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Critical reflection on the indication for computed tomography: an interdisciplinary survey of risk and benefit management in patients with sepsis.
Insights Imaging
January 2025
Department of Radiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt- Universität zu Berlin, Charitéplatz 1, Berlin, Germany.
Objectives: To survey physicians' views on the risks and benefits of computed tomography (CT) in the management of septic patients and indications for and contraindications to contrast media use in searching for septic foci.
Methods: A web-based questionnaire was administered to physicians at a large European university medical center in January 2022. A total of 371 questionnaires met the inclusion criteria and were analyzed with physicians' work experience, workplace, and medical specialty as independent variables.
Enhancing Clinical Confidence: Effects of Medical Screening and Differential Diagnosis Training for Low Back Pain.
J Multidiscip Healthc
January 2025
The Neuromuscular & Human Performance Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel.
Purpose: Direct access to physical therapy (PT) requires PTs to act as primary care providers, making differential diagnosis a critical component of patient assessment. We investigated how participation in postgraduate training in differential diagnosis and medical screening influences PTs' confidence, self-efficacy, attitudes and beliefs about treating patients with low back pain (LBP).
Patients And Methods: This prospective, two-arm study involved 49 PTs in an intervention group and 70 in a control group.
Uncertainty estimation in diagnosis generation from large language models: next-word probability is not pre-test probability.
JAMIA Open
February 2025
Department of Medicine, University of Wisconsin-Madison, Madison, WI 53792, United States.
Objective: To evaluate large language models (LLMs) for pre-test diagnostic probability estimation and compare their uncertainty estimation performance with a traditional machine learning classifier.
Materials And Methods: We assessed 2 instruction-tuned LLMs, Mistral-7B-Instruct and Llama3-70B-chat-hf, on predicting binary outcomes for Sepsis, Arrhythmia, and Congestive Heart Failure (CHF) using electronic health record (EHR) data from 660 patients. Three uncertainty estimation methods-Verbalized Confidence, Token Logits, and LLM Embedding+XGB-were compared against an eXtreme Gradient Boosting (XGB) classifier trained on raw EHR data.
Clinical Significance of Serum MMP-9, S100-β and GFAP in Patients with Mental Disorders after Traumatic Brain Injury.
Actas Esp Psiquiatr
January 2025
Department of Neurosurgery, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, 325000 Wenzhou, Zhejiang, China.
Background: Diagnosing psychiatric disorders following craniocerebral trauma primarily depends on clinical symptoms and neuropsychological evaluation, which can be subjective and limited. This study aimed to investigate the diagnostic value of serum matrix metalloproteinase-9 (MMP-9), S100 calcium-binding protein β (S100-β), and glial fibrillary acidic protein (GFAP) in post-traumatic mental disorders.
Methods: A retrospective analysis was conducted on 108 patients with craniocerebral trauma admitted to Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine between January 2021 and December 2023.
Transformation and articulation of clinical data to understand students' clinical reasoning: a scoping review.
BMC Med Educ
January 2025
Faculté des sciences infirmières, Université de Montréal, Succ. Centre-Ville, Montréal, C. P. 6128, H3C 3J7, Canada.
Background: Despite the importance of effective educational strategies to promote the transformation and articulation of clinical data while teaching and learning clinical reasoning, unanswered questions remain. Understanding how these cognitive operations can be observed and assessed is crucial, particularly considering the rapid growth of artificial intelligence and its integration into health education. A scoping review was conducted to map the literature regarding educational strategies to support transformation and articulation of clinical data, the learning tasks expected of students when exposed to these strategies and methods used to assess individuals' proficiency METHODS: Based on the Joanna Briggs Institute methodology, the authors searched 5 databases (CINAHL, MEDLINE, EMBASE, PsycINFO and Web of Science), ProQuest Dissertations & Theses electronic database and Google Scholar.
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