Assessing ChatGPT's capacity for clinical decision support in pediatrics: A comparative study with pediatricians using KIDMAP of Rasch analysis.

BACKGROUND: The application of large language models in clinical decision support (CDS) is an area that warrants further investigation. ChatGPT, a prominent large language models developed by OpenAI, has shown promising performance across various domains. However, there is limited research evaluating its use specifically in pediatric clinical decision-making. This study aimed to assess ChatGPT's potential as a CDS tool in pediatrics by evCDSaluating its performance on 8 common clinical symptom prompts. Study objectives were to answer the 2 research questions: the ChatGPT's overall grade in a range from A (high) to E (low) compared to a normal sample and the difference in assessment of ChatGPT between 2 pediatricians. METHODS: We compared ChatGPT's responses to 8 items related to clinical symptoms commonly encountered by pediatricians. Two pediatricians independently assessed the answers provided by ChatGPT in an open-ended format. The scoring system ranged from 0 to 100, which was then transformed into 5 ordinal categories. We simulated 300 virtual students with a normal distribution to provide scores on items based on Rasch rating scale model and their difficulties in a range between -2 to 2.5 logits. Two visual presentations (Wright map and KIDMAP) were generated to answer the 2 research questions outlined in the objectives of the study. RESULTS: The 2 pediatricians' assessments indicated that ChatGPT's overall performance corresponded to a grade of C in a range from A to E, with average scores of -0.89 logits and 0.90 logits (=log odds), respectively. The assessments revealed a significant difference in performance between the 2 pediatricians (P < .05), with scores of -0.89 (SE = 0.37) and 0.90 (SE = 0.41) in log odds units (logits in Rasch analysis). CONCLUSION: This study demonstrates the feasibility of utilizing ChatGPT as a CDS tool for patients presenting with common pediatric symptoms. The findings suggest that ChatGPT has the potential to enhance clinical workflow and aid in responsible clinical decision-making. Further exploration and refinement of ChatGPT's capabilities in pediatric care can potentially contribute to improved healthcare outcomes and patient management.

Hepatitis C Virus Subtypes Novel 6g-Related Subtype and 6w Could Be Indigenous in Southern Taiwan with Characteristic Geographic Distribution.

Hepatitis C virus (HCV) genotype (GT) 6 is the most genetically diverse GT and mainly distributed in Southeast Asia and south China but not Taiwan. Earlier studies showed the major HCV GTs in Taiwan were GT 1b and 2 with very rare GT 6 except in injection drug users (IDUs), and subtype 6a is the main GT 6 subtype among IDUs. Recently, we reported a much higher prevalence (18.3%) of GT 6 in Tainan City, southern Taiwan. This study was designed to clarify the subtypes of GT 6 in this endemic area. A total of 3022 (1343 men and 1679 women) HCV viremic patients were enrolled. Subtypes of GT 6 were determined by sequencing of core/E1 and nonstructural protein 5B in 322 of 518 GT 6 patients. The overall GT 6 prevalence rate was 17.1% (518/3022), with higher prevalence districts (>25%) located in northern Tainan. A novel 6g-related subtype is the most prevalent subtype (81.0%), followed by 6w (10.8%), 6a (7.5%), and 6n (0.7%). The high GT 6 prevalence in Tainan was mainly due to a novel 6g-related subtype and 6w. These two subtypes could be indigenous in Tainan with characteristic geographic distribution.

Geographic variation of genotype 6 hepatitis C virus infection in an endemic area of southern Taiwan.

Taiwan is a hepatitis C virus (HCV) endemic country with geographic variation of prevalence and main genotypes(GTs) are 1 b and 2a. We recently reported high GT6 prevalence in Tainan of southern Taiwan. To clarify this special genotype as a local endemic disease and its geographic variation, the prevalence rates of HCV GTs of 37 districts of Tainan were analyzed. A total of 3040 patients with HCV viremia were enrolled. The prevalence rates of HCV GT 1a, 1 b, 2, 3, 4, 6 and mixed types were 3.9%, 31.6%, 45.9%, 0.6%, 0.2%, 17.1% and 0.5% respectively. GT6 prevalence showed marked variation from 0 to 39.2%. Four districts with GT6 prevalence >30% are located between Jishui and Zengwen rivers. Preliminary subtyping data were 6 g/a/w. This geographic variation with spatial restriction by two rivers with 6 g/w is suggestive of local endemic infection of preexisting GT 6 HCV for centuries.

High prevalence of genotype 6 hepatitis C virus infection in Southern Taiwan using Abbott genotype assays.

BACKGROUND/PURPOSE: Abbott RealTime Genotype II assay can effectively identify hepatitis C virus (HCV) genotypes (GTs), but some GT 6 subtypes might not be differentiated from GT 1. Abbott RealTime Genotype II PLUS and sequencing might be needed to resolve these ambiguous results. Unlike the high prevalence of GT 6 in Southeast Asia, GT 6 had rarely been reported in Taiwan except in intravenous drug abusers (IDU). But the prevalence of GT 6 in Taiwan might be underestimated. We conducted this study to determine the GTs in a HCV endemic area in Southern Taiwan. METHODS: A total of 1147 patients with hepatitis C viremia for direct acting antivirals (DAA) treatment at the Chi Mei medical system in Tainan were enrolled. Genotype was determined using a working flow consisted of Abbott GT II, PLUS assays and 5' untranslated region (5' UTR)/core sequencing. RESULTS: Among the 1147 patients, 883 (77.0%) obtained GT results by GT II, 264 (23.0%) samples with ambiguous results by GT II assay received further tests, including 194 (73.5%) with PLUS assay and 70 (26.5%) with 5'UTR/core sequencing. Nearly three-quarters (73.5%) of ambiguous results by GT II assay were GT 6. Overall, 18.3% of samples were GT 6. Phylogenetic study of 11 samples of GT 6 subtypes showed 7 (63.6%) were 6 g. CONCLUSION: GT 6 is the major factor for high ambiguous rate by GT II. Unexpected high prevalence of GT 6 (18.3%) in Southern Taiwan, especially subtype 6 g, closely related to Indonesian strains, is first reported.