification. Results: Thirty-seven (38%) patients were positive for H. pylori in at least one biopsy site. Atrophic gastritis without intestinal metaplasia (IM) was found in 17 (17.5%) of the patients (6.2% in IA, 5.2% in each of LCA, GCA, and LCC, and 2% in GCC). The prevalence of atrophic gastritis with IM was 42.3% (21.6% in LCA, 20.6% in GCA, 20.6% in IA, 14.4% in LCC, and 5.2% in GCC). Endoscopic follow-up was planned in 21 (22%) patients due to the presence of extensive atrophy or incomplete IM. If a single biopsy of the LCA or a biopsy of both LCA and GCA was taken, endoscopic follow-up would have been missed in 12 (57%) or 6 (29%) patients, respectively. Conclusion: Taking biopsies in accordance with the USS had higher sensitivity in detecting atrophic gastritis with or without IM compared to single biopsy. One or two biopsies is not sufficient to identify patients for whom endoscopic follow-up is recommended.