Current Developments from Silicon Valley - How Artificial Intelligence is Changing Gynecology and Obstetrics.

Artificial intelligence (AI) has become an omnipresent topic in the media. Lively discussions are being held on how AI could revolutionize the global healthcare landscape. The development of innovative AI models, including in the medical sector, is increasingly dominated by large high-tech companies.

Evaluating Patient-Reported Adherence And Safety for Oral Contraception Treatment in Women via a Direct-To-Consumer Prescription Platform: A Cross-Sectional Study.

The acceptance of telemedicine in the German health care system is growing. This also extends to gynecological applications such as the prescription of contraceptives. This study investigates the contraceptive use and adherence of patients using a direct-to-consumer (DTC) prescription platform for oral contraception.

Vignette-based comparative analysis of ChatGPT and specialist treatment decisions for rheumatic patients: results of the Rheum2Guide study.

Background: The complex nature of rheumatic diseases poses considerable challenges for clinicians when developing individualized treatment plans. Large language models (LLMs) such as ChatGPT could enable treatment decision support.

Objective: To compare treatment plans generated by ChatGPT-3.

Awareness and intention-to-use of digital health applications, artificial intelligence and blockchain technology in breast cancer care.

Emerging digital technologies promise to improve breast cancer care, however lack of awareness among clinicians often prevents timely adoption. This study aims to investigate current awareness and intention-to-use of three technologies among breast cancer healthcare professionals (HCP): (1) digital health applications (DHA), (2) artificial intelligence (AI), and (3) blockchain technology (BC). A 22-item questionnaire was designed and administered before and after a 30 min educational presentation highlighting technology implementation examples.

Evolution of publicly available large language models for complex decision-making in breast cancer care.

Purpose: This study investigated the concordance of five different publicly available Large Language Models (LLM) with the recommendations of a multidisciplinary tumor board regarding treatment recommendations for complex breast cancer patient profiles.

Methods: Five LLM, including three versions of ChatGPT (version 4 and 3.5, with data access until September 3021 and January 2022), Llama2, and Bard were prompted to produce treatment recommendations for 20 complex breast cancer patient profiles.

NGS-Guided Precision Oncology in Breast Cancer and Gynecological Tumors-A Retrospective Molecular Tumor Board Analysis.

Precision oncology treatments are being applied more commonly in breast and gynecological oncology through the implementation of Molecular Tumor Boards (MTBs), but real-world clinical outcome data remain limited. A retrospective analysis was conducted in patients with breast cancer (BC) and gynecological malignancies referred to our center's MTB from 2018 to 2023. The analysis covered patient characteristics, next-generation sequencing (NGS) results, MTB recommendations, therapy received, and clinical outcomes.

Discussion of hemodynamic optimization strategies and the canonical understanding of hemodynamics during biventricular mechanical support in cardiogenic shock: does the flow balance make the difference?

Background: Mechanical circulatory support (MCS) devices may stabilize patients with severe cardiogenic shock (CS) following myocardial infarction (MI). However, the canonical understanding of hemodynamics related to the determination of the native cardiac output (CO) does not explain or support the understanding of combined left and right MCS. To ensure the most optimal therapy control, the current principles of hemodynamic measurements during biventricular support should be re-evaluated.

Challenging ChatGPT 3.5 in Senology-An Assessment of Concordance with Breast Cancer Tumor Board Decision Making.

With the recent diffusion of access to publicly available large language models (LLMs), common interest in generative artificial-intelligence-based applications for medical purposes has skyrocketed. The increased use of these models by tech-savvy patients for personal health issues calls for a scientific evaluation of whether LLMs provide a satisfactory level of accuracy for treatment decisions. This observational study compares the concordance of treatment recommendations from the popular LLM ChatGPT 3.

Status quo and future directions of digitalization in gynecology and obstetrics in Germany: a survey of the commission Digital Medicine of the German Society for Gynecology and Obstetrics.

Purpose: Digitalization plays a critical role and is beginning to impact every part of the patient journey, from drug discovery and data collection to treatment and patient-reported outcomes. We aimed to evaluate the status quo and future directions of digital medicine in the specialty of gynecology and obstetrics in Germany.

Methods: An anonymous questionnaire was distributed via the German Society of Gynecology and Obstetrics newsletter in December 2022.

Therapy delay due to COVID-19 pandemic among European women with breast cancer: prevalence and associated factors.

Purpose: This study investigates the impact of the COVID-19 pandemic on breast cancer (BC) care, analyzing treatment delays and factors associated with them.

Methods: This retrospective cross-sectional study analyzed data from the Oncology Dynamics (OD) database. Surveys of 26,933 women with BC performed between January 2021 and December 2022 in Germany, France, Italy, the United Kingdom, and Spain were examined.

Resilience of Gynecological and Obstetric Inpatient Care in Central Germany in Times of Repetitive Socioeconomic Shocks-An Epidemiological Study Assessing Standardized Health Services Indicators and Economic Status According to the aG-DRG Catalog.

Sequential socioeconomic shocks, including the COVID-19 pandemic, economic recession, or energy and refugee crises in the face of violent conflicts, have led to the failure of healthcare systems in Europe. Against this background, the aim of this study was to evaluate the resilience of regional gynecological and obstetric inpatient care using the example of a regional core medical provider in central Germany. Base data were retrieved from Marburg University Hospital and underwent standardized calculation and descriptive statistical assessment pursuant to the aG-DRG catalog.

Association between gout and subsequent breast cancer: a retrospective cohort study including 67,598 primary care patients in Germany.

Purpose: The aim of this retrospective cohort study was to analyze the cumulative incidence of breast cancer following gout and to investigate the association between gout and subsequent breast cancer in 67,598 primary care patients in Germany.

Methods: This study included adult female patients (≥ 18 years) with an initial diagnosis of gout in 1284 general practices in Germany between January 2005 and December 2020. Individuals without gout were matched to gout patients using propensity score matching based on average yearly consultation frequency during the follow-up period, diabetes, obesity, chronic bronchitis/COPD diagnoses, and diuretic therapy.

Initiation of Antiresorptive Drug Treatment during Endocrine Therapy for Breast Cancer-A Retrospective Cohort Study of 161,492 Patients in Germany.

Background: The aim of this retrospective cohort study was to measure the proportion of women with an initial prescription of an antiresorptive drug (bisphosphonates or denosumab) during five years of endocrine breast cancer therapy.

Methods: The study included women with an initial prescription of tamoxifen (TAM) or aromatase inhibitors (AIs) between January 2016 and December 2020. Kaplan-Meier analyses were performed to show the cumulative incidence of antiresorptive drug prescription for TAM and AIs separately for four age groups.

Impact of the COVID-19 Pandemic on Gyne-Oncological Treatment-A Retrospective Single-Center Analysis of a German University Hospital with 30,525 Patients.

The study pursues the objective of drawing a comparison between the data of gyne-oncology, gynecology, and obstetrics patient collectives of a German university hospital regarding the progression of patient number and corresponding treatment data during the five-year period of 2017-2021 to assess the impact of the COVID-19 pandemic on gyne-oncological treatment. Descriptive assessment is based on data extracted from the database of the hospital controlling system QlikView for patients hospitalized at the Department of Gynecology and Obstetrics of Marburg University Hospital. Gynecology and gyne-oncology experience a maintained decline in patient number (n: -6% 2019 to 2020, -5% 2019 to 2021; n: -6% 2019 to 2020, -2% 2019 to 2021) with varying effects on the specific gyne-oncological main diagnoses.

Association between Parkinson's Disease Medication and the Risk of Lower Urinary Tract Infection (LUTI): A Retrospective Cohort Study.

Background: The occurrence of autonomic dysfunctions (e.g., urological dysfunctions) is a common phenomenon during the course of Parkinson's disease (PD) and resulting complications such as lower urinary tract infections (LUTI) are one of the leading causes of hospitalizations and mortality in patients with the condition.

Use Case Evaluation and Digital Workflow of Breast Cancer Care by Artificial Intelligence and Blockchain Technology Application.

This study aims at evaluating the use case potential of breast cancer care for artificial intelligence and blockchain technology application based on the patient data analysis at Marburg University Hospital and, thereupon, developing a digital workflow for breast cancer care. It is based on a retrospective descriptive data analysis of all in-patient breast and ovarian cancer patients admitted at the Department of Gynecology of Marburg University Hospital within the five-year observation period of 2017 to 2021. According to the German breast cancer guideline, the care workflow was visualized and, thereon, the digital concept was developed, premised on the literature foundation provided by a Boolean combination open search.

Chronological Development of Cardiovascular Disease in Times of COVID-19: A Retrospective Analysis of Hospitalized Diseases of the Circulatory System and COVID-19 Patients of a German University Hospital.

This study aims at examining the chronological development of hospitalized cardiovascular and COVID-19 patients and comparing the effects on related sub-disciplines and main diagnoses for pre-pandemic (2017-2019) and pandemic (2020-2021) years in the setting of a German university maximum care provider. Data were retrospectively retrieved from the hospital performance controlling system for patient collectives with main diagnosis of diseases of the circulatory system (n) and COVID-19 secondary diagnosis (n). The cardiovascular patient collective (n = 25,157) depicts a steady state in terms of relative yearly development of patient numbers (+0.

Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Cervical Cancer Screening in Gynecological Practices in Germany.

Purpose: the aim of this cross-sectional study was to analyze the impact of the COVID-19 pandemic on Cervical Cancer Screening (CCS) in gynecological practices in Germany. Methods: The basis of the analysis was the Uniform Evaluation Standard (EBM) of the Statutory Health Insurance Scheme. This cross-sectional study included all women aged ≥20 years with at least one CCS (clinical and cytological examination) in 223 gynecological practices in Germany during the period 2018−2021.

Persistence with tamoxifen and aromatase inhibitors in Germany: a retrospective cohort study with 284,383 patients.

Purpose: The aim of this study was to analyze the persistence of women on tamoxifen (TAM) and aromatase inhibitors (AIs) in Germany, and to investigate possible determinants of non-persistence.

Methods: The present retrospective cohort study was based on the IQVIA longitudinal prescription database (LRx). The study included women with an initial prescription of TAM or AIs (anastrozole, letrozole, and exemestane) between January 2016 and December 2020 (index date).

Positive association between body height and breast cancer prevalence: a retrospective study with 135,741 women in Germany.

Purpose: The aim of this study was to analyze the prevalence of breast cancer in relation to body height and to investigate associations between body height and breast cancer in Germany.

Methods: This retrospective cohort study included 135,741 adult women followed in one of 161 gynecology practices in Germany between January 2019 and December 2021. The 3 year prevalence of breast cancer (ICD-10: C50) during the study period was shown in relation to body height, which was included in this study as a five-category variable for women: ≤ 160 cm, 161-165 cm, 166-170 cm, 171-175 cm, > 175 cm.