LINKED CONTENT
This article is linked to Tamaki et al papers. To view these articles, visit https://doi.org/10.1111/apt.18015 and https://doi.org/10.1111/apt.18047
Editorial: Quantity is important Tan, Chee‐Kiat
Alimentary pharmacology & therapeutics,
September 2024, 2024-09-00, 20240901, Letnik:
60, Številka:
6
Journal Article
Recenzirano
Odprti dostop
LINKED CONTENT
This article is linked to Sultanik et al papers. To view these articles, visit https://doi.org/10.1111/apt.18165 and https://doi.org/10.1111/apt.18216
Background and Aims
Nonalcoholic steatohepatitis (NASH) is a common cause of chronic liver disease. Clinical trials use the NASH Clinical Research Network (CRN) system for semiquantitative ...histological assessment of disease severity. Interobserver variability may hamper histological assessment, and diagnostic consensus is not always achieved. We evaluate a second harmonic generation/two‐photon excitation fluorescence (SHG/TPEF) imaging‐based tool to provide an automated quantitative assessment of histological features pertinent to NASH.
Approach and Results
Images were acquired by SHG/TPEF from 219 nonalcoholic fatty liver disease (NAFLD)/NASH liver biopsy samples from seven centers in Asia and Europe. These were used to develop and validate qFIBS, a computational algorithm that quantifies key histological features of NASH. qFIBS was developed based on in silico analysis of selected signature parameters for four cardinal histopathological features, that is, fibrosis (qFibrosis), inflammation (qInflammation), hepatocyte ballooning (qBallooning), and steatosis (qSteatosis), treating each as a continuous rather than categorical variable. Automated qFIBS analysis outputs showed strong correlation with each respective component of the NASH CRN scoring (P < 0.001; qFibrosis r = 0.776, qInflammation r = 0.557, qBallooning r = 0.533, and qSteatosis r = 0.802) and high area under the receiver operating characteristic curve values (qFibrosis 0.870‐0.951; 95% confidence interval {CI}, 0.787‐1.000; P < 0.001, qInflammation 0.820‐0.838; 95% CI, 0.726‐0.933; P < 0.001), qBallooning 0.813‐0.844; 95% CI, 0.708‐0.957; P < 0.001, and qSteatosis 0.939‐0.986; 95% CI, 0.867‐1.000; P < 0.001) and was able to distinguish differing grades/stages of histological disease. Performance of qFIBS was best when assessing degree of steatosis and fibrosis, but performed less well when distinguishing severe inflammation and higher ballooning grades.
Conclusions
qFIBS is an automated tool that accurately quantifies the critical components of NASH histological assessment. It offers a tool that could potentially aid reproducibility and standardization of liver biopsy assessments required for NASH therapeutic clinical trials.
Background and Aim
Colonoscopy is commonly used in screening and surveillance for colorectal cancer. Multiple different guidelines provide recommendations on the interval between colonoscopies. This ...can be challenging for non‐specialist healthcare providers to navigate. Large language models like ChatGPT are a potential tool for parsing patient histories and providing advice. However, the standard GPT model is not designed for medical use and can hallucinate. One way to overcome these challenges is to provide contextual information with medical guidelines to help the model respond accurately to queries.
Our study compares the standard GPT4 against a contextualized model provided with relevant screening guidelines. We evaluated whether the models could provide correct advice for screening and surveillance intervals for colonoscopy.
Methods
Relevant guidelines pertaining to colorectal cancer screening and surveillance were formulated into a knowledge base for GPT. We tested 62 example case scenarios (three times each) on standard GPT4 and on a contextualized model with the knowledge base.
Results
The contextualized GPT4 model outperformed the standard GPT4 in all domains. No high‐risk features were missed, and only two cases had hallucination of additional high‐risk features. A correct interval to colonoscopy was provided in the majority of cases. Guidelines were appropriately cited in almost all cases.
Conclusions
A contextualized GPT4 model could identify high‐risk features and quote appropriate guidelines without significant hallucination. It gave a correct interval to the next colonoscopy in the majority of cases. This provides proof of concept that ChatGPT with appropriate refinement can serve as an accurate physician assistant.
Linked Content
This article is linked to Kuo et al and Kuo and Lu papers. To view these articles visit https://doi.org/10.1111/apt.14960 and https://doi.org/10.1111/apt.14509.
There have been increasing reports of food-borne zoonotic transmission of hepatitis E virus (HEV) genotype 3, which causes chronic infections in immunosuppressed patients. We performed phylogenetic ...analyses of the HEV sequence (partial and full-length) from 1 patient from the Middle East who underwent liver transplantation, and compared it with other orthohepevirus A sequences. We found the patient to be infected by camelid HEV. This patient regularly consumed camel meat and milk, therefore camelid HEV, which is genotype 7, might infect human beings. Our finding links consumption of camel-derived food products to post-transplantation hepatitis E, which, if detected at early stages, can be cured with antiviral therapy and reduced administration of immunosuppressive agents.
Background and Aim
Despite efforts in controlling and managing liver diseases, significant health issues remain. This study aims to evaluate the degree of public awareness and knowledge regarding ...liver health and diseases in Singapore.
Methods
A cross‐sectional, self‐reported, web‐based questionnaire was administered to 500 adult individuals. Questionnaire items pertained to knowledge and awareness of overall liver health, liver diseases and their associated risk factors.
Results
Sixty‐four percent of respondents were ≥35 years old and 54.0% were male. While majority agreed that regular screening was important for liver health (91.2%), only 65.4% attended health screening within recent 2 years. Hepatitis B had more awareness than hepatitis C among the respondents. About 70% agreed the consequences of viral hepatitis included liver cirrhosis, failure, and/or cancer. Yet, only 15% knew hepatitis C is not preventable by vaccination and more than half mistaken hepatitis B and C are transmissible via contaminated or raw seafood. Despite 75% being aware of non‐alcoholic fatty liver disease, many were not aware of the related risk factors and complications. Awareness of specific screening and diagnostic tests for liver health was poor as one‐fifth correctly identified the diagnostic tests for viral hepatitis. Preferences for doctor's consultation, TV, or newspapers (online) as information channels contrasted those currently used in the public health education efforts.
Conclusions
The levels of understanding of liver diseases, risk factors, and potential complications are suboptimal among the Singapore public. More public education efforts aligned with respondents' information‐seeking preferences could facilitate addressing misperceptions and increase knowledge about liver diseases.
Linked ContentThis article is linked to Hosaka et al and Hosaka papers. To view these articles, visit https://doi.org/10.1111/apt.15108. https://doi.org/10.1111/apt.15332 and ...https://doi.org/10.1111/apt.15361.
Changing epidemiology of hepatocellular carcinoma in Asia Goh, George Boon-Bee, MBBS, MMed, MRCP (UK); Chang, Pik-Eu, MBBS, MMed, MRCP (UK); Tan, Chee-Kiat, MBBS, MRCP (UK), FRCP (Edinburgh)
Baillière's best practice & research. Clinical gastroenterology,
12/2015, Letnik:
29, Številka:
6
Journal Article
Recenzirano
Abstract Hepatocellular carcinoma is a major problem in Asia because of the presence of multiple risk factors in the region such as endemicity of hepatitis B and significant contamination of ...foodstuff by aflatoxin in some areas. Another risk factor for HCC, chronic hepatitis C infection, in Asia is most significant in Japan, the only Asian country with more HCV than HBV-related hepatocellular carcinoma. As these risk factors can and are being modified by measures such as universal hepatitis B immunisation, successful treatment of HCV infections, reduction and improved surveillance of aflatoxin contamination of foodstuff, it is not surprising that the epidemiology of HCC in Asia is changing. All these are offset by the rising importance of NAFLD and NASH as chronic liver diseases and risk factors for HCC which contributes to the changing epidemiology of HCC in Asia.
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