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Quality of Information in Carpal Tunnel Syndrome: Social Media Platforms Versus Large Language Models

INTRODUCTION

Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment disease, and it is a subject of great interest and concern to medical professionals and the general public. Our study aims to analyze and compare the quality and accuracy of the information related to CTS provided by social media platforms (SMPs) and the new large language models (LLM).

METHODS

On YouTube, the first 20 videos in English and the first 20 videos in Spanish when searching for "carpal tunnel syndrome" and "síndrome túnel carpo" were selected. On Instagram, the first 20 videos with the hashtag #carpaltunnelsyndrome and #tunelcarpiano were chosen (in total 80 videos). Duration, number of likes, number of views, number of followers, upload date, and author category (medical specialist, patient, etc) were evaluated. Three specific questions about CTS were asked to 2 new LLMs (ChatGPT and Google Bard). The quality of information was analyzed and compared by two independent board-certified plastic surgeons using the Journal of American Medical Association (JAMA) and DISCERN scales.

RESULTS

LLMs showed a significant higher quality of information when compared with SMPs based on the DISCERN scores ( P < 0.05). Average DISCERN scores for answers given by ChatGPT and Google Bard were 52.83 and 57.83, respectively (good quality). In YouTube and Instagram, the average score for the 80 videos based on the JAMA scale was 1.92 (low reliability) and 25.18 (very low quality) on the DISCERN scale. Videos created by medical professionals in SMPs were associated with a higher JAMA and DISCERN scores ( P < 0.05). 53.8% of the videos were made by a nonmedical author.

CONCLUSIONS

The quality of information from LLMs was good and significantly better than in SMP. A low participation of board-certified surgeons in SMP was found. Board-certified surgeons should be more involved in LLM and SMPs to increase leadership, improve education, and spread knowledge of peripheral nerve surgery.

Reducing the Distance Between Anode and Cathode to Make Handheld Nerve Stimulators More Selective in Nerve Fascicle Selection: Report of Two Cases

Precise nerve fascicle identification is important in certain peripheral nerve procedures. Although we believe bipolar nerve stimulation with intraoperative neuromonitoring is a superior method, many rely on clinical response evoked by handheld monopolar nerve stimulators. We present a modification in the use of the latter for a more precise fascicle stimulation. A 55-year-old man with a right high brachial plexus injury and a 47-year-old woman with a left median nerve schwannoma were scheduled for exploration and ulnar-to-musculocutaneous nerve transfer, and for surgical excision respectively. Intraoperatively, we used a disposable handheld monopolar nerve stimulator in an unorthodox way, placing the anode right next to the cathode (both touching the same nerve fascicle). In the first case, a fascicle that showed flexor carpi ulnaris (FCU) and intrinsic hand muscle contraction with standard stimulation (anode placed on patient's skin), showed only FCU activation with our modified method, and was chosen as donor. A BMC grade M4 elbow flexion was achieved 9 months after surgery. In the second case, safe schwannoma excision was performed after our modified stimulation technique caused thenar muscle activation in a single, unaffected fascicle, while standard monopolar stimulation showed activation in several fascicles. No unexpected motor/sensory deficits were noted during follow-up. This report shows an easy modification in the use of handheld nerve stimulators that improves selectiveness when looking for nerve fascicles.

Return to work following ultrasound guided thread carpal tunnel release versus open carpal tunnel release: a comparative study

A retrospective review of hospital employees at a single employer institution who underwent ultrasound guided thread carpal tunnel release (TCTR) or open carpal tunnel release (OCTR) between January 2018 and August 2020 was performed to ascertain differences in return-to-work status. Patient age, sex, occupation, handedness, severity of carpal tunnel syndrome, prior treatments and surgical outcomes were reviewed. A total of 18 patients underwent TCTR and 17 patients underwent OCTR. The TCTR group averaged 12 days to return to work without restrictions, as opposed to 33 days for the OCTR group. Resolution of symptoms was afforded in all patients without any complications regardless of surgical technique. While both TCTR and OCTR were effective, our data indicates that TCTR resulted in a shorter return to work.Level of evidence: III.