medical examination

体检
  • 文章类型: Journal Article
    自1970年代以来,甲褶毛细管镜检查(NFC)在诊断风湿病如系统性硬化症中的应用已经得到了很好的证实.进一步的研究还表明,NFC可以检测非风湿性疾病,如糖尿病,青光眼,皮炎,和阿尔茨海默病。在过去的十年里,甲皱毛细血管形态变化也被报道为不健康的生活习惯的症状,如不良的饮食习惯,吸烟,睡眠剥夺,甚至心理压力,所有这些都会导致血液流动缓慢。因此,研究甲皱毛细血管的形态与生活习惯之间的关系很有可能表明不健康的状态,甚至是疾病前的状况。简单,便宜,和诸如NFC的非侵入性方法对于常规医学检查是重要且有用的。本研究从PubMed数据库的系统文献检索开始,然后是报告通过NFC检测到的形态学变化的评估的研究摘要。并全面审查NFC在临床诊断和改善不健康饮食生活方式中的效用。它总结了饮食和生活方式健康促进策略,基于NFC和其他指示健康微血管血流和内皮功能的相关测量进行评估。
    Since the 1970s, the utility of nailfold capillaroscopy (NFC) in diagnosing rheumatological disorders such as systemic sclerosis has been well established. Further studies have also shown that NFC can detect non-rheumatic diseases such as diabetes, glaucoma, dermatitis, and Alzheimer disease. In the past decade, nailfold capillary morphological changes have also been reported as symptoms of unhealthy lifestyle habits such as poor diet, smoking, sleep deprivation, and even psychological stress, all of which contribute to slow blood flow. Therefore, studying the relationships between the morphology of nailfold capillaries and lifestyle habits has a high potential to indicate unhealthy states or even pre-disease conditions. Simple, inexpensive, and non-invasive methods such as NFC are important and useful for routine medical examinations. The present study began with a systematic literature search of the PubMed database followed by a summary of studies reporting the assessment of morphological changes detected by NFC, and a comprehensive review of NFC\'s utility in clinical diagnosis and improving unhealthy dietary lifestyles. It culminates in a summary of dietary and lifestyle health promotion strategy, assessed based on NFC and other related measurements that indicate healthy microvascular blood flow and endothelial function.
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  • 文章类型: Systematic Review
    背景:为医学检查目的编写多项选择题(MCQ)具有挑战性。它需要广泛的医学知识,医学教育工作者的时间和精力。本系统综述着重于大型语言模型(LLM)在生成医学MCQ中的应用。
    方法:作者搜索了截至2023年11月发表的研究。搜索术语集中在LLM上,生成了用于体检的MCQ。非英语,超出年度范围,不关注人工智能生成的多项选择题的研究被排除在外。MEDLINE用作搜索数据库。使用定制的QUADAS-2工具评估偏倚风险。
    结果:总体而言,纳入了2023年4月至2023年10月间发表的8项研究.六项研究使用了Chat-GPT3.5,而两项研究使用了GPT4。五项研究表明,LLM可以提出适合医学考试的合格问题。三项研究使用LLM撰写医学问题,但没有评估问题的有效性。一项研究对不同的模型进行了比较分析。另一项研究将LLM生成的问题与人类编写的问题进行了比较。所有研究都提出了错误的问题,被认为不适合进行医学检查。有些问题需要额外的修改才能合格。
    结论:LLM可用于编写医学检查的MCQ。然而,其局限性不容忽视。该领域的进一步研究至关重要,需要更多确凿的证据。在那之前,LLM可以作为撰写医学检查的补充工具。2项研究存在高偏倚风险。该研究遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目。
    BACKGROUND: Writing multiple choice questions (MCQs) for the purpose of medical exams is challenging. It requires extensive medical knowledge, time and effort from medical educators. This systematic review focuses on the application of large language models (LLMs) in generating medical MCQs.
    METHODS: The authors searched for studies published up to November 2023. Search terms focused on LLMs generated MCQs for medical examinations. Non-English, out of year range and studies not focusing on AI generated multiple-choice questions were excluded. MEDLINE was used as a search database. Risk of bias was evaluated using a tailored QUADAS-2 tool.
    RESULTS: Overall, eight studies published between April 2023 and October 2023 were included. Six studies used Chat-GPT 3.5, while two employed GPT 4. Five studies showed that LLMs can produce competent questions valid for medical exams. Three studies used LLMs to write medical questions but did not evaluate the validity of the questions. One study conducted a comparative analysis of different models. One other study compared LLM-generated questions with those written by humans. All studies presented faulty questions that were deemed inappropriate for medical exams. Some questions required additional modifications in order to qualify.
    CONCLUSIONS: LLMs can be used to write MCQs for medical examinations. However, their limitations cannot be ignored. Further study in this field is essential and more conclusive evidence is needed. Until then, LLMs may serve as a supplementary tool for writing medical examinations. 2 studies were at high risk of bias. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
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  • 文章类型: Journal Article
    法医学是位于健康和法律领域的医学分支,有助于解决包括民事,罪犯,和劳动法。在劳动法中,医学专家报告旨在评估工人的能力,并确保他们的权利和义务。本研究旨在讨论有关职业健康专家报告的科学文献中可用的信息。这是一份2012年至2018年期间的书目审查,搜索了MEDLINE,PubMed,和LILACS数据库,以及有关该主题的正式文件。我们选择了与最初提出的标准相对应的7篇文章,并仔细阅读了它们。这使我们能够建立与研究结果相对应的3个主要主题:1)专家报告在职业健康中的重要性;2)专家报告在职业健康中的障碍;3)医学专家在劳动诉讼中的作用。通过选定的研究和对本综述最初命题的评估,我们确认了专家报告在确保工人职业健康权利方面的重要性。此外,这项研究允许识别有关专家报告在职业健康中的作用的研究中的差距,因此,鉴于这一主题的重大社会意义,应鼓励更多的研究。
    Forensic medicine is a branch of medicine located within both the health and law domains that contributes in issues that include civil, criminal, and labor law. Within labor law, medical expert reports aim to evaluate the capacity of workers and ensure them their rights and duties. This study aimed to discuss the information available on the scientific literature regarding expert reports in occupational health. This is a bibliographic review ranging the period of 2012 to 2018 that searched the MEDLINE, PubMed, and LILACS databases, as well as official documents on the subject. We selected 7 articles corresponding to the initially proposed criteria and read them thoroughly. This allowed us to establish 3 main themes corresponding to the study results: 1) The importance of expert reports in occupational health; 2) Hurdles in the context of expert reports in occupational health; and 3) The role of the medical expert in labor lawsuits. Through the selected studies and the evaluation of the initial proposition of this review, we confirmed the importance of expert reports in ensuring workers\' rights in occupational health. Moreover, this study allowed the identification of gaps in studies regarding the role of expert reports in occupational health, thus more research should be encouraged in view of the great social relevance of this theme.
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