Author Interviews, Health Care Systems, JAMA, Technology, UCSD / 01.05.2023
ChatGPT Provided Surprising Empathetic Answers to Patient Queries
MedicalResearch.com Interview with:
Zechariah Zhu, B.S.
Affiliate Scientist with the Qualcomm Institute at UC San Diego and study co-author
First author: John W. Ayers, PhD, MA
MedicalResearch.com: What is the background for this study?
Response: In today’s day and age (especially after the COVID-19 pandemic), an increasing number of people are turning to virtual options for healthcare. Most notably, there was a 1.6-fold increase in electronic patient messages, which significantly increased the burden on physicians, with a record-high proportion of physicians (62%) reporting burnout symptoms.
On the other hand, we also see the rise of AI technologies like ChatGPT—an AI chatbot assistant that has taken the world by storm recently with its ability to provide lengthy response essays to many questions it is asked. Our objective for this study, then, was to evaluate the ability of ChatGPT to provide quality and empathetic responses to patient questions.
Dr. Ruiz[/caption]
John M. Ruiz, Ph.D
Associate Professor of Clinical Psychology
Department of Psychology
University of Arizona
Dr. Ruiz is the incoming editor-in-chief of the American Psychological Association (APA) journal, Health Psychology
Dr. Ruiz joined the U.S. Preventive Services Task Force in January 2022
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Skin cancer is the most common type of cancer in the United States, but it often does not cause serious complications or death. The Task Force’s recommendation on screening for skin cancer focuses on the effectiveness of visual skin exams for children and adults who do not have any symptoms. When reviewing the latest research, we found that there is currently not enough evidence to tell us whether or not screening people without signs or symptoms is beneficial. This is an I statement.
Ridge Maxson[/caption]
Ridge Maxson
M.D. Candidate, Class of 2024
Johns Hopkins University School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Dog walking is an increasingly popular mode of physical activity for adults in the US, but its injury burden and associated risk factors are not fully understood. This study found that the 3 most common injuries sustained by adult dog walkers in the US were finger fracture, TBI, and shoulder sprain or strain. Dog walking-related injuries sent approximately 423,000 adults to US EDs between 2001 and 2020, with an annual average of more than 21,000 visits. During that 20-year period, the estimated annual injury incidence increased by more than 4-fold. Among injured dog walkers, older adults and women were particularly vulnerable to serious injury, such as fracture and TBI.
Dr. Fallah[/caption]
Mahdi Fallah, MD, PhD
Dr. Stephens[/caption]
Dr Jacqueline Stephens MPH, PhD
Epidemiologist & Senior lecturer
Flinders University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: An increase in the volume of evidence published in the peer-reviewed literature on this topic prompted an update of this Cochrane Review.
Dr. Gandhi[/caption]
Manoj Gandhi, MD PhD
Senior Medical Director of Genetic Testing Services, 
Response: We were broadly interested in discovering instances of bacterial genes that have been acquired by diverse animal genomes over millions of years of evolution by the process of horizontal gene transfer (HGT). Since these events are quite rare and most previous discoveries have been serendipitous, we developed computational methods to identify genes acquired by HGT in animals. One of the exciting discoveries from our work was that vertebrate IRBP appeared to have originated in bacteria and is now a critical component of the vertebrate visual cycle, so this paper focuses on that one discovery.
IRBP or interphotoreceptor retinoid binding protein is an important protein present in the space between two major cell types in our eyes, photoreceptor cells and RPE cells. Our ability to see involves an intricate set of steps where light is first sensed by causing a change (isomerization) in the chemical structure of molecules in the eye called retinoids. This sensing of light occurs in our photoreceptor cells. Following this change in the chemical structure, the retinoid needs to be recycled back to the chemical structure that can again sense light. This recycling occurs in RPE cells. IRBP performs the essential function of shuttling retinoids between the photoreceptors and the RPE cells, which allows the cycle of sensing and regeneration to work. Supporting its importance, mutations in IRBP (also known as retinol binding protein 3 or RBP3) can cause several severe human eye diseases.
Larissa K. Samuelson, PhD
Professor
Developmental Dynamics Lab
School of Psychology; UK 14th for Research Quality
Psychology, Psychiatry, and Neuroscience
University of East Anglia, United Kingdom
MedicalResearch.com: What is the background for this study?
Response: Words direct the attention of infants, children and adults to mentioned objects in the environment. When someone says “Can you find the candy,” you look to the candy sitting on the counter. This fact is the basis of many tests of infant cognition in laboratories. To find out if a child knows the word “bike” we put a picture of a bike and a truck on a TV screen, say the word “bike” and see if they look at the correct object.
There is also evidence that words can direct attention even if you don’t know what they mean yet. For example, in studies of learning in the lab novel made up words like “modi” can direct children’s attention to specific features of objects. One particular example of this is the “shape bias”. If a two-year-old is shown a novel object and told a novel name, for example “This is my blicket,” and then asked, “Can you get your blicket” and shown one object that matches the named one in shape and another that is made from the same material, they will attend to the one that matches in shape. Researchers think the naming event “This is my…” cues children to look at things that are the same shape because they already know many names for things in sets that are similar in shape; cups are all cup-shaped, keys are all key-shaped, spoons are all spoon-shaped, etc.
Prior research suggests there may be differences in the way children who struggle with language decide what a new word means. For example, children with Developmental Language Disorder do not pay attention to the same things when learning new words as children with typical language development. These children do not look to an object that matches a named exemplar in shape when asked to “get your blicket”. But you can’t diagnose children with DLD until they are 3 or 4. We want to see if we can identify these children earlier, so they can get early support.
Edward Liu[/caption]
Edward Liu, BA
Second year medical student
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, PA
Medicalresearch.com: What is the background for this study?
Response: The United States’ opioid epidemic continues to rise because of increasing opioid use and availability, contributing to prescription opioid misuse, mortality, and rising cost.1 The worsening health and economic impact of opioid use disorder in the US warrants further attention on the adverse effects and distribution pattern of commonly prescribed opioids like oxycodone (OxyContin), fentanyl (Duragesic), and morphine (MS-Contin). Using the Automated Reports and Consolidated Ordering System (ARCOS) database,2 a comprehensive data collection system of pharmacies and hospitals distribution of Schedule II and III controlled substances in the US with the FDA Adverse Event Reporting System (FAERS)3 has never been done before. This approach may provide a more complete picture of the risks of prescription opioids which can include drowsiness, nausea, and potentially fatal respiratory depression. 
Prof. Hamdy[/caption]
Freddie C. Hamdy FRCS, FMedSci
Nuffield Professor of Surgery, University of Oxford
[caption id="attachment_60283" align="alignleft" width="100"]
Prof. Donovan[/caption]
Jenny L. Donovan PhD, FMedSci
Professor of Social Medicine, University of Bristol
MedicalResearch.com: What is the background for this study?
Response: Prostate cancer is a common malignancy in men. Prostate cancer diagnosis is made largely through opportunistic screening with a PSA (Prostate Specific Antigen) blood test, followed by prostate biopsies. The ProtecT study, funded by the National Institute for Health and Care Research in the UK, is the largest randomised trial of treatment in screen-detected localised prostate cancer. The study began by testing 82,429 men between the ages of 50 and 69 years, across nine UK centres with a PSA blood test, followed by biopsies of the prostate if the PSA level was elevated. 2,664 men with clinically localised prostate cancer were found. From these, 1,643 (62%) agreed to be randomised to Surgery (radical prostatectomy to remove the prostate gland), Radiotherapy (external beam with a period of hormone treatment beforehand), or Active Monitoring (where men received regular checks and further investigations, with change to radical treatment as necessary). The men were carefully followed up for an average of 15 years. In parallel, the side-effects of treatments and quality of life of these men was investigated using patient-reported outcomes included in an annual study questionnaire completed for at least 12 years.
Dr. Tauscher-Wisniewski,[/caption]
Sitra Tauscher-Wisniewski, MD
Vice President Clinical Development & Analytics
Novartis Gene Therapies
MedicalResearch.com: What is the background for this study? Would you briefly describe the condition of Spinal muscular atrophy (SMA)?
Response: At the 2023 Muscular Dystrophy Association Conference, we presented new data from two of our Long-Term Follow-Up (LTFU) studies, LT001 and LT002, which show the continued efficacy and durability of Zolgensma across a range of patient populations, with an overall benefit-risk profile that remains favorable. LT001 is a 15-year ongoing observational LTFU study following the Phase 1 START patients, who were the very first patients to receive our gene replacement therapy. LT-002 is a voluntary Phase 4 15-year ongoing follow-up safety and efficacy study of Zolgensma IV and investigational intrathecal (IT) OAV101 in patients previously treated in the Phase 3 IV studies (STR1VE-US, STR1VE-EU, STR1VE-AP, SPR1NT) and the Phase 1 IT study (STRONG).
Spinal muscular atrophy (SMA) is a rare, devastating genetic disease that leads to progressive muscle weakness, paralysis, and when left untreated in one of its most severe forms (SMA Type 1), permanent ventilation or death in 90% of cases by age 2. It is caused by a lack of a functional survival motor neuron 1 (SMN1) gene, and in the most severe forms results in the rapid and irreversible loss of motor neurons, affecting muscle functions, including breathing, swallowing and basic movement.
Dr. Potter[/caption]
MedicalResearch.com Interview with:
Kelly Potter, PhD, RN, CNE
T32 Postdoctoral Scholar
CRISMA Center, Department of Critical Care Medicine
University of Pittsburgh
MedicalResearch.com: What is the background for this study?
Response: While it is well-recognized that survivors of critical illness often experience persistent problems with mental, cognitive, and physical health, very little is known about how these problems (collectively known as post-intensive care syndrome (PICS)) affect resumption of meaningful activities, such as driving.
Dr. Levin[/caption]
Trevor Levin Ph.D.
Founder and CEO of Convergent Genomics that produces the Uroamp assay
San Francisco, CA
MedicalResearch.com: What is the background for this study?
Response: Bladder cancer is one of the most expensive and challenging to diagnose and treat. Therefore, identifying cost-effective urine bladder cancer biomarkers to complement or replace the gold-standard invasive and costly cystoscopy for the early detection and monitoring of this highly recurrent disease is crucial. At the international Agency for research on Cancer (IARC-WHO), we have developed a simple urine-based assay TERT promoter mutations, the most common mutations in bladder cancer, and showed that the urine biomarker could detect bladder cancer patients at diagnosis but many years prior to clinical diagnosis. However, in this study, we wanted to see whether a more comprehensive genomic profiling of urine samples collected years prior to clinical diagnosis of bladder cancer could identify even more patients before they develop any symptoms.
The study was based on the UroAmp test, a general urine test that identifies mutations in 60 genes, developed by the Oregon Health Science University spin out company, Convergent Genomics. Drawing on previous research to identify genetic mutations linked to bladder cancer, the research team narrowed the new test down to focus on mutations within just ten genes.
Working with colleagues from the Tehran University of Medical Sciences in Iran, they trialled the potential new test using samples from the Golestan Cohort Study, which has tracked the health of more than 50,000 participants over ten years, all of whom provided urine samples at recruitment. Forty people within the study developed bladder cancer during that decade, and the team were able to test urine samples from twenty-nine of them, along with samples from 98 other similar participants as controls.
Dr. D'Orsogna[/caption]
Maria-Rita D'Orsogna Ph.D.
Professor, Mathematics
California State University, Northridge
Adjunct Associate Professor
Department of Computational Medicine at UCLA
MedicalResearch.com: What is the background for this study?
Response: Drug overdose deaths have been increasing in the USA for the past two decades. A ‘third wave’ of overdose fatalities started in 2013, with a shift from prescription opioids towards synthetic ones, in particular illicit fentanyl.
To examine trends in drug overdose deaths by gender, race and geography in the United States during the period 2013-2020, we used an epidemiological database provided by the Centers for Disease Control and Prevention, extracting rates by race and gender in all 50 states plus the District of Columbia. We considered the impact of four main drug categories psychostimulants with addiction potential such as methamphetamines; heroin; prescription opioids and synthetic opioids such as fentanyl and its derivatives.
Dr. Koh[/caption]
Andrew Y. Koh, M.D.
Associate Professor, Pediatrics and Microbiology
Prof. Rahimi[/caption]
Kazem Rahimi FRCP, DM, MSc, FESC
Professor of Cardiovascular Medicine and Population Health
University of Oxford
Consultant cardiologist
Oxford University Hospitals NHS Trust
MedicalResearch.com: What is the background for this study?
Response: The prevalence of hypertension has been rising worldwide. To mitigate the burden, identifying the modifiable environmental risk factors of hypertension and developing preventive interventions constitute important public health priorities. Despite the biological plausibility of the link between road traffic noise and the risk of hypertension, the quality of relevant evidence has been low, and the role of air pollution has been uncertain.
Dr. Keyes[/caption]
Dr Helen Keyes