Evaluating Literature Reviews Conducted by Humans Versus ChatGPT: Comparative Study.

BACKGROUND: With the rapid evolution of artificial intelligence (AI), particularly large language models (LLMs) such as ChatGPT-4 (OpenAI), there is an increasing interest in their potential to assist in scholarly tasks, including conducting literature reviews. However, the efficacy of AI-generated reviews compared with traditional human-led approaches remains underexplored. OBJECTIVE: This study aims to compare the quality of literature reviews conducted by the ChatGPT-4 model with those conducted by human researchers, focusing on the relational dynamics between physicians and patients. METHODS: We included 2 literature reviews in the study on the same topic, namely, exploring factors affecting relational dynamics between physicians and patients in medicolegal contexts. One review used GPT-4, last updated in September 2021, and the other was conducted by human researchers. The human review involved a comprehensive literature search using medical subject headings and keywords in Ovid MEDLINE, followed by a thematic analysis of the literature to synthesize information from selected articles. The AI-generated review used a new prompt engineering approach, using iterative and sequential prompts to generate results. Comparative analysis was based on qualitative measures such as accuracy, response time, consistency, breadth and depth of knowledge, contextual understanding, and transparency. RESULTS: GPT-4 produced an extensive list of relational factors rapidly. The AI model demonstrated an impressive breadth of knowledge but exhibited limitations in in-depth and contextual understanding, occasionally producing irrelevant or incorrect information. In comparison, human researchers provided a more nuanced and contextually relevant review. The comparative analysis assessed the reviews based on criteria including accuracy, response time, consistency, breadth and depth of knowledge, contextual understanding, and transparency. While GPT-4 showed advantages in response time and breadth of knowledge, human-led reviews excelled in accuracy, depth of knowledge, and contextual understanding. CONCLUSIONS: The study suggests that GPT-4, with structured prompt engineering, can be a valuable tool for conducting preliminary literature reviews by providing a broad overview of topics quickly. However, its limitations necessitate careful expert evaluation and refinement, making it an assistant rather than a substitute for human expertise in comprehensive literature reviews. Moreover, this research highlights the potential and limitations of using AI tools like GPT-4 in academic research, particularly in the fields of health services and medical research. It underscores the necessity of combining AI's rapid information retrieval capabilities with human expertise for more accurate and contextually rich scholarly outputs.

Lessons Learned From a Retrospective Analysis of Medicolegal Risks for Physicians Treated Adolescents and Young Adults With Medical Complexity.

PURPOSE: Adolescent and young adult patients occupy a clinically transitional space between pediatric and adult care. Youth with chronic conditions and special healthcare needs may have trouble accessing and receiving appropriate care in this transition, which may lead to patient safety issues and medicolegal risks for physicians. The objectives of this article were to explore patient safety issues and identify medicolegal risks for physicians. METHODS: A national repository was retrospectively searched for medicolegal cases (MLCs) involving complaints from youth. The study included MLCs closed at the Canadian Medical Protective Association between 2013 and 2022 involving youth. The study participants were adolescents and young adults aged ≥ 15 and ≤ 21 years with medical complexity. The frequencies and proportions of patient safety events and medicolegal risks for physicians were calculated by exploring factors that contributed to each incident using established frameworks. RESULTS: A total of 182 eligible MLCs were identified. Of 206 involved physicians, 55 were psychiatrists. The most common reasons for patient complaints were deficient assessment, diagnostic error, and communication breakdown with the patient and/or family. More than half of the cases were related to a harmful incident. Peer experts reviewed the cases and identified factors such as a deficient assessment, a failure to perform a test or intervention, failure to refer the patient, and insufficient provider knowledge/skill as contributing to the patient safety event. DISCUSSION: The impact of our findings is to identify gaps in care delivery to youth that can inform practitioners of ways to mitigate the gaps and improve patient care and health outcomes.

Exploring perceptions of online calculators for identifying community-dwelling older people at risk of dying: A qualitative study.

Objectives: This study aimed to assess the acceptability, value, and perceived barriers of using electronic risk calculators for predicting and communicating the risk of death in community-dwelling older adults. Methods: One focus group and eight interviews were conducted with 16 participants with experience caring for patients or family members at end of life. A prototype mortality risk tool was used to anchor discussions. Data were analysed using a qualitative content analysis approach. Results: Five themes emerged: acceptability, communication, barriers to use, broadening the circle of care, and tool limitations. Participants found the tool helpful for preparation, planning, and providing care, but disagreed on its community availability. Personalized risk estimates were valued for facilitating early goals of care conversations and normalizing discussions about death. However, concerns were raised about the tool's interpretation for individuals with different language, cultural, or educational backgrounds. Conclusions: While electronic risk calculators were found to be acceptable, balancing autonomy with varying preferences for receiving the information and potential need for support is crucial. Innovation: Providing patient-oriented life-expectancy estimates can enhance decisional capacity and facilitate shared decision-making between patients, their families, and healthcare professionals. Further research is needed to explore effective communication of personalized risk tools and additional benefits, harms, and barriers to implementation.

Medico-legal risk of infectious disease physicians in Canada: A retrospective review.

Objective: There is little known about the medico-legal risk for infectious disease specialists in Canada. The objective of this study was to identify the causes of these medico-legal risks with the goal of improving patient safety and outcomes. Methods: A 10-year retrospective analysis of Canadian Medical Protective Association (CMPA) closed medico-legal cases from 2012 to 2021 was performed. Peer expert criticism was used to identify factors that contributed to the medico-legal cases at the provider, team, or system level, and were contrasted with the patient complaint. Results: During the study period there were 571 infectious disease physician members of the CMPA. There were 96 patient medico-legal cases: 45 College complaints, 40 civil legal matters, and 11 hospital complaints. Ten cases were associated with severe patient harm or death. Patients were most likely to complain about perceived deficient assessments (54%), diagnostic errors (53%), inadequate monitoring or follow-up (20%), and unprofessional manner (20%). In contrast, peer experts were most critical of the areas of diagnostic assessment (20%), deficient assessment (10%), failure to perform test/intervention (8%), and failure to refer (6%). Conclusion: While infectious disease physicians tend to have lower medico-legal risks compared to other health care providers, these risks still do exist. This descriptive study provides insights into the types of cases, presenting conditions, and patient allegations associated with their practice.

Objectif: On sait peu de choses sur les risques médico-légaux auxquels sont exposés les spécialistes des maladies infectieuses au Canada. L'objectif de cette étude est de cibler les causes qui sous-tendent ces risques et, ce faisant, d'améliorer la sécurité et l'issue clinique des patients. Méthodes: Une analyse rétrospective sur 10 ans des dossiers médico-légaux conclus par l'Association canadienne de protection médicale (ACPM) entre 2012 et 2021 a été effectuée. Des experts ont été consultés pour cerner les facteurs à l'origine des dossiers médico-légaux en question, que ce soit à l'échelle des prestataires de soins, des équipes ou du système, et ces facteurs ont été mis en parallèle avec les plaintes des patients. Résultats: Au cours de la période de l'étude, 571 médecins membres de l'ACPM étaient spécialisés dans le traitement des maladies infectieuses. Quatre-vingt-seize dossiers médico-légaux portant sur des patients ont été recensés : 45 plaintes auprès d'un Collège, 40 poursuites au civil et 11 plaintes intrahospitalières. Un préjudice grave ou un décès a été constaté dans dix dossiers. Les motifs de plainte les plus répandus chez les patients étaient les évaluations perçues comme déficientes (54 %), les erreurs de diagnostic (53 %), une surveillance ou un suivi inadéquats (20 %) et un comportement non professionnel (20 %). En revanche, les experts consultés se sont surtout montrés critiques à l'égard des évaluations diagnostiques (20 %), des évaluations déficientes (10 %), du manquement à faire un test ou une intervention (8 %) et du manquement à orienter quelqu'un vers une ou un collègue (6 %). Conclusion: Les risques médico-légaux des médecins spécialisés dans le traitement des maladies infectieuses sont généralement moindres que ceux d'autres professionnels de la santé. Néanmoins, ces risques existent. Cette étude descriptive jette un éclairage sur le type de dossiers associés à la pratique de ces médecins, sur les motifs de consultation et sur les allégations formulées par les patients. Summary: Infectious disease (ID) physicians play a vital role in managing a broad spectrum of illnesses, from common infections to complex conditions, through rapid disease detection, effective treatment, preventive measures, and appropriate use of antimicrobial agents. ID doctors generally have a lower risk of complaints and lawsuits compared to other types of doctors. However, these risks do still exist and are important to consider.Our research team conducted a review of medico-legal cases over a 10-year period (2012­2021) involving ID physicians, with the goal of identifying why these problems occurred and how physicians might avoid them in the future. We examined why patients complained, what the types of diseases were, and the extent of patient harm. We also looked at which other types of doctors were most often involved in these cases.Most of the cases were either complaints made to a college (47%) or civil legal cases (42%). The rate of cases remained relatively stable over the study period. Twenty percent of complaints were linked to conditions of the bones, muscles, and connective tissue, such as osteomyelitis and septic arthritis. More than half of the patients who complained specifically mentioned concerns with the physician's assessment or a diagnostic error. In contrast, when expert physicians reviewed these cases, they only identified diagnostic errors in 20% of cases, and deficient assessments in 10% of cases.This research is important for two reasons. First, it may help to create a clearer picture of the current medico-legal landscape within the ID specialty. Second, by identifying areas of potential risk, it can guide the development of strategies to reduce these risks, thereby improving patient safety and trust in health care providers.

Tírala Plena: findings from the formative research to inform the initiative "Reaching those most left behind through comprehensive sexuality education for out-of-school young people" in Colombia.

This paper presents the results of formative research conducted from January to June 2020 in the Department of Atlántico, Caribbean region of Colombia, whose findings were used as inputs to design the national strategy for comprehensive sexuality education (CSE) outside school - Tírala Plena - including its curriculum. This is within the framework of the multi-country project coordinated by UNFPA and WHO aimed at generating evidence on the role of facilitators in the delivery of CSE in non-school contexts. The research was carried out in four municipalities in northern Colombia, in rural and marginal urban contexts with conditions of vulnerability for the adolescent population, including a strong presence of migrant populations from Venezuela. A total of 150 male and female adolescents ages 10-17 participated in the formative research. Workshops such as patchwork quilt, body mapping and talking maps were used as methods to gather information. The groups were divided by sex and age (10-13 years old and 14-17 years old). Knowledge, attitudes and social norms regarding adolescent pregnancy, sexually transmitted infections, including human immunodeficiency virus, and gender-based violence, were identified in adolescents (schooled and not schooled, but with minimal or no access to CSE). All of the above enabled us to establish a set of recommendations for the strengthening of the CSE strategy Tírala plena.

Automating Detection of Drug-Related Harms on Social Media: Machine Learning Framework.

BACKGROUND: A hallmark of unregulated drug markets is their unpredictability and constant evolution with newly introduced substances. People who use drugs and the public health workforce are often unaware of the appearance of new drugs on the unregulated market and their type, safe dosage, and potential adverse effects. This increases risks to people who use drugs, including the risk of unknown consumption and unintentional drug poisoning. Early warning systems (EWSs) can help monitor the landscape of emerging drugs in a given community by collecting and tracking up-to-date information and determining trends. However, there are currently few ways to systematically monitor the appearance and harms of new drugs on the unregulated market in Canada. OBJECTIVE: The goal of this work is to examine how artificial intelligence can assist in identifying patterns of drug-related risks and harms, by monitoring the social media activity of public health and law enforcement groups. This information is beneficial in the form of an EWS as it can be used to identify new and emerging drug trends in various communities. METHODS: To collect data for this study, 145 relevant Twitter accounts throughout Quebec (n=33), Ontario (n=78), and British Columbia (n=34) were manually identified. Tweets posted between August 23 and December 21, 2021, were collected via the application programming interface developed by Twitter for a total of 40,393 tweets. Next, subject matter experts (1) developed keyword filters that reduced the data set to 3746 tweets and (2) manually identified relevant tweets for monitoring and early warning efforts for a total of 464 tweets. Using this information, a zero-shot classifier was applied to tweets from step 1 with a set of keep (drug arrest, drug discovery, and drug report) and not-keep (drug addiction support, public safety report, and others) labels to see how accurately it could extract the tweets identified in step 2. RESULTS: When looking at the accuracy in identifying relevant posts, the system extracted a total of 584 tweets and had an overlap of 392 out of 477 (specificity of ~84.5%) with the subject matter experts. Conversely, the system identified a total of 3162 irrelevant tweets and had an overlap of 3090 (sensitivity of ~94.1%) with the subject matter experts. CONCLUSIONS: This study demonstrates the benefits of using artificial intelligence to assist in finding relevant tweets for an EWS. The results showed that it can be quite accurate in filtering out irrelevant information, which greatly reduces the amount of manual work required. Although the accuracy in retaining relevant information was observed to be lower, an analysis showed that the label definitions can impact the results significantly and would therefore be suitable for future work to refine. Nonetheless, the performance is promising and demonstrates the usefulness of artificial intelligence in this domain.

Use of dental implants among older adults of two southern Brazilian cities: A population-based cross-sectional study.

AIM: To assess the prevalence and associated factors with use of dental implants among older adults. METHODS: This cross-sectional study was performed with home dwelling older adults from the cities Cruz Alta and Veranópolis, Brazil. The main outcome was obtained by a clinical oral examination, considering those with at least one dental implant. Independent variables were collected by a structured questionnaire. Crude and adjusted analysis was performed by Poisson regression with robust variance estimation; results are presented in prevalence ratio (PR) and 95% confidence interval. RESULTS: It was included 569 participants. The overall prevalence of using at least one dental implant was 16.7%. Higher PR for the use of dental implants was observed in white individuals (PR:5.147; 95% CI:2.033-3.034), in those with at least medium income (PR:3.202; 95% CI:1.196-5.572) and in those with access to dental care in the last 12 months (RP:1.595; 95% CI:1.087-2.340). Older adults with a medium level of education (RP:0.484; 95% CI:0.240-0.978) and those that did not use dental floss (RP:0.627; 95% CI:0.240-0.978) demonstrated a significantly lower PR for use of dental implants. CONCLUSION: A substantial prevalence of use of dental implants was observed among older adults. In addition, white ones, those with a better financial situation and users of dental floss presented higher use of dental implants.

An analysis of cannabis home cultivation and associated risks in Canada, before and after legalization.

Background: In 2018, Canada legalized the use and sale of non-medical cannabis, with most provinces also permitting home cultivation. To advance the knowledge of home cultivation patterns in Canada within the context of legalization, this study examines (1) the demographics and use patterns of cannabis home growers before and after legalization and (2) the relationship between home cultivation and cannabis-related risks, including workplace use and driving after cannabis use(DACU). Data and methods: The study is based on seven waves of the National Cannabis Survey, dating from 2018 to 2019. Descriptive statistics were used to analyze home cultivation across several individual and sociodemographic characteristics pre- and post-legalization. Logistic regression was used to examine whether home cultivation is correlated to selected cannabis-related risks. Results: The rate and demographics of home cultivation remained relatively unchanged post-legalization. Those most likely to cultivate cannabis post-legalization were male; 35 years and older; not single; married, common law, divorced, separated or widowed; lived in the Atlantic provinces; consumed cannabis medically or medically and non-medically on a daily or almost daily basis; had more than a high school diploma; and reported "smoking" as their primary consumption method. Home cultivation was correlated to workplace use but not to DACU. Interpretation: The research provides early insights into home cultivation within a legalized framework. It also shows a relationship between home cultivation and certain cannabis-related risks (e.g., workplace use), suggesting a need for future research to determine whether tailored education and policy interventions are needed to target cannabis home growers.

Home cultivation across Canadian provinces after cannabis legalization.

Aims: Little research exists on home cultivation in Canada after non-medical cannabis legalization in 2018. The aims of the study were to: (1) estimate the percentage of home cultivation before and after legalization; (2) estimate the quantity and expenditure of cannabis plants; and (3) examine the association between provincial policies and home cultivation after legalization. Methods: Repeat cross-sectional survey data come from Canadian respondents in the International Cannabis Policy Study in 2018, 2019, and 2020. Respondents aged 16-65 were recruited through online commercial panels. Home cultivation rates were estimated among all respondents in 2019 and 2020 (n = 26,304) and among a sub-sample of past 12-month cannabis consumers in 2018-2020 (n = 12,493). Weighted multivariable logistic regression models examined the association between home cultivation and provincial policies among all respondents, 2019-2020. Results: Cannabis consumers in 2019 (7.9%; AOR = 1.47, 95% CI: 1.07,2.01) and 2020 (8.8%; AOR = 1.62, 95 %CI: 1.18,2.23) had higher odds of reporting home cultivation in the past 12 months than pre-legalization (5.8%). Post-legalization, past 12-month home cultivation was lower in Quebec and Manitoba, the two provinces that prohibited home cultivation (3.2%), than in provinces where home cultivation was permitted (6.8%; AOR = 0.48, 95 %CI: 0.39, 0.59). The median number of plants grown across all provinces was between 3.1 and 3.5 in all years. Conclusions: Almost one in ten Canadian cannabis consumers reported home cultivation of cannabis in 2020, with modest increases following legalization and most growing within the non-medical limit of four plants. Home cultivation was less common in provinces where home cultivation was prohibited.

Reabilitação oral estética com laminados cerâmicos ultrafinos / Aesthetic oral rehabilitation with ultrathin ceramic veneers

A utilização de laminados cerâmicos ultrafinos nas reabilitações orais estéticas tem-se tornado uma opção de tratamento cada vez mais popular. Entretanto não há elevado nível de evidência científica quanto à longevidade dessas restaurações. Com base nisso, o objetivo do presente artigo é relatar a instalação de laminados cerâmicos ultrafinos na bateria labial superior de uma paciente com queixa de insatisfação estética do sorriso após ter finalizado um tratamento ortodôntico, destacando aspectos relacionados ao diagnóstico, ao planejamento do caso e ao preparo dentário...

The use of ultrathin ceramic veneers for the aesthetic oral rehabilitation has become an increasingly popular treatment. However, there is few high-quality scientific evidence regarding the longevity of these restorations. Based on this fact, the purpose of this study is to report a clinical case of ultra-thin ceramic veneers in the maxillary teeth of a patient unsatisfied with her smile after the end of the orthodontic treatment, highlighting aspects related to diagnosis, treatment planning and tooth preparation...

How male sound pressure level influences phonotaxis in virgin female Jamaican field crickets (Gryllus assimilis).

Understanding female mate preference is important for determining the strength and direction of sexual trait evolution. The sound pressure level (SPL) acoustic signalers use is often an important predictor of mating success because higher sound pressure levels are detectable at greater distances. If females are more attracted to signals produced at higher sound pressure levels, then the potential fitness impacts of signalling at higher sound pressure levels should be elevated beyond what would be expected from detection distance alone. Here we manipulated the sound pressure level of cricket mate attraction signals to determine how female phonotaxis was influenced. We examined female phonotaxis using two common experimental methods: spherical treadmills and open arenas. Both methods showed similar results, with females exhibiting greatest phonotaxis towards loud sound pressure levels relative to the standard signal (69 vs. 60 dB SPL) but showing reduced phonotaxis towards very loud sound pressure level signals relative to the standard (77 vs. 60 dB SPL). Reduced female phonotaxis towards supernormal stimuli may signify an acoustic startle response, an absence of other required sensory cues, or perceived increases in predation risk.

How age influences phonotaxis in virgin female Jamaican field crickets (Gryllus assimilis).

Female mating preference can be a dominant force shaping the evolution of sexual signals. However, females rarely have consistent mating preferences throughout their lives. Preference flexibility results from complex interactions of predation risk, social and sexual experience, and age. Because residual reproductive value should theoretically decline with age, older females should not be as choosy as younger females. We explored how age influences phonotaxis towards a standard mate attraction signal using a spherical treadmill (trackball) and a no-choice experimental protocol. Female Jamaican field crickets, Gryllus assimilis, were highly variable in their phonotaxis; age explained up to 64% of this variation. Females 10 days post imaginal eclosion and older oriented toward the mate attraction signal, with 10- and 13-day females exhibiting the greatest movement in the direction of the signal. Our study suggests 10- and 13-day old females would be most responsive when quantifying the preference landscape for G. assimilis sexual signals.