Trends in Accuracy and Appropriateness of Alopecia Areata Information Obtained from a Popular Online Large Language Model, ChatGPT

BACKGROUND

Patients with alopecia areata (AA) may access a wide range of sources for information about AA, including the recently developed ChatGPT. Assessing the quality of health information provided by these sources is crucial, as patients are utilizing them in increasing numbers.

OBJECTIVES

The aim of the study was to evaluate appropriateness and accuracy of responses to common patient questions about AA generated by ChatGPT.

METHODS

Responses generated by ChatGPT 3.5 and ChatGPT 4.0 to 25 questions addressing common patient concerns were assessed by multiple attending dermatologists in an academic center for appropriateness and accuracy. Appropriateness of responses by both models for use in two hypothetical contexts as follows: (1) for patient-facing general information websites, and (2) for electronic health record (EHR) message drafts.

RESULTS

The accuracy across all responses was 4.41 out of 5. Accuracy scores of responses ChatGPT 3.5 responses had a mean of 4.29, whereas those generated by ChatGPT 4.0 had mean accuracy score of 4.53. Assessments ranged from 100% of responses rated as appropriate for the general question category to 79% questions about management for an EHR message draft. Raters largely preferred responses generated by ChatGPT 4.0 versus ChatGPT 3.5. Reviewer agreement was found to be moderate across all questions, with a 53.7% agreement and Fleiss' κ co-efficient of 0.522 (p value <0.001).

CONCLUSIONS

The large language model ChatGPT outputted mostly appropriate information for common patient concerns. While not all responses were accurate, the trend toward improvement with newer iterations suggests potential future utility for patients and dermatologists.

Cross-Sectional Study of Psoriasis, Atopic Dermatitis, Rosacea, and Alopecia Areata Suggests Association With Cardiovascular Diseases

BACKGROUND

A growing body of evidence suggests that several inflammatory skin diseases (ISDs) are associated with systemic inflammation and cardiovascular disease (CVDs).

METHODS

We used the TriNetX analytics platform to conduct a retrospective, cross-sectional, single-center study in the Mount Sinai Health System network. Cases (all patients &ge;18 years of age with a diagnosis of 1 of the 4 ISDs studied) were compared with matched controls (no history of any of these ISDs) to evaluate odds ratios for being diagnosed with CVD.

RESULTS

We identified a total of 70,090 patients with ISDs, including 35,160 patients with atopic dermatitis, 19,490 with psoriasis, 12,470 with rosacea, and 2,970 with alopecia areata, and 70,090 propensity score-matched controls without any of these ISDs. Patients with atopic dermatitis and psoriasis had significantly increased odds of all CVD diagnoses analyzed compared to controls (P&lt;0.001 for all comparisons). Patients with rosacea had significantly increased odds of being diagnosed with all diseases of the circulatory system (P&lt;0.001), hypertensive diseases (P&lt;0.001), cerebrovascular diseases (P=0.037), and arterial disease (P&lt;0.001) compared to controls. Patients with alopecia areata had increased odds for all diseases of the circulatory system (P&lt;0.001), hypertensive diseases (P&lt;0.001), and arterial disease (P&lt;0.001). The prevalence of patients with elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels was significantly greater in all ISD groups compared to controls.

CONCLUSION

This study identified significant associations between ISDs and several CVD diagnoses. Furthermore, CRP and ESR were elevated in all ISD groups compared to controls. Pagan AD, Jung S, Caldas S, et al. Cross-sectional study of psoriasis, atopic dermatitis, rosacea, and alopecia areata suggests association with cardiovascular diseases. J Drugs Dermatol. 2023;22(6):576-581. doi:10.36849/JDD.7424.

Effects of lipoic acid on growth and biochemical responses of common carp fed with carbohydrate diets

Lipoic acid (LA) is an antioxidant that also favors glucose uptake in mammals. Until now, there are no studies evaluating the potential effect of this molecule on glycemic control in fish. It was evaluated LA effects on glucose uptake in common carp Cyprinus carpio fed with carbohydrate diets from two carbohydrate sources: glucose (GLU) and starch (STA), and supplemented or not with LA, being the diets: +GLU/-LA (GLU); +GLU/+LA (GLU + LA); +STA/-LA (STA); and +STA/+LA (STA + LA). Carp juveniles (6.5 ± 0.1 g) were fed with each diet ad libitum 4 times a day, during 68 days. Muscle glycogen concentration was higher (p < 0.05) in GLU and GLU + LA than in STA and STA + LA groups. On fish fed with starch, muscle cholesterol and triglyceride concentrations were higher (p < 0.05) in fish fed diets supplemented with LA. Muscle protein levels were higher in fish fed with LA, independent of the diet carbohydrate source. Lipid peroxidation was significantly reduced (p < 0.05) in fish muscle on fish fed the STA + LA diets when compared with the STA diet. Our findings indicate that LA modulates lipid, proteins and carbohydrate metabolism together with the well-known antioxidant effect. Also, LA showed to enhance starch utilization taking into account muscle cholesterol and triglyceride levels.

Prophylaxis for recurrent acute otitis media: a Brazilian study

We enrolled 60 children with recurrent acute otitis media (AOM) in a study of the effectiveness of antimicrobial prophylaxis. All children were entered into the study following an acute episode of infection treated with amoxicillin (AMX) for 10 days. Following therapy, the children were re-examined, and then randomly assigned to receive either trimethoprim-sulfamethoxazole (TMP-SMX), amoxicillin (AMX) or a placebo (PLA). Twenty children were included in each group. Each drug was administered once a day at bedtime, at 1/3 the therapeutic dose, for 3 months. Children were re-evaluated with pneumootoscopy during episodes of acute illness and with pneumootoscopy and impedance tympanometry (TYMP) at monthly intervals. We observed a significantly increased rate of recurrent AOM in children receiving placebo compared with those who received antibiotics (50% vs. 17% P < 0.005). Both prophylactic antibiotics were equally effective in preventing recurrent AOM (recurrence rate 20% TMP-SMX, 15% AMX). We also observed that recurrences in children receiving placebo occurred earlier in the study period than in those receiving antibiotics. These results suggest that antimicrobial prophylaxis in children with recurrent acute otitis media is effective in reducing subsequent disease. The similar efficacy of both antibiotics tested suggests that the less expensive agent should be used.