This study aimed to assess the knowledge, attitudes, and intended practices of healthcare workers (HCWs) in Saudi Arabia towards ChatGPT, an artificial intelligence (AI) Chatbot, within the first ...three months after its launch. We also aimed to identify potential barriers to AI Chatbot adoption among healthcare professionals. A cross-sectional survey was conducted among 1057 HCWs in Saudi Arabia, distributed electronically via social media channels from 21 February to 6 March 2023. The survey evaluated HCWs' familiarity with ChatGPT-3.5, their satisfaction, intended future use, and perceived usefulness in healthcare practice. Of the respondents, 18.4% had used ChatGPT for healthcare purposes, while 84.1% of non-users expressed interest in utilizing AI Chatbots in the future. Most participants (75.1%) were comfortable with incorporating ChatGPT into their healthcare practice. HCWs perceived the Chatbot to be useful in various aspects of healthcare, such as medical decision-making (39.5%), patient and family support (44.7%), medical literature appraisal (48.5%), and medical research assistance (65.9%). A majority (76.7%) believed ChatGPT could positively impact the future of healthcare systems. Nevertheless, concerns about credibility and the source of information provided by AI Chatbots (46.9%) were identified as the main barriers. Although HCWs recognize ChatGPT as a valuable addition to digital health in the early stages of adoption, addressing concerns regarding accuracy, reliability, and medicolegal implications is crucial. Therefore, due to their unreliability, the current forms of ChatGPT and other Chatbots should not be used for diagnostic or treatment purposes without human expert oversight. Ensuring the trustworthiness and dependability of AI Chatbots is essential for successful implementation in healthcare settings. Future research should focus on evaluating the clinical outcomes of ChatGPT and benchmarking its performance against other AI Chatbots.
Automatic voice pathology detection and classification systems effectively contribute to the assessment of voice disorders, enabling the early detection of voice pathologies and the diagnosis of the ...type of pathology from which patients suffer. This paper concentrates on developing an accurate and robust feature extraction for detecting and classifying voice pathologies by investigating different frequency bands using autocorrelation and entropy. We extracted maximum peak values and their corresponding lag values from each frame of a voiced signal by using autocorrelation as features to detect and classify pathological samples. We also extracted the entropy for each frame of the voice signal after we normalized its values to be used as the features. These features were investigated in distinct frequency bands to assess the contribution of each band to the detection and classification processes. Various samples of the sustained vowel /a/ for both normal and pathological voices were extracted from three different databases in English, German, and Arabic. A support vector machine was used as a classifier. We also performed u-tests to investigate if there is a significant difference between the means of the normal and pathological samples. The best achieved accuracies in both detection and classification varied depending on the used band, method, and database. The most contributive bands in both detection and classification were between 1000 and 8000 Hz. The highest obtained accuracies in the case of detection were 99.69%, 92.79%, and 99.79% for Massachusetts eye and ear infirmary (MEEI), Saarbrücken voice database (SVD), and Arabic voice pathology database (AVPD), respectively. However, the highest achieved accuracies for classification were 99.54%, 99.53%, and 96.02% for MEEI, SVD, and AVPD, correspondingly, using the combined feature.
OBJECTIVES/HYPOTHESISThe Glottal Function Index (GFI) is a four-item self-administered survey suitable for the evaluation and treatment of patients with glottal dysfunction. To date, it has been ...translated into Lithuanian, Persian, and Hebrew. This study is intended to translate and cross-culturally adapt the GFI for use in Arabic-speaking patients with dysphonia.STUDY DESIGNThis work is a cross-sectional study involving the administration of the GFI to participants with dysphonia (cases) and patients without dysphonia (controls). The validation process included reliability and validity assessments.METHODSThe GFI was translated using forward and backward translation methods from English into Arabic. The questionnaire's reliability was assessed using Cronbach's alpha and test-retest reliability (intraclass correlation coefficient, ICC). The Mann-Whitney test evaluated validity by comparing cases and controls. Finally, the Kruskal-Wallis test examined differences in the GFI across various pathologies.RESULTSThe GFI demonstrated favorable internal consistency (Cronbach's alpha = 0.848) and excellent test-retest reliability (ICC = 0.993). Significant differences in the A-GFI score between the cases and controls were also observed (P < 0.001), supporting the instrument's validity. However, no statistically significant differences were found in A-GFI across different diagnoses (P = 0.712).CONCLUSIONSThe A-GFI is a valid and reliable screening tool for clinicians to assess dysphonia and voice impairment in patients in Arabic-speaking countries. The tool is easy to administer in daily clinical practice given its brevity and self-administration.
Summary Background and Objective Automatic voice-pathology detection and classification systems may help clinicians to detect the existence of any voice pathologies and the type of pathology from ...which patients suffer in the early stages. The main aim of this paper is to investigate Multidimensional Voice Program (MDVP) parameters to automatically detect and classify the voice pathologies in multiple databases, and then to find out which parameters performed well in these two processes. Materials and Methods Samples of the sustained vowel /a/ of normal and pathological voices were extracted from three different databases, which have three voice pathologies in common. The selected databases in this study represent three distinct languages: (1) the Arabic voice pathology database; (2) the Massachusetts Eye and Ear Infirmary database (English database); and (3) the Saarbruecken Voice Database (German database). A computerized speech lab program was used to extract MDVP parameters as features, and an acoustical analysis was performed. The Fisher discrimination ratio was applied to rank the parameters. A t test was performed to highlight any significant differences in the means of the normal and pathological samples. Results The experimental results demonstrate a clear difference in the performance of the MDVP parameters using these databases. The highly ranked parameters also differed from one database to another. The best accuracies were obtained by using the three highest ranked MDVP parameters arranged according to the Fisher discrimination ratio: these accuracies were 99.68%, 88.21%, and 72.53% for the Saarbruecken Voice Database, the Massachusetts Eye and Ear Infirmary database, and the Arabic voice pathology database, respectively.
Inducible laryngeal obstruction (ILO) is the adduction of the true vocal folds during inspiration or, less frequently, expiration. Its etiology is unknown.
This study aimed to identify ILO as a ...possible cause of shortness of breath (SOB) in post-COVID-19 patients.
A retrospective study was conducted on 59 post-COVID-19 adults complaining of SOB. We collected the cases' clinical and chest imaging data, including demographic data, pulmonary function test (PFT), CT chest, and laryngeal endoscopic examination. A visual score was used to assign the severity of the glottic obstruction. The grades of this score ranged from 0 (complete patency) to 3 (almost complete closure).
ILO was detected in 8 out of 59 cases (13.5%). Two cases out of eight had glottic closure grade 1, while five cases had glottic closure grade 2, and one had glottic closure grade 3. There was a positive correlation between ILO grades (the severity of glottic closure) and PFT results (the degree of upper airway restriction). PFTs in ILO have a specific pattern. It was typical for the expiratory loop to be normal and the inspiratory loop to be flattened.
ILO is a possible cause of SOB in post-COVID-19 adult cases. It should be considered during evaluation and management.
Voice disorders can significantly affect quality of life. This study aimed to translate, culturally adapt, and validate an Arabic version of the Voice Disability Coping Questionnaire (A-VDCQ) for use ...in Arabic-speaking populations with dysphonia.
This was a cross-sectional study involving the translation and cultural adaptation of the VDCQ into Arabic. The validation process included reliability and validity assessments. Participants were categorized into cases (individuals with dysphonia) and controls (individuals without dysphonia) to compare coping strategies between the two groups.
The 15-item VDCQ was translated from English into Arabic using the forward and backward translation methods. The questionnaire’s reliability was assessed using Cronbach’s alpha and test–retest reliability (intraclass correlation coefficient, ICC). Validity was evaluated by comparing cases and controls using the Mann–Whitney test. Differences in coping strategies across different diagnoses were examined using the Kruskal–Wallis test.
The A-VDCQ demonstrated satisfactory internal consistency (Cronbach's alpha = 0.769) and excellent test–retest reliability (ICC = 0.993). Significant differences in coping strategies between the cases and controls were also observed (p < 0.001), supporting the instrument’s validity. Notably, item 4, which is related to information seeking, had the highest impact score among the cases. However, no statistically significant differences were found in coping strategies across different diagnoses (p = 0.249).
The A-VDCQ demonstrated robust psychometric properties for assessing coping strategies in individuals with voice disorders and such strategies’ potential implications for clinical practice and research.
Post-thyroidectomy patients commonly experience voice changes, swallowing symptoms, and neck discomfort, a condition known as post-thyroidectomy syndrome. The Thyroidectomy-Related Voice and Symptom ...Questionnaire (TVSQ) is a validated tool showing strong correlations with established tools with a potential predictive value for post-thyroidectomy voice outcomes. Our study aims to translate and validate the TVSQ into Arabic.
This validation study was conducted at King Abdulaziz University Hospital and King Khalid University Hospital in Riyadh, Saudi Arabia. Forward and backward translations ensured the conceptual equivalence of the Arabic TVSQ (A-TVSQ) and were reviewed by an expert panel. A pilot test assessed the A-TVSQ’s face validity and clarity, leading to necessary cultural adjustments. The final A-TVSQ was pre- and post-operatively administered to thyroidectomy patients to evaluate its test-retest reliability.
Data were collected from 116 participants (53 cases 45.6% and 63 controls 54.3%). The internal consistency analysis showed strong inter-correlation among the A-TVSQ items, with Cronbach’s alpha coefficients (0.951) indicating excellent estimated internal consistency within both domains. Test-retest reliability showed a moderate level of reliability with an intraclass correlation coefficient of 0.696. A-TVSQ item discrimination analysis showed significant associations between the total and domain scores pre- and post-thyroidectomy. External validity analysis showed significant changes in A-TVSQ voice change (p < 0.010) and neck discomfort (p = 0.011) domains and total scores (p < 0.010) between before and two weeks after thyroidectomy. However, no significant changes were observed between two and four weeks after thyroidectomy.
The translated and validated A-TVSQ showed excellent internal consistency and moderate test-retest reliability, comparable to the original version. Voice change significantly worsened after thyroidectomy, highlighting the need for continued monitoring and management strategies for this complication.
To assess the prevalence of voice problems among teachers in Riyadh during tele-teaching and examine the relationship between the Voice Handicap Index 10 (VHI10) scores and a variety of risk factors ...believed to be related to voice problems. We also assessed awareness of voice hygiene and therapy among teachers.
An observational cross-sectional study conducted using a multistage random sampling method among Riyadh school teachers who taught by tele-teaching for a minimum of one year.
A self-assessment questionnaire which included demographic information about teachers, factors related to their teaching backgrounds, tele-teaching settings, effects of tele-teaching on the voice, medical and social histories, reports of voice and reflux symptoms, VHI10, and general knowledge about voice hygiene. This was distributed to school teachers using an SMS link through the Ministry of Education's IT department.
A total 495 were included in the study after exclusions. The prevalence of teachers who had significant voice problems during tele-teaching (VHI10>11) was 21.6%. Multiple risk factors significantly increased the risk of voice problems during tele-teaching. These factors included being female, teacher age, the presence of background noise from both teachers and students, loud voices, using an open camera during the teaching, stress and anxiety, allergies, respiratory disease, reflux, hearing problems, and a family history of voice problems. Only 4.6% of respondents were familiar with voice hygiene and voice therapy, but 65% believe that it is important for teachers to be knowledgeable about them.
Due to the lower prevalence of voice disorders among tele-teaching compared to traditional teaching methods, tele-teaching may be a viable option for teachers who have voice problems. There are still several factors influencing voice problems among tele-teachers. To attenuate potential risks, it is crucial that teachers are aware of the concepts of voice hygiene and voice therapy.
The aging voice index (AVI) is a 23-item self-administered, patient-reported outcome measure. It was developed in the English language to assess the impact of voice disorders on the elderly ...population.
This study aimed to develop an Arabic version of the AVI (A-AVI), test its reliability and validity, and assess its psychometric aspects in Arabic-speaking elderly persons with voice disorders.
This was an observational, cross-sectional study involving elderly patients aged ≥60 years. Eighty-two patients with voice disorders were included in the dysphonia group and 77 patients without voice disorders were included in the vocally healthy group. The translated A-AVI and Arabic voice handicap index 10 (A-VHI10) were distributed to the study groups. The A-AVI was tested for its reliability (test-retest reliability and internal consistency) and validity (content, construct, and concurrent with A-VHI10).
The A-AVI showed excellent test-retest reliability and internal consistency (intraclass correlation coefficient = 0.987 and Cronbach's alpha = 0.954, respectively). There was a significant difference in A-AVI scores between the elderly in the dysphonia and vocally healthy groups (P < 0.001). In addition, a significant correlation was demonstrated between A-AVI and A-VHI10 (r = 0.89). Unilateral vocal fold immobility and inflammatory laryngeal disorders were most frequently reported by the dysphonia group (28%).
A-AVI has excellent validity and reliability in Arab-speaking elderly patients with voice disorders. It can be considered in the assessment of the effect of voice disorders on the quality of life of the elderly.
Artificial intelligence (AI) chatbots, such as ChatGPT, have widely invaded all domains of human life. They have the potential to transform healthcare future. However, their effective implementation ...hinges on healthcare workers’ (HCWs) adoption and perceptions. This study aimed to evaluate HCWs usability of ChatGPT three months post-launch in Saudi Arabia using the System Usability Scale (SUS).
A total of 194 HCWs participated in the survey. Forty-seven percent were satisfied with their usage, 57 % expressed moderate to high trust in its ability to generate medical decisions. 58 % expected ChatGPT would improve patients’ outcomes, even though 84 % were optimistic of its potential to improve the future of healthcare practice. They expressed possible concerns like recommending harmful medical decisions and medicolegal implications.
The overall mean SUS score was 64.52, equivalent to 50 % percentile rank, indicating high marginal acceptability of the system. The strongest positive predictors of high SUS scores were participants' belief in AI chatbot's benefits in medical research, self-rated familiarity with ChatGPT and self-rated computer skills proficiency. Participants' learnability and ease of use score correlated positively but weakly. On the other hand, medical students and interns had significantly high learnability scores compared to others, while ease of use scores correlated very strongly with participants' perception of positive impact of ChatGPT on the future of healthcare practice.
Our findings highlight the HCWs' perceived marginal acceptance of ChatGPT at the current stage and their optimism of its potential in supporting them in future practice, especially in the research domain, in addition to humble ambition of its potential to improve patients’ outcomes particularly in regard of medical decisions. On the other end, it underscores the need for ongoing efforts to build trust and address ethical and legal concerns of AI implications in healthcare. The study contributes to the growing body of literature on AI chatbots in healthcare, especially addressing its future improvement strategies and provides insights for policymakers and healthcare providers about the potential benefits and challenges of implementing them in their practice.
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