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Establishing priorities for implementation of large language models in pathology and laboratory medicine 确定在病理学和检验医学中实施大型语言模型的优先事项
IF 1 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.acpath.2023.100101
Simone Arvisais-Anhalt MD , Steven L. Gonias MD, PhD , Sara G. Murray MD, MAS

Artificial intelligence and machine learning have numerous applications in pathology and laboratory medicine. The release of ChatGPT prompted speculation regarding the potentially transformative role of large-language models (LLMs) in academic pathology, laboratory medicine, and pathology education. Because of the potential to improve LLMs over the upcoming years, pathology and laboratory medicine clinicians are encouraged to embrace this technology, identify pathways by which LLMs may support our missions in education, clinical practice, and research, participate in the refinement of AI modalities, and design user-friendly interfaces that integrate these tools into our most important workflows. Challenges regarding the use of LLMs, which have already received considerable attention in a general sense, are also reviewed herein within the context of the pathology field and are important to consider as LLM applications are identified and operationalized.

人工智能和机器学习在病理学和检验医学中应用广泛。ChatGPT 的发布引发了人们对大型语言模型(LLM)在病理学学术、检验医学和病理学教育中的潜在变革作用的猜测。由于 LLM 有可能在未来几年内得到改进,因此我们鼓励病理学和检验医学临床医生接受这项技术,确定 LLM 可以支持我们在教育、临床实践和研究方面的任务的途径,参与人工智能模式的改进,并设计用户友好的界面,将这些工具集成到我们最重要的工作流程中。本文还结合病理学领域的情况,回顾了在使用 LLM 方面所面临的挑战,这些挑战在 LLM 应用的确定和操作化过程中非常重要。
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引用次数: 0
Collaboration to Improve Emergency Laboratory Response: Open letter from the Open letter from the Association of Pathology Chairs to the Centers for Disease Control & Prevention 合作改进实验室应急响应:病理学主席协会致美国疾病控制与预防中心的公开信
IF 1 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.acpath.2023.100100
Lydia Pleotis Howell MD , Michael Laposata MD, PhD , Priscilla S. Markwood
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引用次数: 0
Educational Case: Hepatocellular carcinoma 教育案例:肝细胞癌
IF 1 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.acpath.2024.100108
Harrison Dai BS , Harrison Klause MD , Richard M. Conran MD, PhD, JD
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引用次数: 0
Selective breast/gynecologic pathology fellowship training in the United States: Experience of program directors 美国选择性乳腺/妇科病理研究员培训:项目主任的经验
IF 1 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.acpath.2023.100103
Mohamed Mokhtar Desouki MD, PhD , Ian S. Hagemann MD, PhD , Thaer Khoury MD , Oluwole Fadare MD , Rohit Bhargava MBBS , Jennifer L. Clark MD, PhD , Michael T. Deavers MD , Julie M. Jorns MD , Ashraf Khan MD , Ediz F. Cosar MD , Rouzan G. Karabakhtsian MD, PhD , Molly E. Klein MD , Andre Pinto MD , Muhammad Ali MD

Published data on combined breast and gynecologic [breast/gyn] surgical pathology fellowship training programs are limited. Our study aimed to survey the landscape of such fellowships in the United States (US), including specific information about their characteristics and the educational activities therein. Using web searches, we identified programs offering combined breast/gyn surgical pathology fellowship training. We developed a 26-item questionnaire asking program directors to report on the characteristics of their fellowship training structure. The search revealed 25 academic based programs offering one-year combined breast/gyn fellowship training, predominantly located (40 %) in the Northeast area. The following data was obtained: 44 % of the programs were accredited by the ACGME, 82 % required >19 weeks of breast and gyn service, and 69.6 % accepted the common application, 54.5 % of programs require completion of a research project for graduation. An annual average of 3000 breast and 3000 gyn cases appears to be the usual volume of cases. Interestingly, only 36 % of the program directors are graduates of a combined breast/gyn fellowship program. In conclusion, we present the most comprehensive and up-to-date census of combined breast/gyn pathology fellowships in the US. Our study provides valuable information on the current state of combined breast/gyn pathology fellowship training. The information will be helpful to current and prospective trainees, as well as program leaders.

有关乳腺和妇科(乳腺/妇科)外科病理学联合研究员培训项目的公开数据非常有限。我们的研究旨在调查美国此类奖学金的情况,包括其特点和教育活动的具体信息。通过网络搜索,我们确定了提供乳腺/妇科联合手术病理学研究员培训的项目。我们编制了一份包含 26 个项目的调查问卷,要求项目主任报告其研究金培训结构的特点。搜索结果显示,有 25 个学术项目提供为期一年的乳腺/妇科联合研究金培训,主要集中在东北部地区(40%)。获得的数据如下:44%的项目通过了ACGME认证,82%的项目要求19周的乳腺和妇科服务,69.6%的项目接受通用申请,54.5%的项目要求完成研究项目方可毕业。年均 3000 例乳腺和 3000 例妇科病例似乎是通常的病例量。有趣的是,只有 36% 的项目主任毕业于乳腺/妇科联合奖学金项目。总之,我们对美国乳腺/妇科联合病理研究员项目进行了最全面、最新的普查。我们的研究为乳腺/妇科联合病理学研究员培训的现状提供了有价值的信息。这些信息将对目前和未来的学员以及项目负责人有所帮助。
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引用次数: 0
Author's response: 作者回复:
IF 1 Q3 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.acpath.2023.100105
Mary F. Lipscomb MD
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引用次数: 0
Pathology teaching in different undergraduate medical curricula within and outside the United States: a pilot study 美国国内外不同医学本科课程中的病理学教学:一项试点研究
IF 1 Q3 Medicine Pub Date : 2023-12-27 DOI: 10.1016/j.acpath.2023.100102
Kevin Carnevale MD , Ritcha Saxena MD , Geoffrey A. Talmon MD , Amy Lin MD , Osvaldo Padilla MD, MPH , Regina A. Kreisle MD, PhD

Pathology education is taught using different curricula in the United States (USA) and abroad. We evaluate and compare the hours spent in different forms of pathology teaching such as lectures, team-based learning (TBL), problem-based learning (PBL), and other methods taught in general and systemic pathology amongst different medical schools within the USA and outside the USA. The total number of lecture hours taught in general and systemic pathology combined was greater in outside schools than within the USA (141 h vs 97.8 h, respectively). Three subjects in general pathology and six subjects in systemic pathology had a significantly greater lecture hours in outside medical schools. The greatest difference was the hours spent in labs were longer for both general and systems pathology in schools outside the USA. The overall utilization of PBL in general and systemic pathology teaching combined was much greater outside the USA compared to within the USA (average overall hours PBL – 97.2 outside vs 16.5 in the USA), however, the reverse was observed for using TBL (average overall hours TBL – 59.5 outside vs 84.5 in USA). Average hours used with other methods of teaching was also greater in outside medical schools compared to USA medical schools (80.8 h vs 44 h, respectively). Pathology teaching in both general and systemic pathology has more extensive lecture hours, laboratory hours, PBL, and other methods of teaching pathology in outside medical schools with different curricula than USA medical schools. TBL is utilized more extensively in USA medical schools.

美国和国外的病理学教育采用不同的课程设置。我们评估并比较了美国境内外不同医学院在普通病理学和系统病理学教学中不同形式病理学教学(如讲座、团队学习(TBL)、基于问题的学习(PBL)和其他方法)所花费的学时。美国以外学校的普通病理学和系统病理学授课总时数(分别为 141 小时和 97.8 小时)高于美国国内学校。有三个普通病理学科目和六个系统病理学科目在国外医学院的授课时数明显多于国内。最大的差异在于,美国以外学校的普通病理学和系统病理学实验时间都更长。在普通病理学和系统病理学教学中,PBL 的总体使用率在美国境外远高于美国境内(PBL 的平均总课时--97.2 小时在境外,16.5 小时在美国境内),但在使用 TBL 时,情况正好相反(TBL 的平均总课时--59.5 小时在境外,84.5 小时在美国境内)。与美国医学院相比,国外医学院使用其他教学方法的平均时数也更多(分别为 80.8 小时和 44 小时)。与美国医学院相比,课程设置不同的国外医学院在普通病理学和系统病理学的病理学教学中使用了更多的讲课时数、实验时数、PBL 和其他病理学教学方法。美国医学院则更广泛地使用 TBL。
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引用次数: 0
ChatGPT 3.5 fails to write appropriate multiple choice practice exam questions ChatGPT 3.5 无法编写适当的多选模拟试题
IF 1 Q3 Medicine Pub Date : 2023-12-19 DOI: 10.1016/j.acpath.2023.100099
Alexander Ngo , Saumya Gupta , Oliver Perrine, Rithik Reddy, Sherry Ershadi, Daniel Remick MD

Artificial intelligence (AI) may have a profound impact on traditional teaching in academic settings. Multiple concerns have been raised, especially related to using ChatGPT for creating de novo essays. However, AI programs such as ChatGPT may augment teaching techniques. In this article, we used ChatGPT 3.5 to create 60 multiple choice questions. Author written text was uploaded and ChatGPT asked to create multiple choice questions with an explanation for the correct answer and explanations for the incorrect answers. Unfortunately, ChatGPT only generated correct questions and answers with explanations in 32 % of the questions (19 out of 60). In many instances, ChatGPT failed to provide an explanation for the incorrect answers. An additional 25 % of the questions had answers that were either wrong or misleading. A grade of 32 % would be considered failing in most courses. Despite these issues, instructors may still find ChatGPT useful for creating practice exams with explanations—with the caveat that extensive editing may be required.

人工智能(AI)可能会对学术环境中的传统教学产生深远影响。人们提出了许多担忧,尤其是在使用 ChatGPT 创建新论文方面。不过,像 ChatGPT 这样的人工智能程序可以增强教学技巧。在本文中,我们使用 ChatGPT 3.5 制作了 60 道选择题。我们上传了作者撰写的文本,要求 ChatGPT 制作选择题,并对正确答案和错误答案进行解释。遗憾的是,ChatGPT 只生成了 32% 的问题(60 道题中有 19 道)的正确答案和解释。在许多情况下,ChatGPT 未能对错误答案提供解释。还有 25% 的问题的答案是错误的或具有误导性的。在大多数课程中,32% 的成绩将被视为不及格。尽管存在这些问题,教师仍然会发现 ChatGPT 对于创建带有解释的练习考试非常有用--但需要注意的是,可能需要进行大量编辑。
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引用次数: 0
Defining and identifying laboratory literacy as a component of health literacy: An assessment of existing health literacy tools 定义和确定实验室扫盲作为卫生扫盲的一个组成部分:对现有卫生扫盲工具的评估
IF 1 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.1016/j.acpath.2023.100096
Jordan Franco BS , Nancy S. Morris PhD, ANP , Mark K. Fung MD, PhD

Health literacy has been defined and studied as an important component of a patient's ability to understand and obtain appropriate healthcare. However, a laboratory component of health literacy, as it pertains to the understanding of laboratory tests and their results, has not been previously defined. An analysis of readily available health literacy tools was conducted to determine laboratory testing-specific content representation. One hundred and four health literacy tools from a publicly available database were analyzed. Many of the health literacy tools were found to be lacking items related to laboratory testing. Of the health literacy tools that did contain a laboratory component, they were categorized pertaining to the laboratory test/testing content. Emerging from this process, eight competencies were identified that encompassed the entire range of laboratory-related aspects of health literacy. We propose that these eight competencies form the basis of a set of competencies needed for one to access, interpret, and act on laboratory results–a capacity we are referring to as “laboratory literacy.”

健康素养被定义为患者理解和获得适当医疗保健的能力的重要组成部分。然而,卫生知识普及的实验室组成部分,因为它涉及对实验室检测及其结果的理解,以前没有定义。对现成的卫生扫盲工具进行了分析,以确定实验室检测特定的内容表示。对来自公共数据库的104种卫生素养工具进行了分析。发现许多卫生知识普及工具缺乏与实验室检测有关的项目。在确实包含实验室成分的卫生素养工具中,它们是根据实验室测试/测试内容进行分类的。在这一过程中,确定了八项能力,涵盖了卫生知识的所有与实验室有关的方面。我们提出,这八项能力构成了一套能力的基础,这些能力是一个人获取、解释和根据实验室结果采取行动所必需的,我们将这种能力称为“实验室素养”。
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引用次数: 0
Perspectives from two recent medical school graduates on exposure to pathology during undergraduate medical education: A narrative inquiry 两位医学院应届毕业生对本科医学教育期间接触病理学的看法:叙述性调查。
IF 1 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.1016/j.acpath.2023.100094
Alex P. Tannenbaum MD , Cullen M. Lilley MD, MS, MA

The field of pathology is facing an inflection point where the demand for pathology services is not being met by a corresponding rise in recruitment into the field. Many of the myths about the field of pathology have been dispelled elsewhere, but there have not been many formal accounts of the experience medical students’ face when finding their path to pathology. Because of challenges in the visibility of pathology as a specialty and not simply a subject required for United States Medical Licensing Examination Step 1, students tend to fall into one of two categories: early differentiators or late discoverers. Here, we provide anecdotal accounts of these two paths at institutions with different curricular designs and provide a first-hand account of the challenges we faced and opportunities discovered in our journeys to pathology. Based on these experiences, we offer suggestions for ways to address some of the issues medical students must navigate when trying to explore pathology in curricula not built for such exploration.

病理学领域正面临一个转折点,该领域的招聘人数相应增加,无法满足对病理学服务的需求。许多关于病理学领域的神话在其他地方已经被消除,但医学生在寻找病理学道路时所面临的经历并没有太多正式的描述。由于病理学作为一门专业而不仅仅是美国医学执照考试第一步所需的科目,在可见性方面存在挑战,学生往往分为两类:早期差异者或晚期发现者。在这里,我们提供了不同课程设计的机构中这两条道路的轶事,并提供了我们在病理学之旅中面临的挑战和发现的机会的第一手资料。基于这些经验,我们提出了一些建议,以解决医学生在非为探索而建的课程中尝试探索病理学时必须解决的一些问题。
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引用次数: 0
Increasing medical student awareness of pathology through a virtual, asynchronous pathology elective 通过虚拟异步病理学选修课提高医学生对病理学的认识。
IF 1 Q3 Medicine Pub Date : 2023-10-01 DOI: 10.1016/j.acpath.2023.100093
Karen Tew BS , Jesse Kresak MD , Stacy G. Beal MD

Faculty from the University of Florida Department of Pathology, Immunology, and Laboratory Medicine developed an asynchronous, fully virtual pathology elective for medical students that emphasizes both foundational pathology concepts as well as the role of pathologists in the broader health system. The program includes ten core modules as well as several selective modules which allows students to tailor their coursework to better align with their desired specialty. After completing each module, students were required to concisely summarize the topic in the form of a 280-character tweet. Students were surveyed immediately after finishing the course and again one year after finishing the course to assess the effectiveness of the course in teaching students about pathology. Survey results showed significant improvement in student knowledge about the field of pathology and high levels of satisfaction with the course content and delivery. The tweet summaries required in the course provided a unique challenge for students. Although the course was initially developed in response to the COVID-19 pandemic, enrollment has continued steadily through 2023. Our study suggests that online pathology electives can be an effective way to increase medical student exposure to pathology and facilitate learning about the field of pathology, especially among students who may not ultimately pursue a career in pathology.

佛罗里达大学病理学、免疫学和实验医学系的教员为医学生开发了一个异步的、完全虚拟的病理学选修课,强调基础病理学概念以及病理学家在更广泛的卫生系统中的作用。该课程包括十个核心模块和几个选择性模块,学生可以根据自己的专业调整课程。在完成每个模块后,学生被要求以280个字符的推文的形式简要总结主题。学生在完成课程后立即接受调查,并在完成课程一年后再次接受调查,以评估该课程在教授学生病理学方面的有效性。调查结果显示,学生对病理学领域的知识有了显著提高,对课程内容和交付的满意度也很高。课程中要求的推特摘要为学生们提供了一个独特的挑战。尽管该课程最初是为应对新冠肺炎疫情而开发的,但招生一直稳步持续到2023年。我们的研究表明,在线病理学选修课可以有效地增加医学生对病理学的接触,并促进对病理学领域的学习,尤其是在那些最终可能不会从事病理学职业的学生中。
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引用次数: 0
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Academic Pathology
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