Comparison of an AI-Generated Case Report With a Human-Written Case Report: Practical Considerations for AI-Assisted Medical Writing.

INTRODUCTION:  The utility of ChatGPT has recently caused consternation in the medical world. While it has been utilized to write manuscripts, only a few studies have evaluated the quality of manuscripts generated by AI (artificial intelligence). OBJECTIVE:  We evaluate the ability of ChatGPT to write a case report when provided with a framework. We also provide practical considerations for manuscript writing using AI. METHODS: We compared a manuscript written by a blinded human author (10 years of medical experience) with a manuscript written by ChatGPT on a rare presentation of a common disease. We used multiple iterations of the manuscript generation request to derive the best ChatGPT output. Participants, outcomes, and measures: 22 human reviewers compared the manuscripts using parameters that characterize human writing and relevant standard manuscript assessment criteria, viz., scholarly impact quotient (SIQ). We also compared the manuscripts using the "average perplexity score" (APS), "burstiness score" (BS), and "highest perplexity of a sentence" (GPTZero parameters to detect AI-generated content). RESULTS: The human manuscript had a significantly higher quality of presentation and nuanced writing (p<0.05). Both manuscripts had a logical flow. 12/22 reviewers were able to identify the AI-generated manuscript (p<0.05), but 4/22 reviewers wrongly identified the human-written manuscript as AI-generated. GPTZero software erroneously identified four sentences of the human-written manuscript to be AI-generated. CONCLUSION:  Though AI showed an ability to highlight the novelty of the case report and project a logical flow comparable to the human manuscript, it could not outperform the human writer on all parameters. The human manuscript showed a better quality of presentation and more nuanced writing. The practical considerations we provide for AI-assisted medical writing will help to better utilize AI in manuscript writing.

Imaging review of spontaneous renal hemorrhage.

Spontaneous renal hemorrhage (SRH) is a diagnostic challenge and a significant cause of morbidity, and sometimes mortality. Early identification is essential to institute lifesaving and reno-protective interventions. In this review, we classify spontaneous renal hemorrhage by location, presentation and etiology. We also discuss the diagnostic approach to renal hemorrhage and optimum imaging modalities to arrive at the diagnosis. Finally, we review strategies to avoid missing a diagnosis of SRH and discuss the pitfalls of imaging in the presence of renal hemorrhage.

Diagnostic performance of triple-contrast versus single-contrast multi-detector computed tomography for the evaluation of penetrating bowel injury.

PURPOSE: Selecting groups of low-risk penetrating trauma patients to forego laparotomy can be challenging. The presence of bowel injury may prevent non-operative management. Optimal CT technique to detect bowel injury related to penetrating injury is controversial. Our goal is to compare the diagnostic performance of triple-contrast (oral, rectal, and IV) against IV contrast-only CT, for the detection of bowel injury from penetrating abdominopelvic trauma, using surgical diagnosis as the reference standard. METHODS: Nine hundred ninety-seven patients who underwent CT for penetrating torso trauma at a single institution between 2009 and 2016 in our HIPPA-compliant and institutional review board-approved retrospective cohort study. A total of 143 patients, including 15 females and 123 males underwent a pre-operative CT, followed by exploratory laparotomy. Of these, 56 patients received triple-contrast CT. CT examinations were independently reviewed by two radiologists, blinded to surgical outcome and clinical presentation. Results were stratified by contrast type and injury mechanism and were compared based upon diagnostic performance indicators of sensitivity, specificity, negative predictive value, and positive predictive value. Area under the receiving operating characteristics curves were analyzed for determination of diagnostic accuracy. RESULTS: Bowel injury was present in 45 out of 143 patients (10 on triple-contrast group and 35 on IV contrast-only group). Specificity and accuracy were higher with triple-contrast CT (98% specific, 97-99% accurate) compared to IV contrast-only CT (66% specific, 78-79% accurate). Sensitivity was highest with IV contrast-only CT (91% sensitive) compared with triple-contrast CT (75% sensitive), although this difference was not statistically significant. Triple-contrast technique increased diagnostic accuracy for both radiologists regardless of mechanism of injury. CONCLUSION: In our retrospective single-institution cohort study, triple-contrast MDCT had greater accuracy, specificity, and positive predictive values when compared to IV contrast-only CT in evaluating for bowel injury from penetrating wounds.

An autopsy study of coronary atherosclerosis and its relation to anthropometric measurements/indices of overweight and obesity in men.

Atherosclerosis accounts for a large proportion of cardiovascular system associated morbidity and mortality. The present autopsy based study is aimed to study the correlation between coronary atherosclerosis and anthropometric measurements/indices of overweight and obesity such as; Waist Circumference (WC), Hip Circumference (HC), Body Mass Index (BMI), and Waist Hip Ratio (WHR) in men from southern India. The present research also analyses the correlation between anthropometric measurements/indices of overweight and obesity in men with number of coronaries affected with atherosclerosis in individuals. The study included 50 autopsies conducted in the Government District Wenlock Hospital, Mangalore during March and September 2008. The heart was dissected following standard autopsy protocol and a 5 cm section of the right coronary artery (RCA) in the atrio-ventricular groove from its origin, a 5 cm segment of the left anterior descending artery (LADA) distal to the origin of the circumflex artery, but including the region of origin of the circumflex branch and left coronary artery (LCA) from its origin till the circumflex branch were excised, dissected out, fixed in 10% formalin, marked for identification and sent for histopathological analysis. The study shows a positive correlation of WC and WHR with atherosclerotic changes in the RCA. The number of arteries affected with atherosclerosis is found to be well correlated with WC, BMI and WHR. The study confirms an association between anthropometric measurements/indices of obesity, grade of atherosclerosis in the RCA and the number of arteries affected with atherosclerosis. Anthropometric measurements/indices of obesity can be an effective means to identify high risk cases of atherosclerosis at an early stage that can be effective in reducing the associated cardiac morbidity and mortality.