derm

真皮
  • 文章类型: Journal Article
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:皮肤科患者教育材料(PEM)的书写水平通常高于全国平均水平的七至八年级阅读水平。ChatGPT-3.5,GPT-4,DermGPT,和DocsGPT是响应用户提示的大型语言模型(LLM)。我们的项目评估了它们在指定阅读水平下生成皮肤病学PEM的用途。
    目的:本研究旨在评估在未指定和指定的阅读水平下,选择LLM在常见和罕见皮肤病学中产生PEM的能力。Further,该研究旨在评估这些LLM生成的PEM的意义保存情况,由皮肤科住院医师评估。
    方法:当前美国皮肤病学会PEMs的Flesch-Kincaid阅读水平(FKRL)评估了4种常见(特应性皮炎,寻常痤疮,牛皮癣,和带状疱疹)和4例罕见(大疱性表皮松解症,大疱性类天疱疮,层状鱼鳞病,和扁平苔藓)皮肤病。我们提示ChatGPT-3.5,GPT-4,DermGPT,和DocsGPT以“在[FKRL]中创建关于[条件]的患者教育讲义”,以在未指定的五年级和七年级FKRL中每个条件迭代生成10个PEM,使用MicrosoftWord可读性统计进行评估。由2名皮肤科住院医师评估了LLM中意义的保留。
    结果:当前的美国皮肤病学会PEMs对常见和罕见疾病的平均(SD)FKRL为9.35(1.26)和9.50(2.3),分别。对于常见疾病,LLM生产的PEM的FKRL介于9.8和11.21之间(未指定提示),在4.22和7.43之间(五年级提示),在5.98和7.28之间(七年级提示)。对于罕见疾病,LLM生产的PEM的FKRL范围在9.85和11.45之间(未指定提示),在4.22和7.43之间(五年级提示),在5.98和7.28之间(七年级提示)。在五年级阅读水平,与ChatGPT-3.5相比,GPT-4在常见和罕见条件下都能更好地生产PEM(分别为P=.001和P=.01),DermGPT(分别为P<.001和P=.03),和DocsGPT(分别为P<.001和P=.02)。在七年级的阅读水平,ChatGPT-3.5、GPT-4、DocsGPT、或DermGPT在生产常见条件下的PEM(所有P>.05);然而,对于罕见的情况,ChatGPT-3.5和DocsGPT的表现优于GPT-4(分别为P=.003和P<.001)。意义分析的保留表明,对于共同条件,DermGPT在整体阅读便利性方面排名最高,患者的可理解性,和准确性(14.75/15,98%);对于罕见的情况,GPT-4产生的施舍排名最高(14.5/15,97%)。
    结论:GPT-4的表现似乎优于ChatGPT-3.5,DocsGPT,和DermGPT在五年级FKRL的常见和罕见的情况下,尽管ChatGPT-3.5和DocsGPT在7级FKRL中在罕见情况下的表现均优于GPT-4。LLM生产的PEM可以可靠地满足七级FKRL的选择常见和罕见的皮肤病,并且易于阅读,患者可以理解,而且大多是准确的。LLM可能在提高健康素养和传播无障碍方面发挥作用,在皮肤病学中可以理解的PEM。
    BACKGROUND: Dermatologic patient education materials (PEMs) are often written above the national average seventh- to eighth-grade reading level. ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT are large language models (LLMs) that are responsive to user prompts. Our project assesses their use in generating dermatologic PEMs at specified reading levels.
    OBJECTIVE: This study aims to assess the ability of select LLMs to generate PEMs for common and rare dermatologic conditions at unspecified and specified reading levels. Further, the study aims to assess the preservation of meaning across such LLM-generated PEMs, as assessed by dermatology resident trainees.
    METHODS: The Flesch-Kincaid reading level (FKRL) of current American Academy of Dermatology PEMs was evaluated for 4 common (atopic dermatitis, acne vulgaris, psoriasis, and herpes zoster) and 4 rare (epidermolysis bullosa, bullous pemphigoid, lamellar ichthyosis, and lichen planus) dermatologic conditions. We prompted ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT to \"Create a patient education handout about [condition] at a [FKRL]\" to iteratively generate 10 PEMs per condition at unspecified fifth- and seventh-grade FKRLs, evaluated with Microsoft Word readability statistics. The preservation of meaning across LLMs was assessed by 2 dermatology resident trainees.
    RESULTS: The current American Academy of Dermatology PEMs had an average (SD) FKRL of 9.35 (1.26) and 9.50 (2.3) for common and rare diseases, respectively. For common diseases, the FKRLs of LLM-produced PEMs ranged between 9.8 and 11.21 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). For rare diseases, the FKRLs of LLM-produced PEMs ranged between 9.85 and 11.45 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). At the fifth-grade reading level, GPT-4 was better at producing PEMs for both common and rare conditions than ChatGPT-3.5 (P=.001 and P=.01, respectively), DermGPT (P<.001 and P=.03, respectively), and DocsGPT (P<.001 and P=.02, respectively). At the seventh-grade reading level, no significant difference was found between ChatGPT-3.5, GPT-4, DocsGPT, or DermGPT in producing PEMs for common conditions (all P>.05); however, for rare conditions, ChatGPT-3.5 and DocsGPT outperformed GPT-4 (P=.003 and P<.001, respectively). The preservation of meaning analysis revealed that for common conditions, DermGPT ranked the highest for overall ease of reading, patient understandability, and accuracy (14.75/15, 98%); for rare conditions, handouts generated by GPT-4 ranked the highest (14.5/15, 97%).
    CONCLUSIONS: GPT-4 appeared to outperform ChatGPT-3.5, DocsGPT, and DermGPT at the fifth-grade FKRL for both common and rare conditions, although both ChatGPT-3.5 and DocsGPT performed better than GPT-4 at the seventh-grade FKRL for rare conditions. LLM-produced PEMs may reliably meet seventh-grade FKRLs for select common and rare dermatologic conditions and are easy to read, understandable for patients, and mostly accurate. LLMs may play a role in enhancing health literacy and disseminating accessible, understandable PEMs in dermatology.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    TikTok是一个新兴的社交媒体平台,为皮肤科医生等健康从业者提供了一个传播准确健康信息的新机会。
    Tik Tok is an emerging social media platform that provides a novel opportunity for health practitioners such as dermatologists to disseminate accurate health information.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    用于识别恶性肿瘤的深度集成(DERM)是一种人工智能,作为用于皮肤病变评估的医疗设备(AIaMD)工具。
    我们报告了其在2021年7月至2022年10月期间在两家国家卫生服务医院(英国)的皮肤癌途径中部署的预期现实世界表现。
    共发现14500例,包括18-100岁的FitzpatrickI-VI型皮肤患者。根据DERM评估的8,571个病变,并确认了结果,版本A和B显示出检测黑色素瘤(95.0-100.0%)或恶性肿瘤(96.0-100.0%)的非常高的灵敏度。良性病变特异性为40.7-49.4%(DERM-vA)和70.1-73.4%(DERM-vB)。DERM确定15.0-31.0%的病例符合出院条件。
    我们展示了DERM性能与敏感性目标和上市前授权研究一致,它通过两种途径减少了医院专家的工作量。根据我们的经验,我们对AIaMD的上市后监督的关键要素提出了建议。
    UNASSIGNED: Deep Ensemble for Recognition of Malignancy (DERM) is an artificial intelligence as a medical device (AIaMD) tool for skin lesion assessment.
    UNASSIGNED: We report prospective real-world performance from its deployment within skin cancer pathways at two National Health Service hospitals (UK) between July 2021 and October 2022.
    UNASSIGNED: A total of 14,500 cases were seen, including patients 18-100 years old with Fitzpatrick skin types I-VI represented. Based on 8,571 lesions assessed by DERM with confirmed outcomes, versions A and B demonstrated very high sensitivity for detecting melanoma (95.0-100.0%) or malignancy (96.0-100.0%). Benign lesion specificity was 40.7-49.4% (DERM-vA) and 70.1-73.4% (DERM-vB). DERM identified 15.0-31.0% of cases as eligible for discharge.
    UNASSIGNED: We show DERM performance in-line with sensitivity targets and pre-marketing authorisation research, and it reduced the caseload for hospital specialists in two pathways. Based on our experience we offer suggestions on key elements of post-market surveillance for AIaMDs.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:在长期使用睾酮治疗的跨男性患者中,痤疮通常会恶化。异维A酸是一种口服类维生素A,用于治疗严重或难治性痤疮,但它有可能导致伤口愈合延迟。经血管的患者可能会接受异维甲酸治疗痤疮,同时还计划进行胸部男性化手术。
    目的:本范围综述旨在确定异维A酸是否对接受胸部男性化手术的患者术后愈合有负面影响。
    方法:使用PubMed和Ovid数据库进行范围审查。总共选择了16种出版物。
    结果:痤疮倾向于在睾酮治疗开始后6个月出现峰值。严重病例可以用异维甲酸治疗;然而,一旦治疗停止,痤疮可能会复发,给予持续的激素治疗。在医学文献中,几乎没有证据表明异维A酸的围手术期使用,特别是在接受胸部男性化手术的跨男性患者中。总的来说,然而,最近的研究没有发现服用异维A酸的患者增加肥厚性瘢痕或瘢痕疙瘩的证据。
    结论:需要进一步的研究来加强目前的证据,表明异维A酸不需要在切开或切除手术之前或之后停用,包括跨男性患者的胸部男性化手术。
    BACKGROUND: Acne often worsens in transmasculine patients who are on prolonged testosterone therapy. Isotretinoin is an oral retinoid used in the treatment of severe or refractory cases of acne, but it has the potential to cause delayed wound healing. Transmasculine patients may potentially be prescribed treatment for acne with isotretinoin while also planning to undergo chest masculinization surgery.
    OBJECTIVE: This scoping review aims to determine whether isotretinoin has a negative impact on postoperative healing in transmasculine patients undergoing chest masculinization surgery.
    METHODS: A scoping review was performed using the PubMed and Ovid databases. A total of 16 publications were selected for inclusion.
    RESULTS: Acne tends to peak in transmasculine patients 6 months after initiation of testosterone treatment. Severe cases can be treated with isotretinoin; however, acne may recur once treatment is discontinued, given ongoing hormone therapy. There is little to no evidence in the medical literature regarding perioperative use of isotretinoin specifically among transmasculine patients undergoing chest masculinization surgery. In general, however, recent studies have found no evidence of increased hypertrophic scars or keloids in patients taking isotretinoin.
    CONCLUSIONS: Further studies are required to strengthen the current evidence that suggests that isotretinoin does not need to be discontinued before or after incisional or excisional surgeries, including chest masculinization surgery in transmasculine patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号