International journal of obstetric anesthesia最新文献

英文中文

Accuracy of Spanish and English-generated ChatGPT responses to commonly asked patient questions about labor epidurals.

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-12-05 DOI: 10.1016/j.ijoa.2024.104308

Hinpetch Daungsupawong, Viroj Wiwanitkit

引用次数: 0

Rethinking personal statements submitted for obstetric anesthesia fellowship: beyond human-written or artificial intelligence-generated.

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-12-05 DOI: 10.1016/j.ijoa.2024.104309

Shigeki Matsubara

引用次数: 0

Artificial intelligence chatbots versus traditional medical resources for patient education on "Labor Epidurals": an evaluation of accuracy, emotional tone, and readability.

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-26 DOI: 10.1016/j.ijoa.2024.104302

Prakash Gyandev Gondode, Ram Singh, Swati Mehta, Sneha Singh, Subodh Kumar, Sudhansu Sekhar Nayak

引用次数: 0

Letter to the Editor: wildfires and obstetric anesthesia care: growing threats in a changing climate.

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-24 DOI: 10.1016/j.ijoa.2024.104301

Fritzner Montalmant, W Reed Cone Le Beaumont, Tabitha M Benney, Deirdre C Kelleher, Robert S White, John F Pearson

引用次数: 0

Author response to comment on: "Pre-oxygenation using high flow humidified nasal oxygen or face mask oxygen in pregnant people - a prospective randomised controlled crossover non-inferiority study".

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-24 DOI: 10.1016/j.ijoa.2024.104300

P C F Tan, A T Dennis

引用次数: 0

Artificial intelligence-created personal statements compared with applicant-written personal statements: a survey of obstetric anesthesia fellowship program directors in the United States 人工智能创建的个人陈述与申请人撰写的个人陈述比较：对美国产科麻醉研究金项目主任的调查

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-15 DOI: 10.1016/j.ijoa.2024.104293

A.M. Ruiz , M.B. Kraus , K.W. Arendt , D.R. Schroeder , E.E. Sharpe

Background

A personal statement is a common requirement in medical residency and fellowship applications. Generative artificial intelligence may be used to create a personal statement for these applications.

Methods

Two personal statements were created using OpenAI’s Chat Generative Pre-trained Transformer (ChatGPT) and two applicant-written statements were collected. A survey was sent to obstetric anesthesia fellowship program directors in the United States to assess the perceived readability, authenticity, and originality of the four personal statements. In addition, the survey assessed perceptions of applicants who use artificial intelligence to write a personal statement, including their integrity, work ethic, reliability, intelligence, and English proficiency.

Results

Surveyed fellowship directors could not accurately discern whether statements were applicant-written or artificial intelligence-generated. The artificial intelligence-generated personal statements were rated as more readable and original than the applicant-written statements. Most program directors were moderately or extremely concerned about the applicant’s integrity, work ethic, and reliability if they suspected the applicant utilized ChatGPT.

Conclusions

Program directors could not accurately discern if the statements were written by a person or artificial intelligence and would have concerns about an applicant suspected of using artificial intelligence. Medical training programs may benefit from outlining their expectations regarding applicants’ use of artificial intelligence.

背景个人陈述是医学住院医师和研究员申请中的一项常见要求。方法使用 OpenAI 的 Chat Generative Pre-trained Transformer (ChatGPT) 创建了两份个人陈述，并收集了两份申请人撰写的陈述。我们向美国的产科麻醉奖学金项目主任发送了一份调查问卷，以评估这四份个人陈述的可读性、真实性和原创性。此外，调查还评估了对使用人工智能撰写个人陈述的申请人的看法，包括他们的诚信度、职业道德、可靠性、智力和英语水平。与申请人撰写的个人陈述相比，人工智能生成的个人陈述被评为更具可读性和原创性。如果怀疑申请人使用了 ChatGPT，大多数项目主任会对申请人的诚信、职业道德和可靠性表示中度或高度关注。医学培训项目可能会受益于对申请人使用人工智能的期望。

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引用次数: 0

Development and validation of a German version of Obstetric Quality of Recovery-10 (ObsQoR10-German)

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-14 DOI: 10.1016/j.ijoa.2024.104292

R. Fantin , C. Hütter , P. Lichtenberger , N. Guo , C. Ortner , P. Sultan

引用次数: 0

Patients’ perspectives on pain relief during childbirth and labor epidurals: A pilot qualitative study among women who chose to deliver without neuraxial labor analgesia 患者对分娩镇痛和分娩镇痛的看法：一项针对选择不使用神经镇痛分娩的产妇的试点定性研究。

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-14 DOI: 10.1016/j.ijoa.2024.104294

E.R. Weinstein , J. Aaronson , S.E. Abramovitz , D. McCullough , R. Gotian , R.S. White

Background

Studies have identified widespread variation in neuraxial labor analgesia use by race, ethnicity, and geographic location. However, limited research has investigated patient-level factors in the decision not to use neuraxial analgesia for labor.

Methods

We conducted semi-structured interviews at a New York City medical center from October 1, 2022, to May 30, 2023. Participants had delivered vaginally and selected not to receive neuraxial labor analgesia. Structured demographic questions were asked after interview completion. Interviews were recorded and transcribed verbatim. We analyzed data and grouped responses into themes according to grounded theory.

Results

We identified five themes encompassing the main factors participants had considered when deciding not to receive neuraxial analgesia for birth: preferences for a natural birth experience, an empowering and supportive labor environment, preparation or preparedness for birth without medication, positive outlook on labor pain, and information, misinformation, knowledge gaps and fears about the epidural. All study participants mentioned these overarching themes in their interviews.

Conclusions

Participants described various factors important in their decision to give birth without an epidural, which we mapped onto five primary themes. Our results can be used to guide effective patient-provider interactions centered on mutual understanding, evidence-based medicine, and honoring patients’ wishes. The information gathered may provide insight into how providers can incorporate shared decision-making into their practice.

背景：研究发现，不同种族、民族和地理位置的患者在使用神经镇痛分娩时存在广泛差异。然而，对决定不使用神经管镇痛分娩的患者层面因素的研究却很有限：我们于 2022 年 10 月 1 日至 2023 年 5 月 30 日在纽约市的一家医疗中心进行了半结构化访谈。参与者均经阴道分娩，并选择不接受神经镇痛分娩。在完成访谈后，还询问了结构化的人口统计学问题。我们对访谈进行了录音和逐字记录。我们对数据进行了分析，并根据基础理论将回答分为不同的主题：我们确定了五个主题，涵盖了参与者在决定不接受神经镇痛分娩时所考虑的主要因素：对自然分娩体验的偏好；有能力和支持性的分娩环境；对不使用药物分娩的准备或准备程度；对分娩疼痛的积极看法；以及关于硬膜外麻醉的信息、错误信息、知识差距和恐惧。所有研究参与者在访谈中都提到了这些重要主题：参与者描述了他们决定不使用硬膜外麻醉分娩的各种重要因素，我们将这些因素归纳为五个主要主题。我们的研究结果可用于指导患者与医护人员之间以相互理解、循证医学和尊重患者意愿为中心的有效互动。收集到的信息可为医护人员如何将共同决策纳入其实践提供启示。

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引用次数: 0

Inhaled epoprostenol via high-flow nasal cannula and intravenous treprostinil for management of severe pulmonary arterial hypertension during cesarean delivery with epidural anesthesia: a case report 通过高流量鼻插管吸入缩宫素和静脉注射曲普瑞替尼治疗硬膜外麻醉下剖宫产术中的重度肺动脉高压：病例报告

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-12 DOI: 10.1016/j.ijoa.2024.104295

N. Perisetla , C. Miranda , J. Louis , O. Omoike , N. Farrat , E. Camporesi

Current guidelines for managing pulmonary arterial hypertension (PAH) in pregnancy recommend the use of PAH-specific medications, including phosphodiesterase type-5 inhibitors, calcium channel blockers, and prostacyclin analogs. However, there is limited consensus on the optimal agents and routes of administration during delivery. This case report describes a 24-year-old gravida 3 para 1 with Group I PAH, admitted at 29 weeks' gestation, for a planned cesarean delivery at 30 weeks gestation. She presented with worsening dyspnea, syncope, and right ventricular dysfunction. A multidisciplinary team planned her management, which included epidural anesthesia, inhaled epoprostenol (iEpo) via high-flow nasal cannula (HFNC), and intravenous (IV) treprostinil. Intraoperatively, despite continued IV treprostinil, her pulmonary artery pressure (PAP) remained elevated, prompting the initiation of iEpo. This resulted in a significant reduction in PAP, leading to successful delivery and maternal-fetal outcomes without complications. Postoperative management included continued iEpo with a hospital discharge seven days later in stable condition. This report highlights the novel use of iEpo via HFNC for managing PAH during cesarean delivery, suggesting its potential for reducing maternal morbidity and mortality in this high-risk population. Future studies should explore the simultaneous use of inhaled and intravenous prostacyclin analogs in pregnant patients with PAH.

目前治疗妊娠期肺动脉高压（PAH）的指南建议使用 PAH 专用药物，包括 5 型磷酸二酯酶抑制剂、钙通道阻滞剂和前列环素类似物。然而，关于分娩期间的最佳药物和给药途径，目前还没有达成共识。本病例报告描述了一名 24 岁的孕 3 1 型 PAH 患者，妊娠 29 周时入院，计划在妊娠 30 周时进行剖宫产。她出现呼吸困难加重、晕厥和右心室功能障碍。多学科团队为她制定了治疗方案，包括硬膜外麻醉、通过高流量鼻插管（HFNC）吸入环前列醇（iEpo）和静脉注射曲普瑞替尼。术中，尽管继续静脉注射曲普瑞司替尼，但她的肺动脉压（PAP）仍然升高，这促使她开始使用 iEpo。这使得肺动脉压明显降低，最终成功分娩，母胎均无并发症。术后管理包括继续使用 iEpo，七天后产妇病情稳定出院。该报告强调了通过 HFNC 使用 iEpo 在剖宫产过程中控制 PAH 的新方法，表明它有可能降低这一高风险人群的孕产妇发病率和死亡率。未来的研究应探索在 PAH 孕妇患者中同时使用吸入和静脉注射前列环素类似物。

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引用次数: 0

Accuracy of Spanish and English-generated ChatGPT responses to commonly asked patient questions about labor epidurals: a survey-based study among bilingual obstetric anesthesia experts 西班牙语和英语生成的 ChatGPT 回答患者有关分娩硬膜外麻醉的常见问题的准确性：一项针对双语产科麻醉专家的调查研究。

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-06 DOI: 10.1016/j.ijoa.2024.104290

Antonio Gonzalez Fiol , Allison A. Mootz , Zili He , Carlos Delgado , Vilma Ortiz , Sharon C. Reale

Background

Large language models (LLMs), of which ChatGPT is the most well known, are now available to patients to seek medical advice in various languages. However, the accuracy of the information utilized to train these models remains unknown.

Methods

Ten commonly asked questions regarding labor epidurals were translated from English to Spanish, and all 20 questions were entered into ChatGPT version 3.5. The answers were transcribed. A survey was then sent to 10 bilingual fellowship-trained obstetric anesthesiologists to assess the accuracy of these answers utilizing a 5-point Likert scale.

Results

Overall, the accuracy scores for the ChatGPT-generated answers in Spanish were lower than for the English answers with a median score of 34 (IQR 33–36.5) versus 40.5 (IQR 39–44.3), respectively (P value 0.02). Answers to two questions were scored significantly lower: “Do epidurals prolong labor?” (2 (IQR 2–2.5) versus 4 (IQR 4–4.5), P value 0.03) and “Do epidurals increase the risk of needing cesarean delivery?” (3(IQR 2–4) versus 4 (IQR 4–5); P value 0.03). There was a strong agreement that answers to the question “Do epidurals cause autism” were accurate in both Spanish and English.

Conclusion

ChatGPT-generated answers in Spanish to ten questions about labor epidurals scored lower for accuracy than answers generated in English, particularly regarding the effect of labor epidurals on labor course and mode of delivery. This disparity in ChatGPT-generated information may extend already-known health inequities among non-English-speaking patients and perpetuate misinformation.

背景：大语言模型（LLMs），其中最著名的是 ChatGPT，现在病人可以用各种语言寻求医疗建议。然而，用于训练这些模型的信息的准确性仍是未知数：将有关分娩硬膜外麻醉的 10 个常见问题从英语翻译成西班牙语，并将所有 20 个问题输入 ChatGPT 3.5 版。对答案进行了转录。然后向 10 位接受过双语研究培训的产科麻醉师发送了一份调查问卷，采用 5 点李克特量表评估这些答案的准确性：总体而言，ChatGPT 生成的西班牙语答案的准确性得分低于英语答案，中位数分别为 34（IQR 33-36.5）和 40.5（IQR 39-44.3）（P 值 0.02）。有两个问题的答案得分明显较低："硬膜外麻醉会延长产程吗？"（2 (IQR 2-2.5) 对 4 (IQR 4-4.5)，P 值 0.03）和 "硬膜外麻醉会增加需要剖宫产的风险吗？3（IQR 2-4）对 4（IQR 4-5）；P 值 0.03）。对于 "硬膜外麻醉会导致自闭症吗 "这一问题，西班牙文和英文的答案都非常准确：结论：对于有关分娩镇痛剂的十个问题，用西班牙语通过 ChatGPT 生成的答案在准确性方面得分低于用英语生成的答案，尤其是在分娩镇痛剂对产程和分娩方式的影响方面。在 ChatGPT 生成的信息中存在的这种差异可能会扩大非英语患者中已知的健康不公平现象，并使错误信息长期存在。

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International journal of obstetric anesthesia

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