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Prenatal diagnosis of severe hydrocephalus caused by fetal intracranial pineal gland tumors 胎儿颅内松果体肿瘤导致的严重脑积水的产前诊断。
IF 8.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ajog.2024.01.030
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引用次数: 0
Human vs machine: identifying ChatGPT-generated abstracts in Gynecology and Urogynecology 人工与机器:识别由 ChatGPT 生成的妇科和泌尿妇科摘要。
IF 8.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ajog.2024.04.045

Background

ChatGPT, a publicly available artificial intelligence large language model, has allowed for sophisticated artificial intelligence technology on demand. Indeed, use of ChatGPT has already begun to make its way into medical research. However, the medical community has yet to understand the capabilities and ethical considerations of artificial intelligence within this context, and unknowns exist regarding ChatGPT’s writing abilities, accuracy, and implications for authorship.

Objective

We hypothesize that human reviewers and artificial intelligence detection software differ in their ability to correctly identify original published abstracts and artificial intelligence-written abstracts in the subjects of Gynecology and Urogynecology. We also suspect that concrete differences in writing errors, readability, and perceived writing quality exist between original and artificial intelligence-generated text.

Study Design

Twenty-five articles published in high-impact medical journals and a collection of Gynecology and Urogynecology journals were selected. ChatGPT was prompted to write 25 corresponding artificial intelligence-generated abstracts, providing the abstract title, journal-dictated abstract requirements, and select original results. The original and artificial intelligence-generated abstracts were reviewed by blinded Gynecology and Urogynecology faculty and fellows to identify the writing as original or artificial intelligence-generated. All abstracts were analyzed by publicly available artificial intelligence detection software GPTZero, Originality, and Copyleaks, and were assessed for writing errors and quality by artificial intelligence writing assistant Grammarly.

Results

A total of 157 reviews of 25 original and 25 artificial intelligence-generated abstracts were conducted by 26 faculty and 4 fellows; 57% of original abstracts and 42.3% of artificial intelligence-generated abstracts were correctly identified, yielding an average accuracy of 49.7% across all abstracts. All 3 artificial intelligence detectors rated the original abstracts as less likely to be artificial intelligence-written than the ChatGPT-generated abstracts (GPTZero, 5.8% vs 73.3%; P<.001; Originality, 10.9% vs 98.1%; P<.001; Copyleaks, 18.6% vs 58.2%; P<.001). The performance of the 3 artificial intelligence detection software differed when analyzing all abstracts (P=.03), original abstracts (P<.001), and artificial intelligence-generated abstracts (P<.001). Grammarly text analysis identified more writing issues and correctness errors in original than in artificial intelligence abstracts, including lower Grammarly score reflective of poorer writing quality (82.3 vs 88.1; P=.006), more total writing issues (19.2 vs 12.8; P<.001), critical issues (5.4 vs 1.3; P<.001), confusin

背景介绍ChatGPT 是一个公开可用的人工智能(AI)大型语言模型,可按需提供复杂的人工智能技术。事实上,ChatGPT 已经开始用于医学研究。然而,医学界还不了解人工智能在这方面的能力和伦理方面的考虑,而且 ChatGPT 的写作能力、准确性和对作者身份的影响也存在未知数:我们假设人类审稿人和人工智能检测软件在正确识别妇科和泌尿妇科领域的原创发表摘要和人工智能撰写摘要的能力上存在差异。此外,我们还怀疑原文和人工智能生成的文本在写作错误、可读性和感知写作质量方面存在具体差异:研究设计:我们选择了 25 篇发表在高影响力医学期刊和妇科和泌尿妇科期刊上的文章。ChatGPT 被提示撰写 25 篇相应的 AI 生成摘要,提供摘要标题、期刊规定的摘要要求,并选择原始结果。原始摘要和人工智能生成的摘要由妇科和泌尿妇科的盲人教员和研究员审阅,以确定是原始摘要还是人工智能生成的摘要。所有摘要均由公开的人工智能检测软件GPTZero、Originality和Copyleaks进行分析,并由人工智能写作助手Grammarly评估写作错误和质量:26 位教师和 4 位研究员对 25 篇原创摘要和 25 篇人工智能生成的摘要进行了 157 次审查。57%的原创摘要和42.3%的人工智能生成摘要被正确识别,所有摘要的平均识别率为49.7%。与 ChatGPT 生成的摘要相比,所有三种人工智能检测器都认为原始摘要不太可能是人工智能撰写的(GPTZero 5.8 vs 73.3%, p结论:由于人工智能能够生成非常逼真的文本,人类审稿人无法检测出人类科学写作与 ChatGPT 生成的科学写作之间的细微差别。人工智能检测软件提高了对人工智能生成的文章的识别能力,但仍然缺乏完全的准确性,需要对程序进行改进才能达到最佳检测效果。由于审稿人和编辑可能无法可靠地检测人工智能生成的文章,因此随着人工智能聊天机器人的使用越来越广泛,需要制定明确的指导方针来报告作者使用人工智能的情况,并在审稿过程中使用人工智能检测软件。
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引用次数: 0
Patient perspectives in adverse event reporting after vaginal apical prolapse surgery 阴道顶脱垂手术后不良事件报告中的患者观点。
IF 8.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ajog.2024.04.043

Background

Many clinical trials use systematic methodology to monitor adverse events and determine grade (severity), expectedness, and relatedness to treatments as determined by clinicians. However, patient perspectives are often not included in this process.

Objective

This study aimed to compare clinician vs patient grading of adverse event severity in a urogynecologic surgical trial. Secondary objectives were to estimate the association of patient grading of adverse events with decision-making and quality of life outcomes and to determine if patient perspective changes over time.

Study Design

This was a planned supplementary study (Patient Perspectives in Adverse Event Reporting [PPAR]) to a randomized trial comparing 3 surgical approaches to vaginal apical prolapse. In the parent trial, adverse events experienced by patients were collected per a standardized protocol every 6 months during which clinicians graded adverse event severity (mild, moderate, severe/life-threatening). In this substudy, we obtained additional longitudinal patient perspectives for 19 predetermined “PPAR adverse events.” Patients provided their own severity grading (mild, moderate, severe/very severe/life-threatening) at initial assessment and at 12 and 36 months postoperatively. Clinicians and patients were masked to each other’s reporting. The primary outcome was the interrater agreement (kappa statistic) for adverse event severity between the initial clinician and patient assessment, combining patient grades of mild and moderate. The association between adverse event severity and the Decision Regret Scale, Satisfaction with Decision Scale, the 12-Item Short-Form Health Survey, and Patient Global Impression of Improvement scores was assessed using the Spearman correlation coefficient (ρ) for continuous scales, the Mantel–Haenszel chi-square test for Patient Global Impression of Improvement, and t tests or chi-square tests comparing the assessments of patients who rated their adverse events or symptoms as severe with those who gave other ratings. To describe patient perspective changes over time, the intraobserver agreement was estimated for adverse event severity grade over time using weighted kappa coefficients.

Results

Of the 360 randomly assigned patients, 219 (61%) experienced a total of 527 PPAR adverse events (91% moderate and 9% severe/life-threatening by clinician grading). Mean patient age was 67 years; 87% were White and 12% Hispanic. Among the patients reporting any PPAR event, the most common were urinary tract infection (61%), de novo urgency urinary incontinence (35%), stress urinary incontinence (22%), and fecal incontinence (13%). Overall agreement between clinician and participant grading of severity was poor (kappa=0.24 [95% confidence int

背景:许多临床试验采用系统的方法监测不良事件(AE),并根据临床医生的判断确定不良事件的等级(严重程度)、预期性以及与治疗的相关性。然而,在这一过程中仍然缺乏患者视角:目的:在一项泌尿妇科手术试验中,比较临床医生和患者对不良事件严重程度的分级。次要目标:估计患者对 AE 的分级与决策和生活质量结果之间的关联,并确定患者的观点是否会随着时间的推移而发生变化:这是一项计划中的补充研究,名为 "不良事件报告中的患者观点"(PPAR),是一项比较三种阴道顶端脱垂手术方法的随机试验。在母试验中,每 6 个月按照标准化方案收集患者发生的不良事件,由临床医生对不良事件的严重程度(轻度、中度、重度/危及生命)进行分级。在这项子研究中,我们针对 19 种预先确定的 "PPAR AE "获得了更多患者的纵向观点。患者在初次评估以及术后 12 个月和 36 个月时提供了自己的严重程度分级(轻度、中度、严重/非常严重/危及生命)。临床医生和患者对彼此的报告进行了屏蔽。主要结果是临床医生和患者在初次评估时对 AE 严重程度的相互一致性(卡帕统计量,κ),将患者的轻度和中度分级合并计算。AE 严重程度与决策后悔量表 (DRS)、决策满意度量表 (SDS)、短表格健康调查-12 (SF-12) 和患者总体改善印象 (PGI-I) 分数之间的关系采用连续量表的 Spearman 相关系数 (ρ)、PGI-I 的 Mantel-Haenszel 方差检验和比较严重与其他等级评估的 T 检验或方差检验进行评估。为了描述患者观点随时间的变化,使用加权卡帕系数估算了观察者内部对AE严重程度等级随时间变化的一致性:在360名随机患者中,219名(61%)共发生了527例PPAR不良反应(根据临床医生的分级,91%为中度,9%为重度/危及生命)。患者平均年龄为 67 岁,87% 为白人,12% 为西班牙裔。在报告任何 PPAR 事件的患者中,最常见的是尿路感染(61%)、新发尿急尿失禁(35%)、压力性尿失禁(22%)和大便失禁(13%)。临床医生和受试者对严重程度分级的总体一致性较差(κ=0.24 (95%CI 0.14, 0.34))。在临床医生分级为中度的 414 例 AE 中,患者分级为轻度的有 120 例(29%),重度的有 80 例(19%)。在临床医生分级为重度的 39 例 AE 中,患者分级为轻度或中度的有 15 例(38%)。患者对报告的最严重 AE 的最初分级与较差的 DRS(ρ=0.2,p=0.01)、SF-12(ρ=-0.24,pConclusions)轻度相关:临床医生和患者对 AE 严重程度的看法并不一致。从患者角度来看,严重程度较差与以患者为中心的结果有关。纳入患者视角可为外科手术评估提供更多信息。
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引用次数: 0
Maternal mortality in the United States: finally some good news 美国的孕产妇死亡率:终于有好消息了
IF 8.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ajog.2024.04.055
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引用次数: 0
Society for Maternal-Fetal Medicine Position Statement: Paid family and medical leave 母胎医学协会立场声明:带薪家庭假和医疗假。
IF 8.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ajog.2024.05.023

Position: The Society for Maternal-Fetal Medicine strongly supports paid family leave and medical leave to optimize the health of pregnant people and their families and to improve health equity. All types of leave should include full wages and benefits and job protection to ensure that parents can care for themselves and their children. The Society for Maternal-Fetal Medicine endorses the implementation of a national policy that would provide fully-paid sick leave in addition to a minimum of 12 weeks of universal paid family and medical leave with job protection to optimize health and well-being across generations.

母胎医学会大力支持带薪家事假和医疗假,将其作为优化孕妇及其家庭健康和改善健康公平的一种机制。所有假期都应包括全额工资和福利以及工作保护,以确保父母能够照顾自己和孩子。本协会赞同实施一项国家政策,除了提供至少 12 周的普遍带薪、有工作保护的家事假和医疗假之外,还提供全薪病假,以优化各代人的健康和福祉。
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引用次数: 0
AJOG MFM Table of Contents AJOG MFM 目录
IF 8.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 DOI: 10.1016/S0002-9378(24)00700-2
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引用次数: 0
Magnesium sulfate prophylaxis for late-postpartum severe hypertension 产后晚期严重高血压的硫酸镁预防疗法。
IF 8.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ajog.2024.03.028
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引用次数: 0
The value of maternal echocardiography after delivery in patients with severe preeclampsia 重度子痫前期患者产后超声心动图的价值。
IF 8.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ajog.2024.03.021
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引用次数: 0
Cardiovascular protection by normotensive placental extracellular vesicles 血压正常的胎盘细胞外囊泡对心血管的保护作用
IF 8.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ajog.2024.03.030
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引用次数: 0
Enduring safety concerns for out-of-hospital births in the United States 美国院外分娩的持久安全问题。
IF 8.7 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.ajog.2024.03.024
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引用次数: 0
期刊
American journal of obstetrics and gynecology
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