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Davis RJ, Ayo-Ajibola O, Lin ME, Swanson MS, Chambers TN, Kwon DI, Kokot NC. Evaluation of Oropharyngeal Cancer Information from Revolutionary Artificial Intelligence Chatbot. Laryngoscope 2024; 134:2252-2257. [PMID: 37983846 DOI: 10.1002/lary.31191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/12/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE With burgeoning popularity of artificial intelligence-based chatbots, oropharyngeal cancer patients now have access to a novel source of medical information. Because chatbot information is not reviewed by experts, we sought to evaluate an artificial intelligence-based chatbot's oropharyngeal cancer-related information for accuracy. METHODS Fifteen oropharyngeal cancer-related questions were developed and input into ChatGPT version 3.5. Four physician-graders independently assessed accuracy, comprehensiveness, and similarity to a physician response using 5-point Likert scales. Responses graded lower than three were then critiqued by physician-graders. Critiques were analyzed using inductive thematic analysis. Readability of responses was assessed using Flesch Reading Ease (FRE) and Flesch-Kincaid Reading Grade Level (FKRGL) scales. RESULTS Average accuracy, comprehensiveness, and similarity to a physician response scores were 3.88 (SD = 0.99), 3.80 (SD = 1.14), and 3.67 (SD = 1.08), respectively. Posttreatment-related questions were most accurate, comprehensive, and similar to a physician response, followed by treatment-related, then diagnosis-related questions. Posttreatment-related questions scored significantly higher than diagnosis-related questions in all three domains (p < 0.01). Two themes of the physician critiques were identified: suboptimal education value and potential to misinform patients. The mean FRE and FKRGL scores both indicated greater than an 11th grade readability level-higher than the 6th grade level recommended for patients. CONCLUSION ChatGPT responses may not educate patients to an appropriate degree, could outright misinform them, and read at a more difficult grade level than is recommended for patient material. As oropharyngeal cancer patients represent a vulnerable population facing complex, life-altering diagnoses, and treatments, they should be cautious when consuming chatbot-generated medical information. LEVEL OF EVIDENCE NA Laryngoscope, 134:2252-2257, 2024.
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Affiliation(s)
- Ryan J Davis
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | | | - Matthew E Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Mark S Swanson
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Tamara N Chambers
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Daniel I Kwon
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Niels C Kokot
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
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Tam B, Lin ME, Shah R, Ulloa R, Luu N, Markarian A, Moayer R. An Evaluation of Male Rhinoplasty Videos on YouTube and TikTok: A DISCERN Analysis. Facial Plast Surg Aesthet Med 2024. [PMID: 38621185 DOI: 10.1089/fpsam.2023.0249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Affiliation(s)
- Benjamin Tam
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Matthew E Lin
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Rishabh Shah
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Ruben Ulloa
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Neil Luu
- Rick and Tina Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Alexander Markarian
- Rick and Tina Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Roxana Moayer
- Rick and Tina Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Elsamna ST, Lin ME, Smith T, Johns M, Rutt A, Bensoussan Y. Impact of BMI on Dyspnea and Need for Surgical Intervention in Bilateral Vocal Fold Immobility. Otolaryngol Head Neck Surg 2024. [PMID: 38591708 DOI: 10.1002/ohn.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 02/03/2024] [Accepted: 03/15/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE Bilateral vocal fold paralysis (BVFP) and posterior glottic stenosis (PGS) are causes of bilateral vocal fold immobility (BVFI) and may cause shortness of breath, stridor, and need for surgical intervention. Although increased body mass index (BMI) is associated with restrictive breathing patterns in patients with normal upper airways, it is unclear how BMI impacts dyspnea and need for surgical intervention in BVFI patients. STUDY DESIGN Retrospective cohort study. SETTING Three tertiary academic centers in the United States. METHODS Demographics, BMI, Dyspnea Index (DI), etiology, presence of tracheostomy and surgical intervention (dilation, tracheostomy, cordotomy, arytenoidectomy, open reconstruction) were collected. Primary outcomes included dyspnea measured by DI and need for surgery to improve airway. Linear regressions were performed to assess continuous outcomes. Mann-Whitney U-test was utilized to assess categorical outcomes. RESULTS Among 121 patients, 52 presented with BVFP and 69 with PGS. Previous neck surgery was the most common cause of BVFI (40.2%). 44.3% of patients received a tracheostomy. Through multivariate linear regression, increased BMI was significantly associated with increased DI in the entire cohort (β = .43, P = .016). Increased BMI was also associated with need for any surgical intervention (odds ratio [OR] = 1.07, 95% confidence interval [CI] = [1.01-1.13]) in the overall cohort. When stratifying our data, BMI was only significantly associated with DI in BVFP (β = .496) and need for surgical intervention in PGS (OR = 1.11, 95% CI = [1.01-1.21]), although a positive trend was seen in all analyses. CONCLUSION Increased BMI may correlate with worsening dyspnea symptoms and need for surgical intervention in patients with BVFI. Weight-loss-related counseling may benefit symptom management.
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Affiliation(s)
- Samer T Elsamna
- Department of Otolaryngology-Head and Neck Surgery, Morsani College of Medicine of the University of South Florida, Tampa, Florida, USA
| | - Matthew E Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Teagen Smith
- Research Methodology and Biostatistics Core, Morsani College of Medicine of the University of South Florida, Tampa, Florida, USA
| | - Michael Johns
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck, School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Amy Rutt
- Mayo Clinic Department of Otolaryngology-Head and Neck Surgery, Jacksonville, Florida, USA
| | - Yael Bensoussan
- Department of Otolaryngology-Head and Neck Surgery, Morsani College of Medicine of the University of South Florida, Tampa, Florida, USA
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Long R, Lin ME, Iyer A, Ayo-Ajibola O, Choi JS, Doherty J. New Paradigm of Music Listening: Hearing Protection Perceptions and Treatment Decision-Making Among Music Venue Attendees. Otolaryngol Head Neck Surg 2024; 170:776-787. [PMID: 37811692 DOI: 10.1002/ohn.553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/31/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE Investigate the prevalence of hearing protection (HP) use and behavioral motivations and barriers among adults attending music venues. STUDY DESIGN Cross-sectional online survey study. SETTING Noise exposure levels at popular social music venues often exceed national guidelines. METHODS Surveys were distributed on online music communities. Respondents (n = 2352) were asked about demographics, HP use at music venues, knowledge about noise exposure impact, and perceptions of HP use. Data were characterized through descriptive statistics. Multivariable regression analysis explored differences in knowledge and perception between HP users and nonusers. RESULTS In this cohort (mean age 29 ± 7 years, 61% male), HP users were significantly more aware of the impact of music venues on hearing (P < .01), believed their hearing ability had decreased after attending music venues (P < 0.01), and believed HP could protect from hearing loss (P < .01) than non-HP users. HP nonusers most frequently cited never considering HP (14.45%) and apathy about it affecting music quality (12.71%). Common sources of HP information were recommended by a friend/peer. Multivariable regression analysis accounting for demographics, medical history, and attendance characteristics found belief that HP use at music venues could protect from hearing loss (β = 0.64, 95% confidence interval [CI] = [0.49-0.78]) and HP use (β = 1.73, 95% CI = [1.47-1.98]) were significantly associated with increased subjective enjoyment while wearing HP. CONCLUSION HP users and nonusers have significantly different perceptions of HP use and its impact. Our findings have implications for understanding motivations and barriers related to HP use and developing strategies to promote HP use at music venues.
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Affiliation(s)
- Ryan Long
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Matthew E Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Avinash Iyer
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | | | - Janet S Choi
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Joni Doherty
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
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Lin ME, Gallagher TJ, Straughan A, Marmor S, Adams ME, Choi JS. Association of Symptomatic Dizziness With All-Cause and Cause-Specific Mortality. JAMA Otolaryngol Head Neck Surg 2024; 150:257-264. [PMID: 38329761 PMCID: PMC10853869 DOI: 10.1001/jamaoto.2023.4554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/10/2023] [Indexed: 02/09/2024]
Abstract
Importance Dizziness is a highly prevalent complaint with wide-ranging causes and resultant morbidity. Whether symptomatic dizziness and its various manifestations are associated with all-cause and cause-specific mortality is unknown. Objective To examine the associations of symptomatic dizziness and its manifestations with all-cause and cause-specific mortality. Design, Setting, and Participants This cohort study is a mortality follow-up study based on the 1999-2004 National Health and Nutrition Examination Survey. The study cohort included adults 40 years and older who completed questions about symptomatic dizziness, including problems with dizziness, balance, falling, and positional dizziness, within the past 12 months. Respondents were linked to mortality data through December 31, 2019. Data were analyzed from February to August 2023. Exposure Self-reported symptomatic dizziness. Main Outcomes and Measures All-cause and cause-specific (cardiovascular disease, diabetes, cancer, and unintentional injuries) mortality. Cox proportional hazard regression models were used to examine associations between symptomatic dizziness and all-cause and cause-specific mortality while adjusting for demographics and medical history. Results In this nationally representative cohort of 9000 middle-aged and older US adults (mean [SD] age, 61.8 [13.8] years; 4570 [50.8%] female), prevalence of symptomatic dizziness was 23.8%. Specifically, 18.3% reported problems with dizziness, 14.5% reported problems with balance, 5.7% reported problems with falling, and 3.8% reported dizziness when turning in bed (positional dizziness). At a median (range) of 16.2 (0.1-20.6) years of follow-up, all-cause mortality for adults with symptomatic dizziness was higher than for those without (45.6% vs 27.1%). Symptomatic dizziness was associated with elevated risk for cause-specific mortality from diabetes (hazard ratio [HR], 1.66; 95% CI, 1.23-2.25), cardiovascular disease (HR, 1.33; 95% CI, 1.12-1.55), and cancer (HR, 1.21; 95% CI, 0.99-1.47) but not unintentional injuries (HR, 0.98; 95% CI, 0.51-1.88). Reporting problems with balance or falling was associated with increased all-cause mortality (balance: HR, 1.27; 95% CI, 1.17-1.39; and falling: HR, 1.52; 95% CI, 1.33-1.73), cardiovascular disease-specific mortality (balance: HR, 1.41; 95% CI, 1.20-1.66; and falling: HR, 1.49; 95% CI, 1.15-1.94), and diabetes-specific mortality risks (balance: HR, 1.74; 95% CI, 1.26-2.39; and falling: HR, 2.01; 95% CI, 1.26-3.18). There was no association between positional dizziness and mortality (HR, 0.98; 95% CI, 0.82-1.19). Conclusions and Relevance In this cohort study, symptomatic dizziness was associated with increased risk for all-cause and diabetes-, cardiovascular disease-, and cancer-specific mortality. The imprecision of the effect size estimate for cancer-specific mortality prevents making a definitive conclusion. Future studies are needed to determine whether symptomatic dizziness indicates underlying health conditions contributing to mortality or if early intervention for imbalance and falls can reduce mortality risk.
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Affiliation(s)
- Matthew E. Lin
- Keck School of Medicine of the University of Southern California, Los Angeles
| | - Tyler J. Gallagher
- Keck School of Medicine of the University of Southern California, Los Angeles
| | - Alexander Straughan
- Department of Otolaryngology–Head & Neck Surgery, University of Minnesota Medical School, Minneapolis
| | - Schelomo Marmor
- Department of Surgery, University of Minnesota Medical School, Minneapolis
| | - Meredith E. Adams
- Department of Otolaryngology–Head & Neck Surgery, University of Minnesota Medical School, Minneapolis
| | - Janet S. Choi
- Department of Otolaryngology–Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles
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Ayo-Ajibola O, Davis RJ, Lin ME, West JD, Kokot NC, Chambers T. Associations Between Risk Perception and HPV Knowledge and Vaccine Uptake: Highlighting the LGBTQ+ Population. Otolaryngol Head Neck Surg 2024. [PMID: 38327242 DOI: 10.1002/ohn.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/14/2023] [Accepted: 01/13/2024] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Gay and bisexual males and other LGBTQ+ communities are more frequently exposed to factors associated with an increased risk of human papillomavirus (HPV) acquisition. Vaccination is critical to protect against HPV+ head and neck cancer (HNC). We characterized the association of perceived level of risk of contraction with HPV knowledge, and vaccine decision-making. STUDY DESIGN Cross-sectional cohort. SETTING LGBTQ and general survey Reddit forums (control). METHODS A survey was shared amongst the online forums. Descriptive statistics characterized the data. Multivariable logistic regression was used to understand factors associated with vaccination, self-perceived high risk, and knowledge of HPV + HNC. RESULTS Of 718 respondents, most were female (41.09%), Caucasian (59.89%), college-educated (33.01%), and insured (77.15%) with a mean age of 30.75 years. Half were vaccinated (49.16%), with most unvaccinated endorsing interest (60.58%). Few dependents were vaccinated (25.91%), with interest in vaccination among parents of unvaccinated children (38.58%). Knowledge of HIV's association with HPV (62.95%), HPV causing HNC (55.57%), and the vaccine's efficacy against HNC (55.57%) was also moderate. Identifying female (P = .042), a self-perceived high-risk (P < .001), and having vaccinated children (P < .001) increased vaccination likelihood; transgender (P = .021), or lesbian or gay sexual identity (P < .001) decreased likelihood. Personal HNC diagnosis (P < .001), self-vaccination (P < .001), having vaccinated children (P < .001), having anal sex (P = .001) or no knowledge of past HPV status (P < .001) increased likelihood of high self-perceived risk. CONCLUSION Efforts to improve public education regarding the association between HPV and HNC and vaccination efficacy are required to better inform vaccine decision-making among individuals at risk for HPV infection.
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Affiliation(s)
| | - Ryan J Davis
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Matthew E Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Jonathan D West
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, USA
| | - Niels C Kokot
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, USA
| | - Tamara Chambers
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, USA
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Lin ME, Castellanos CX, Acevedo JR, Yu JC, Kokot NC. Cost-Effectiveness Analysis of PET-CT Surveillance After Treatment of Human Papillomavirus-Positive Oropharyngeal Cancer. Otolaryngol Head Neck Surg 2024; 170:122-131. [PMID: 37622527 DOI: 10.1002/ohn.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To determine the cost-effectiveness of surveillance imaging with PET/CT scan among patients with human papillomavirus-positive oropharyngeal squamous cell carcinoma. STUDY DESIGN Cost-effectiveness analysis. SETTING Oncologic care centers in the United States with head and neck oncologic surgeons and physicians. METHODS We compared the cost-effectiveness of 2 posttreatment surveillance strategies: clinical surveillance with the addition of PET/CT scan versus clinical surveillance alone in human papillomavirus-positive oropharyngeal squamous cell carcinoma patients. We constructed a Markov decision model which was analyzed from a third-party payer's perspective using 1-year Markov cycles and a 30-year time horizon. Values for transition probabilities, costs, health care utilities, and their studied ranges were derived from the literature. RESULTS The incremental cost-effectiveness ratio for PET/CT with clinical surveillance versus clinical surveillance alone was $89,850 per quality-adjusted life year gained. Flexible fiberoptic scope exams during clinical surveillance would have to be over 51% sensitive or PET/CT scan cost would have to exceed $1678 for clinical surveillance alone to be more cost-effective. The willingness-to-pay threshold at which imaging surveillance was equally cost-effective to clinical surveillance was approximately $80,000/QALY. CONCLUSION Despite lower recurrence rates of human papillomavirus-positive oropharyngeal cancer, a single PET/CT scan within 6 months after primary treatment remains a cost-effective tool for routine surveillance when its cost does not exceed $1678. The cost-effectiveness of this strategy is also dependent on the clinical surveillance sensitivity (flexible fiberoptic pharyngoscopy), and willingness-to-pay thresholds which vary by country.
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Affiliation(s)
- Matthew E Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Carlos X Castellanos
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Joseph R Acevedo
- Department of Otolaryngology-Head & Neck Surgery, Kaiser Permanente Medical Center, Panorama City, California, USA
| | - Jeffrey C Yu
- School of Pharmacy, University of Southern California, Los Angeles, California, USA
- Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California, USA
| | - Niels C Kokot
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
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Ayo‐Ajibola O, Davis RJ, Theriault C, Lamb C, Choe D, Lin ME, Angell TE, Kwon DI. Evaluation of YouTube As A Source For Graves' Disease Information: Is High-Quality Guideline-Based Information Available? OTO Open 2024; 8:e118. [PMID: 38504881 PMCID: PMC10949313 DOI: 10.1002/oto2.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 01/21/2024] [Indexed: 03/21/2024] Open
Abstract
Objective To understand the quality of informational Graves' disease (GD) videos on YouTube for treatment decision-making quality and inclusion of American Thyroid Association (ATA) treatment guidelines. Study Design Cross-sectional cohort. Setting Informational YouTube videos with subject matter "Graves' Disease treatment." Method The top 50 videos based on our query were assessed using the DISCERN instrument. This validated algorithm discretely rates treatment-related information from excellent (≥4.5) to very poor (<1.9). Videos were also screened for ATA guideline inclusion. Descriptive statistics were used for cohort characterization. Univariate and multivariate linear regressions characterized factors associated with DISCERN scores. Significance was set at P < .05. Results The videos featured 57,513.43 views (SD = 162,579.25), 1054.70 likes (SD = 2329.77), and 168.80 comments (SD = 292.97). Most were patient education (52%) or patient experience (24%). A minority (40%) were made by thyroid specialists (endocrinologists, endocrine surgeons, or otolaryngologists). Under half did not mention all 3 treatment modalities (44%), and 54% did not mention any ATA recommendations. Overall, videos displayed poor reliability (mean = 2.26, SD = 0.67), treatment information quality (mean = 2.29, SD = 0.75), and overall video quality (mean = 2.47, SD = 1.07). Physician videos were associated with lower likes, views, and comments (P < .001) but higher DISCERN reliability (P = .015) and overall score (P = .019). Longer videos (P = .015), patient accounts (P = .013), and patient experience (P = .002) were associated with lower scores. Conclusion The most available GD treatment content on YouTube varies significantly in the quality of medical information. This may contribute to suboptimal disease understanding, especially for patients highly engaged with online health information sources.
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Affiliation(s)
| | - Ryan J. Davis
- Keck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Claire Theriault
- Keck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Christopher Lamb
- Keck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Deborah Choe
- Keck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Matthew E. Lin
- Keck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Trevor E. Angell
- Division of Endocrinology and DiabetesKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Daniel I. Kwon
- Department of Otolaryngology–Head & Neck SurgeryKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
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Lin ME, Ayo‐Ajibola O, Castellanos CX, West J, Luu N, Kim I, Kokot NC. Assessing Laryngectomy Patient Education on YouTube: Investigating Quality and Reliability. OTO Open 2024; 8:e113. [PMID: 38299048 PMCID: PMC10828916 DOI: 10.1002/oto2.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 12/24/2023] [Accepted: 01/06/2024] [Indexed: 02/02/2024] Open
Abstract
Objective This study aimed to characterize the quality of laryngectomy-related patient education on YouTube and understand factors impacting video content quality. Study Design Cross-sectional cohort analysis. Setting Laryngectomy-related videos on YouTube. Methods YouTube was anonymously queried for various laryngectomy procedure search terms. Video quality was evaluated using the validated DISCERN instrument which assesses treatment-related information quality. Descriptive statistics were used to characterize our cohort. Univariate and multivariable linear regression were used to assess factors associated with increased DISCERN score. Significance was set at P < .05. Results Our 78-video cohort exhibited moderate levels of engagement, averaging 13,028.40 views (SD = 24,246.93), 69.79 likes (SD = 163.75), and 5.27 comments (SD = 18.81). Videos were most frequently uploaded to accounts belonging to physicians (43.59%) or health care groups (41.03%) and showcased operations (52.56%) or physician-led education (20.51%). Otolaryngologists were featured in most videos (85.90%), and most videos originated outside the United States (67.95%). Laryngectomy videos demonstrated poor reliability (mean = 2.35, SD = 0.77), quality of treatment information (mean = 1.92, SD = 0.86), and overall video quality (mean = 1.97, SD = 1.12). In multivariable linear regression, operative videos were associated with lower video quality relative to nonoperative videos (β = -1.63, 95% confidence interval [CI] = [-2.03 to -1.24], P < .001); the opposite was true for videos from accounts with higher subscriber counts (β = 0.02, 95% CI = [0.01-0.03], P = .005). Conclusion The quality and quantity of YouTube's laryngectomy educational content is limited. There is an acute need to increase the quantity and quality of online laryngectomy-related content to better support patients and caregivers as they cope with their diagnosis, prepare for, and recover from surgery.
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Affiliation(s)
- Matthew E. Lin
- Keck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | | | - Carlos X. Castellanos
- Keck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Jonathan West
- Caruso Department of Otolaryngology–Head & Neck SurgeryKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Neil Luu
- Caruso Department of Otolaryngology–Head & Neck SurgeryKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Ian Kim
- Departments of Pediatrics and MedicineStanford UniversityStanfordCaliforniaUSA
- Department of KinesiologyPennsylvania State UniversityUniversity ParkPennsylvaniaUSA
| | - Niels C. Kokot
- Caruso Department of Otolaryngology–Head & Neck SurgeryKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
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Lin ME, Kharidia K, Choe D, Bagrodia N, Luu NN, Chambers T. A Comparison of Otolaryngology Residency Applicants Over Time and to Other Surgical Applicants. OTO Open 2024; 8:e115. [PMID: 38390224 PMCID: PMC10883093 DOI: 10.1002/oto2.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 01/21/2024] [Indexed: 02/24/2024] Open
Abstract
Objective Understand how otolaryngology residency applicant characteristics have changed over time and compare them to those of other surgical subspecialties. Study Design Retrospective analysis of academic, extracurricular, and application data in the Texas Seeking Transparency in Application to Residency databases. Setting Applicants to otolaryngology, neurological surgery, ophthalmology, plastic surgery, urology, and orthopedic surgery applicants from 2019 to 2023. Methods Kruskal-Wallis, Wilcoxon rank sum, Fischer's exact, and Mann-Whitney U tests were used to compare temporal, match-based, and subspecialty differences in applicant characteristics. Results Across 4 match cycles and 541 otolaryngology applicants, significant differences were found in the average number of honored clerkships per applicant (P = 0.044), the percentage of matched applicants (P = 0.017), and the average number of research experiences (P < 0.001), peer-revied publications (P = 0.002), applied programs (P < 0.001), and interviews received (P = 0.041). Relative to their unmatched counterparts, matched applicants frequently received more interviews, belonged to higher academic quartiles, and were more likely to belong to academic honor societies (all P < 0.05). Matched applicants exhibited significant differences in the number of research experiences (P = 0.002), peer-reviewed publications (P = 0.004), and applied programs across cycles (P < 0.001). Relative to applicants from other surgical subspecialties, otolaryngology applicants exhibited high amounts of extracurricular involvement, were on par in terms of research output, and received a low proportion of interviews despite applying to a high number of programs. Conclusion Matching into otolaryngology has become increasingly competitive and is as competitive as peer surgical subspecialties. Strong academic performance, judicious program signaling, increased research involvement, and holistic factors like letters of recommendation may help applicants successfully match.
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Affiliation(s)
- Matthew E Lin
- Keck School of Medicine of the University of Southern California Los Angeles California USA
| | - Khush Kharidia
- Department of Internal Medicine University of Texas Southwestern Dallas Texas USA
| | - Deborah Choe
- Keck School of Medicine of the University of Southern California Los Angeles California USA
| | - Neelesh Bagrodia
- Keck School of Medicine of the University of Southern California Los Angeles California USA
| | - Neil N Luu
- Caruso Department of Otolaryngology-Head and Neck Surgery Keck, School of Medicine of the University of Southern California Los Angeles California USA
| | - Tamara Chambers
- Caruso Department of Otolaryngology-Head and Neck Surgery Keck, School of Medicine of the University of Southern California Los Angeles California USA
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Lin ME, Kim C, Howard A, Kokot N. Variations of the trapezius branch of the accessory nerve: an anatomic study. Sci Rep 2023; 13:22369. [PMID: 38102194 PMCID: PMC10724171 DOI: 10.1038/s41598-023-47031-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023] Open
Abstract
Although modified radical neck dissections have increased in popularity to reduce morbidity secondary to intraoperative accessory nerve damage, inadvertent injury still often occurs. As this phenomenon is thought to be due to anatomic variation in the trapezius branch of the accessory nerve, it is imperative to better understand the nuances of these anatomic variations to better inform surgical decision-making. A total of 24 accessory nerves were dissected, exposed, and traced in 15 cadavers. Three aspects of the accessory nerve were identified and recorded: the course of the trapezius branch in relation to the sternocleidomastoid, the number of trapezius branches at muscle insertion, and the number of cervical rootlet contributions. Four different anatomic patterns for the trapezius branch were identified, with the most common being where the trapezius branch separates from the main accessory nerve just medial to the sternocleidomastoid and courses deep to the sternocleidomastoid (58.3%). Most (75%) trapezius branches entered the muscle as a single nerve, whereas some (21%) were inserted as two separate nerves. The number of cervical rootlet contributions for each trapezius branch varied from zero to three. Bilateral anatomic variations were also noted. Even when the accessory nerve and its branches are thought to be spared during neck dissection, patients may postoperatively present with different degrees of accessory nerve damage. There may be unrecognized anatomic pathways that the nerve takes that may confer a higher risk of unintentional damage, especially those that have greater exposure within the anterior triangle unprotected by the sternocleidomastoid.
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Affiliation(s)
- Matthew E Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Celeste Kim
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA, USA
| | - Adam Howard
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR, USA
| | - Niels Kokot
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1540 Alcazar Street, Suite 204Q, Los Angeles, CA, 90033, USA.
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Lin ME, Tam B, Ulloa R, Hong-Willis C, Markarian A, Moayer R. Adverse Events Associated with Biodegradable Polymer Nasal Implants: An Institutional and National Perspective. Facial Plast Surg Aesthet Med 2023; 25:539-541. [PMID: 37527214 DOI: 10.1089/fpsam.2022.0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Affiliation(s)
- Matthew E Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Benjamin Tam
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Ruben Ulloa
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Connor Hong-Willis
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Alexander Markarian
- USC Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Roxana Moayer
- USC Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
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Kharidia KM, Lin ME, West JD, Sarode DN, Ma HJ, Vanstrum EB, Wu FM, Johns MM. Virtual Versus In-Person Head and Neck Physical Examination Training in Medical Students: A Pilot Assessment. Ann Otol Rhinol Laryngol 2023; 132:1140-1148. [PMID: 36514234 DOI: 10.1177/00034894221139107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To compare the effect of virtual and in-person head and neck physical examination training events on medical student confidence in performing examination maneuvers and seeking mentorship from otolaryngology faculty and residents. METHODS Training events were held with first-year medical student volunteers in 2020 (in-person) and 2021 (virtual). Participants in both cohorts were given didactics on head and neck cancer, trained to perform a head and neck physical examination, and demonstrated their clinical skills to otolaryngology faculty and residents. Pre- and post-training surveys were utilized to assess the following outcomes: participant head and neck cancer knowledge, confidence in performing examination maneuvers, and confidence in seeking mentorship in otolaryngology. Differences in outcomes between training settings were assessed by comparing participant survey responses pre- and post- training. RESULTS Both in-person and virtual training modalities improved participant confidence in performing the physical examination. There was no significant difference in the degree of improvement between training types. In-person training significantly increased participant confidence in seeking mentorship from otolaryngology faculty and residents (P = .003), while virtual training did not (P = .194). CONCLUSION Virtual training modalities are feasible methods of teaching the head and neck physical examination. Instruction through a video conferencing platform has the potential to be incorporated into traditional in-person medical education in a permanent fashion. This pilot study can inform future studies directly comparing in-person and virtual physical examination training modalities.
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Affiliation(s)
- Khush M Kharidia
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Matthew E Lin
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jonathan D West
- Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Deepika N Sarode
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Harrison J Ma
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Erik B Vanstrum
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Franklin M Wu
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Michael M Johns
- Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Lin ME, Tang L, Hasday S, Kwon DI, Selby RR, Kokot NC. Jehovah's witness head and neck free flap reconstruction patient outcomes. Am J Otolaryngol 2022; 44:103681. [DOI: 10.1016/j.amjoto.2022.103681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/16/2022] [Indexed: 11/01/2022]
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Purcell ST, Binh VT, Garcia N, Lin ME, Andres RP, Reifenberger R. Field emission from narrow bands above the Fermi level of nanometer-scale objects. Phys Rev B Condens Matter 1994; 49:17259-17263. [PMID: 10010905 DOI: 10.1103/physrevb.49.17259] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Lin ME, Andres RP, Reifenberger R, Huffman DR. Electron emission from an individual, supported C60 molecule. Phys Rev B Condens Matter 1993; 47:7546-7553. [PMID: 10004750 DOI: 10.1103/physrevb.47.7546] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Lin ME, Reifenberger R, Andres RP. Field-emission spectrum of a nanometer-size supported gold cluster: Theory and experiment. Phys Rev B Condens Matter 1992; 46:15490-15497. [PMID: 10003672 DOI: 10.1103/physrevb.46.15490] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Lin ME, Reifenberger R, Ramachandra A, Andres RP. Size-dependent field-emission spectra from nanometer-size supported gold clusters. Phys Rev B Condens Matter 1992; 46:15498-15502. [PMID: 10003673 DOI: 10.1103/physrevb.46.15498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Lin ME, Andres RP, Reifenberger R. Observation of the discrete electron energy states of an individual nanometer-size supported gold cluster. Phys Rev Lett 1991; 67:477-480. [PMID: 10044904 DOI: 10.1103/physrevlett.67.477] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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