Purpose
With the increasing adoption of artificial intelligence (AI) in various domains, including healthcare, there is growing acceptance and interest in consulting AI models to provide medical ...information and advice. This study aimed to evaluate the accuracy of ChatGPT’s responses to practice quiz questions designed for otolaryngology board certification and decipher potential performance disparities across different otolaryngology subspecialties.
Methods
A dataset covering 15 otolaryngology subspecialties was collected from an online learning platform funded by the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery, designed for board certification examination preparation. These questions were entered into ChatGPT, with its responses being analyzed for accuracy and variance in performance.
Results
The dataset included 2576 questions (479 multiple-choice and 2097 single-choice), of which 57% (
n
= 1475) were answered correctly by ChatGPT. An in-depth analysis of question style revealed that single-choice questions were associated with a significantly higher rate (
p
< 0.001) of correct responses (
n
= 1313; 63%) compared to multiple-choice questions (
n
= 162; 34%). Stratified by question categories, ChatGPT yielded the highest rate of correct responses (
n
= 151; 72%) in the field of allergology, whereas 7 out of 10 questions (
n
= 65; 71%) on legal otolaryngology aspects were answered incorrectly.
Conclusion
The study reveals ChatGPT’s potential as a supplementary tool for otolaryngology board certification preparation. However, its propensity for errors in certain otolaryngology areas calls for further refinement. Future research should address these limitations to improve ChatGPT’s educational use. An approach, with expert collaboration, is recommended for the reliable and accurate integration of such AI models.
For the treatment of vascular adverse events caused by filler injections, duplex ultrasound imaging may be used. The findings of duplex ultrasound examination and the clinical features of reticulated ...livedoid skin patterns were compared with the hemifaces anatomy.
The objective of this study was to link the reticulated livedoid skin patterns to the corresponding duplex ultrasound findings and the facial perforasomes.
Duplex ultrasound imaging was used for the diagnosis and treatment of vascular adverse events. The clinical features and duplex ultrasound findings of 125 patients were investigated. Six cadaver hemifaces were examined to compare the typical livedo skin patterns with the vasculature of the face.
Clinically, the affected skin showed a similar reticulated pattern in each facial area corresponding with arterial anatomy and their perforators in the cadaver hemifaces. With duplex ultrasound, a disturbed microvascularization in the superficial fatty layer was visualized. After hyaluronidase injection, clinical improvement of the skin pattern was seen. Normalization of blood flow was noted accompanied by restoration of flow in the corresponding perforator artery. The skin patterns could be linked to the perforators of the superficial fat compartments.
The livedo skin patterns seen in vascular adverse events may reflect the involvement of the perforators.
Noninflammatory nodules may be persistent to dissolve. To evaluate the possible reasons, a case series of ultrasound images and medical data of patients who were prospectively referred with ...noninflammatory nodules were evaluated.
A total of 27 patients with nodules but without signs of inflammation were included. All cases were assessed with an 18-MHz linear ultrasound device. Exact location of the filler material was noted. Relations with clinical data were analyzed using chi-square tests.
Early onset of complaints (<2 weeks) was found in 16 patients and late onset (>2 weeks) in 11. All patients had multiple nodules. In all cases, the filler nodule was found to be located inside the fascia. Extension to the subcutaneous tissue was seen in 8 cases and to the deeper planes in 5. In 14 cases, the filler material was completely located inside layers of the fascia, and migration was observed in 5 cases.
Accumulation of filler material in the superficial musculoaponeurotic system or fascia may be an important cause for the occurrence of persistent noninflammatory nodules, either by initial faulty injection technique or by later accumulation through the pathway generated with a needle or cannula. Ultrasound-guided injections are helpful to dissolve the nodule.
BACKGROUND:Understanding the precise position and course of the superior and inferior labial arteries within the upper and the lower lip is crucial for safe and complication free applications of ...volumizing materials.
METHODS:193 anatomic head specimens (56.5% females) of Caucasian ethnicity were investigated in this large multi-centric anatomical study. In total six 3cm long vertical incisions were performed on each lip (midline and 1cm medial to the angles of the mouth) to identify the position of the superior and the inferior labial arteries in relation to the orbicularis oris muscle.
RESULTS:Three different positions of the superior and inferior labial arteries were identifiedsubmucosal, i.e. between the oral mucosa and the orbicularis oris muscle in 78.1% of the cases, intra-muscular, i.e. between the superficial and the deep layer of the orbicularis oris muscle in 17.5% and subcutaneous, i.e. between the skin and the orbicularis oris muscle observed in 2.1% of the cases. The variability in changing the respective position along the labial course was 29% for the total upper and 32% for the total lower lip. The midline location was identified in both the upper and lower lip to be the most variable.
CONCLUSIONS:Based on the results of our investigation, a safer location for the application of volumizing material is the subcutaneous plane in the paramedian location of both the upper and the lower lip. Care has to be taken when aiming to inject in the midline as the artery can be identified more frequently in superficial positions.
BACKGROUND:The purpose of this article is to provide a comprehensive review based on images and discussion of the current understanding of the arterial supply of the face to facilitate safe minimally ...invasive antiaging procedures.
METHODS:Contrast-enhanced computed tomographic scans of 40 fresh frozen heads from 17 male and 23 female Caucasian body donors with a mean age of 76.9 ± 13.1 years and a mean body mass index of 23.6 ± 5.3 kg/m were retrospectively analyzed and compared to cadaveric dissections performed in more than 400 fresh cephalic specimens.
RESULTS:This review presents the current understanding of the facial arteries based on existing literature, direct observation from cadaveric dissection, and the dissection experience of the two authors of the study. It reveals the constant three-dimensional locations of the facial and angular arteriesmandible, modiolus, and medial canthus as compared to their unpredictable course in other facial regions. In addition, the anatomy of the ophthalmic and central retinal arteries is discussed in the context of current treatment strategies in cases of blindness following facial soft-tissue filler injections.
CONCLUSIONS:The arterial supply of the face exhibits high variability in branching patterns, course (two-dimensional), and depth (three-dimensional). Because of the lack of predictability of the vascular anatomy, it is impossible to absolutely guarantee safety when performing minimally invasive injectable procedures. Injectors should understand the potential for adverse vascular events, communicate this risk appropriately to patients, and be properly trained and equipped to treat any such complication.
ChatGPT has garnered attention as a multifaceted AI chatbot with potential applications in medicine. Despite intriguing preliminary findings in areas such as clinical management and patient ...education, there remains a substantial knowledge gap in comprehensively understanding the chances and limitations of ChatGPT’s capabilities, especially in medical test-taking and education. A total of n = 2,729 USMLE Step 1 practice questions were extracted from the Amboss question bank. After excluding 352 image-based questions, a total of 2,377 text-based questions were further categorized and entered manually into ChatGPT, and its responses were recorded. ChatGPT’s overall performance was analyzed based on question difficulty, category, and content with regards to specific signal words and phrases. ChatGPT achieved an overall accuracy rate of 55.8% in a total number of n = 2,377 USMLE Step 1 preparation questions obtained from the Amboss online question bank. It demonstrated a significant inverse correlation between question difficulty and performance with rs = -0.306; p < 0.001, maintaining comparable accuracy to the human user peer group across different levels of question difficulty. Notably, ChatGPT outperformed in serology-related questions (61.1% vs. 53.8%; p = 0.005) but struggled with ECG-related content (42.9% vs. 55.6%; p = 0.021). ChatGPT achieved statistically significant worse performances in pathophysiology-related question stems. (Signal phrase = “what is the most likely/probable cause”). ChatGPT performed consistent across various question categories and difficulty levels. These findings emphasize the need for further investigations to explore the potential and limitations of ChatGPT in medical examination and education.
The anatomical basis for auricular flaps used in multiple aesthetic and reconstructive procedures is currently based on a random distribution of the underlying arterial network. However, recent ...findings reveal a systematic pattern as opposed to the present concepts. Therefore, we designed this study to assess the arterial vascular pattern of the auricle in order to provide reliable data about the vascular map required for surgical interventions. Sixteen human auricles from eight body donors (five females/three males, 84.33 ± 9.0 years) were investigated using the unique ‘Spalteholz’ method. After arterial injection of silicone, a complete transparency of the tissue was achieved and the auricular arteries and branches were visible. Qualitative and quantitative evaluation of the arterial vascular pattern was performed. The superior and the inferior anterior auricular artery provided the vascular supply to the helical rim, forming an arcade, i.e. helical rim arcade. On the superior third of the helical rim another arcade was confirmed between the superior anterior auricular artery and the posterior auricular artery (PAA), i.e. the helical arcade. The perforators of the PAA were identified lying in a vertical line 1 cm posterior to the tragus, supplying the concha, inferior crus, triangular fossa, antihelix and the earlobe. The results of this study confirmed the constant presence of the helical rim arcade (Zilinsky‐Cotofana), consistent perforating branches of the PAA, and the helical arcade (Erdman), and will help and guide physicians performing auricular surgeries toward fast and simple procedures with optimal patient satisfaction.
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