Performance of ChatGPT on the Peruvian National Licensing Medical Examination: Cross-Sectional Study.

BACKGROUND: ChatGPT has shown impressive performance in national medical licensing examinations, such as the United States Medical Licensing Examination (USMLE), even passing it with expert-level performance. However, there is a lack of research on its performance in low-income countries' national licensing medical examinations. In Peru, where almost one out of three examinees fails the national licensing medical examination, ChatGPT has the potential to enhance medical education. OBJECTIVE: We aimed to assess the accuracy of ChatGPT using GPT-3.5 and GPT-4 on the Peruvian National Licensing Medical Examination (Examen Nacional de Medicina [ENAM]). Additionally, we sought to identify factors associated with incorrect answers provided by ChatGPT. METHODS: We used the ENAM 2022 data set, which consisted of 180 multiple-choice questions, to evaluate the performance of ChatGPT. Various prompts were used, and accuracy was evaluated. The performance of ChatGPT was compared to that of a sample of 1025 examinees. Factors such as question type, Peruvian-specific knowledge, discrimination, difficulty, quality of questions, and subject were analyzed to determine their influence on incorrect answers. Questions that received incorrect answers underwent a three-step process involving different prompts to explore the potential impact of adding roles and context on ChatGPT's accuracy. RESULTS: GPT-4 achieved an accuracy of 86% on the ENAM, followed by GPT-3.5 with 77%. The accuracy obtained by the 1025 examinees was 55%. There was a fair agreement (κ=0.38) between GPT-3.5 and GPT-4. Moderate-to-high-difficulty questions were associated with incorrect answers in the crude and adjusted model for GPT-3.5 (odds ratio [OR] 6.6, 95% CI 2.73-15.95) and GPT-4 (OR 33.23, 95% CI 4.3-257.12). After reinputting questions that received incorrect answers, GPT-3.5 went from 41 (100%) to 12 (29%) incorrect answers, and GPT-4 from 25 (100%) to 4 (16%). CONCLUSIONS: Our study found that ChatGPT (GPT-3.5 and GPT-4) can achieve expert-level performance on the ENAM, outperforming most of our examinees. We found fair agreement between both GPT-3.5 and GPT-4. Incorrect answers were associated with the difficulty of questions, which may resemble human performance. Furthermore, by reinputting questions that initially received incorrect answers with different prompts containing additional roles and context, ChatGPT achieved improved accuracy.

Food insecurity in Piura, Peru, in the context of post-earthquake and the COVID-19 pandemic.

Introduction: Piura, located in a seismic zone, faces challenges related to food security. The aim of this study was to analyze aspects related to food insecurity in the region following the 6.1-magnitude earthquake that occurred in 2021, within the context of the COVID-19 pandemic. Methods: A secondary analysis was performed in 177 people exposed to the earthquake in Piura. Food insecurity was assessed with the Household Food Insecurity Access Scale. Its association with insomnia, resilience, anxiety/depressive symptoms, and general variables were determined using generalized linear models. Results: Food insecurity was observed in 31.1% (95% CI: 24.3-38.4) of participants. This prevalence was higher in people with mild (PR: 1.73, 95% CI: 1.12-2.70) and moderate (PR: 1.55, 95% CI: 1.09-2.22) anxiety symptoms, severe depressive symptoms (PR: 2.74, 95% CI: 1.24-6.03), and previous exposure to the El Niño Phenomenon (PR: 1.72; 95% CI: 1.06-2.81). An income higher than 5000 Peruvian soles (approximately 1300 US dollars) was associated with a lower prevalence of food insecurity (PR: 0.22, 95% CI: 0.13-0.40). Conclusions: Overall, three out of 10 individuals experienced food insecurity after the 2021 earthquake in Piura. Food insecurity may be aggravated by mental disorders, previous exposure to the El Niño phenomenon, and the COVID-19 pandemic. Our study contributes to the field by exploring a range of variables related to food insecurity in a unique context: post-earthquake and during the COVID-19 health emergency in Peru. These findings enhance our understanding of food insecurity at the regional level and highlight the need for preventive food security programs in seismic events.

Prevalence and Factors Associated with Eating Disorders in Military First Line of Defense against COVID-19: A Cross-Sectional Study during the Second Epidemic Wave in Peru.

Few studies have evaluated eating disorders in military personnel engaged in defense activities during the COVID-19 pandemic. We aimed to determine the prevalence and factors associated with eating disorders in military personnel from Lambayeque, Peru. A secondary data analysis was performed among 510 military personnel during the second epidemic wave of COVID-19 in Peru. We used the Eating Attitudes Test (EAT-26) to assess eating disorders. We explored associations with insomnia, food insecurity, physical activity, resilience, fear to COVID-19, burnout syndrome, anxiety, depression, post-traumatic stress and selected sociodemographic variables. Eating disorders were experienced by 10.2% of participants. A higher prevalence of eating disorders was associated with having 7 to 12 months (PR: 2.97; 95% CI: 1.24-7.11) and 19 months or more (PR: 2.62; 95% CI: 1.11-6.17) working in the first line of defense against COVID-19, fear of COVID-19 (PR: 2.20; 95% CI: 1.26-3.85), burnout syndrome (PR: 3.73; 95% CI: 1.90-7.33) and post-traumatic stress (PR: 2.97; 95% CI: 1.13-7.83). A low prevalence of eating disorders was found in the military personnel. However, prevention of this problem should be focused on at-risk groups that experience mental health burdens.

Factors Associated with Knowledge of Evacuation Routes and Having an Emergency Backpack in Individuals Affected by a Major Earthquake in Piura, Peru.

Information on the prevention of earthquakes in Peru, a high-risk country, is still emerging. We determined the frequency and factors associated with knowledge of evacuation routes and the use of emergency backpacks in people affected by a major earthquake. A cross-sectional study using secondary data was conducted from August-December 2021 on people that experienced the 6.1 magnitude earthquake that occurred in Piura, Peru on 30 July 2021. The outcome was self-reported knowledge of evacuation routes and the use of emergency backpacks. The association with self-reported earthquake preparation training, use of sources of information on earthquakes, and sociodemographic variables was investigated. A total of 69.5% of participants knew evacuation routes, and 46.3% had an emergency backpack. A higher frequency of knowledge of evacuation routes was associated with previous training (PR: 1.47; 95% CI: 1.15-1.87), use of the media (PR: 1.35; 95% CI: 1.06-1.72), having received information from the COEN (PR: 1.19; 95% CI: 1.02-1.40), and with a greater number of household members (PR: 1.03; 95% CI: 1.01-1.06). There is a high frequency of knowledge of evacuation routes among participants. However, basic notions of prevention culture are still needed. This research contributes to policy development on earthquake preparation at the community level.

Post-Traumatic Stress Disorder after the 6.1 Magnitude Earthquake in Piura, Peru: A Cross-Sectional Study.

In Peru, major disasters like the 2007 Pisco earthquake have produced high rates of post-traumatic stress. However, evidence is still needed to strengthen interventions. In 2021, a major earthquake struck Piura, in northern Peru. In this context, we aimed to assess the prevalence of PTSD and its associated factors. A cross-sectional study was conducted during August-September 2021 in people who experienced the 6.1 Piura earthquake on 30 July 2021. The questionnaire included the PCL-C, CD-RISC, ISI, HFIAS, and additional demographic data. Generalized linear models were used. The prevalence of PTSD was 20.3%. Household income was between PEN 2001 and 3000 (PR = 4.26, 95% CI: 1.08-16.75), smoking (PR = 2.49, 95% CI: 1.03-6.01), experience of a nervous breakdown (PR = 1.83, 95% CI: 1.09-3.09), moderate food insecurity (PR = 2.91, 95% CI: 1.10-7.73), and severe insomnia (PR = 8.25, 95% CI: 2.22-30.71) increased the prevalence of PTSD. One out of five individuals experienced post-traumatic stress symptoms after the 2021 earthquake in Piura, which varies depending on socioeconomic, psychosocial, and individual factors. Further research should strengthen these findings to ensure a fair and early mental health intervention against new seismic events in this and other Peruvian regions.

Mental Health Disturbance after a Major Earthquake in Northern Peru: A Preliminary, Cross-Sectional Study.

Little has been studied in Peru on the mental health repercussions after a major earthquake. We aimed to explore the factors associated with depressive and anxiety symptoms in people who experienced a 6.1 magnitude earthquake in Piura, Peru, on 30 July 2021. A preliminary cross-sectional study was conducted in the general population between August-September 2021. An online questionnaire was provided using PHQ-9, GAD-7, and other relevant measures. Generalized linear models were applied. Of the 177 participants, the median age was 22 years, the majority were female (56%), and many experienced depressive (52%) or anxiety symptoms (52%). Presence of depressive symptoms was associated with a personal history of mental disorder, moderate housing damage, social/material support from politicians, moderate food insecurity, and insomnia. Presence of anxiety symptoms was associated with physical injury caused by the earthquake, mild food insecurity, and insomnia. The development of depressive and anxiety symptoms following the 2021 earthquake experienced in Piura depended on multiple individual and socioeconomic factors. Additional studies should reinforce the factors identified here given the methodological limitations, such as the study design, sampling method, and sample size. This would lead to effective intervention measures to mitigate the impact of earthquakes on mental health.