The 10 most-cited articles in Southern Medical Journal, 2024

OBJECTIVES: Our aim was to compare the usability and reliability of answers to clinical questions posed of Chat-Generative Pre-Trained Transformer (ChatGPT) compared to those of a human-authored Web source (www.Pearls4Peers.com) in response to "real-world" clinical questions raised during the care of patients. METHODS: Two domains of clinical information quality were studied: usability, based on organization/readability, relevance, and usefulness, and reliability, based on clarity, accuracy, and thoroughness. The top 36 most viewed real-world questions from a human-authored Web site (www.Pearls4Peers.com [P4P]) were posed to ChatGPT 3.5. Anonymized answers by ChatGPT and P4P (without literature citations) were separately assessed for usability by 18 practicing physicians ("clinician users") in triplicate and for reliability by 21 expert providers ("content experts") on a Likert scale ("definitely yes," "generally yes," or "no") in duplicate or triplicate. Participants also directly compared the usability and reliability of paired answers. RESULTS: The usability and reliability of…

OBJECTIVES: This study aimed to analyze the association between physical therapists' recommended number of visits for a full recovery from common orthopedic injuries/surgeries and the extent of insurance coverage for these visits. METHODS: A prospective observational study was conducted with board-certified physical therapists. A qualitative questionnaire was used to gather physical therapists' demographics and the recommended number of physical therapy visits to achieve a full recovery after 11 common orthopedic diagnoses. Physical therapists also were asked to report whether they believe that insurance provides an adequate number of visits overall. In addition to the qualitative survey, insurance coverage details of major Alabama companies were obtained for comparison. Descriptive statistics of the participating therapists were analyzed for sex, age, degree/training, and years of experience. Kruskal-Wallis statistics were used to analyze variance between the aforementioned groupings when compared with the reported average number of sessions. RESULTS: The survey (N = 251) collected…

OBJECTIVES: Many epidemiological studies have shown that coronavirus disease 2019 (COVID-19) disproportionately affects males, compared with females, although other studies show that there were no such differences. The aim of the present study was to assess differences in the prevalence of hospitalizations and in-hospital outcomes between the sexes, using a larger administrative database. METHODS: codes. The primary outcome of the study was hospitalization rate, and secondary outcomes were in-hospital mortality, prolonged length of stay, vasopressor use, mechanical ventilation, and intensive care unit (ICU) admission. RESULTS: There were 95,180 COVID-19 hospitalizations among patients 18 years and older, 52,465 (55.1%) of which were among men and 42,715 (44.9%) were among women. In-hospital mortality (12.4% vs 10.1%), prolonged length of hospital stays (30.6% vs 25.8%), vasopressor use (2.6% vs 1.6%), mechanical ventilation (11.8% vs 8.0%), and ICU admission rates (11.4% versus 7.8%) were significantly higher among male compared with female hospitalizations. Conditional logistic…

predicted to result in a missense mutation p.Ala440Glu. HFTC should be considered for patients presenting with diffuse calcinosis cutis-like features, and a multidisciplinary evaluation should be pursued.

OBJECTIVES: Addressing structural barriers to care for people living with human immunodeficiency virus (HIV) in the southern United States is critical to increase rates of viral suppression and to reduce existing HIV disparities. This qualitative study aimed to describe transportation-related barriers experienced by people living with HIV in South Carolina, understand perceived effects of transportation vulnerability on HIV care, and explore strategies used by individuals to overcome transportation-related challenges. METHODS: We conducted semistructured interviews with 20 people living with HIV from South Carolina who were either reengaging in HIV care after a prolonged absence (>9 months) or in care but with a detectable viral load (ie, >200 copies/mL). All people living with HIV reported transportation vulnerability. A deductive/inductive approach was used to identify transportation-related barriers perceived to negatively affect HIV care. We also identified strategies and resources described by people living with HIV as helpful in addressing transportation challenges. RESULTS:…

OBJECTIVES: This article aims to broaden the understanding of burnout in healthcare providers, its causes, and its reduction strategies. The objectives are to raise awareness, facilitate early intervention, and, ultimately, improve the overall well-being of healthcare providers and the quality of patient care. METHODS: The study investigated healthcare-provision-associated burnout, an often-unrecognized syndrome affecting professionals worldwide, and its prevalence. It also examined the impact of burnout on patient outcomes, safety, and provider health and well-being. Here, we delve into the triad of burnout attributes: emotional exhaustion, depersonalization, and decreased personal accomplishment. Specific causes, such as work-life balance, workplace environment, and communication/teamwork, are investigated. The existing literature and studies we report explore the pathophysiological effects of burnout, including its impact on health, sleep patterns, and the alarming correlation with suicide. RESULTS: The prevalence of burnout among healthcare providers is between 30% and 50%.…

OBJECTIVES: Organizations recommend providing confidential adolescent health care to reduce the consequences of high-risk health behaviors such as substance use, unhealthy eating patterns, and high-risk sexual behaviors. Family physicians are uniquely positioned to provide confidential counseling and care to this vulnerable population but must be trained to provide such care. This study describes the impact of formal and informal training on the knowledge of and comfort level in providing confidential adolescent healthcare among a sample of US Family Medicine residents. METHODS: analysis where appropriate to determine the association between resident-reported receipt of training, confidence, and frequency in providing confidential adolescent health care. RESULTS: 0.001). CONCLUSIONS: Training focused on confidential adolescent health care in medical school or residency was associated with a greater degree of comfort and a higher likelihood of providing confidential adolescent health care.

OBJECTIVES: Orthopedic surgery is a highly competitive field. The residency applicant pool is expected to grow with the increasing number of new medical schools in the United States, posing significant challenges for applicants. This study explored the impact of an engaged faculty mentor in an orthopedic surgery interest group (OSIG) at a new medical school and the impact it has on students. The study aimed to uncover the most valuable features of an OSIG at a new medical school to create a blueprint for other student-leaders and/or faculty in future initiatives. METHODS: An observational study was conducted via survey responses from active OSIG members at a new medical school in Texas. Questions were mostly in a "before and after" format asking about students' perspectives of the group before and after the addition of an engaged faculty advisor. Descriptive and inferential statistics were used to analyze the data. RESULTS: Twenty of 21 (95.2%) eligible OSIG members participated in the study. The survey results revealed that faculty engagement significantly enhanced the OSIG and its…

Without rural hospitals, many patients may not have access to essential services, or even any health care. Rural hospitals provide a community hub for local access to primary care and emergency services, as well as a bridge to specialized care outside the community. The goal of this review was to demonstrate how the University of Arkansas for Medical Sciences supports and empowers rural hospitals through an alliance that provides cost savings through clinical networks, collaborative purchasing, and leveraged services; workforce recruitment and education; telemedicine and distance learning; community outreach; and access to best practices, resources, and tools for hospital transformation. Born out of grassroots efforts in the rural US South, this model alliance, the Arkansas Rural Health Partnership, with the University of Arkansas for Medical Sciences supporting as an academic medical center participant, offers resources and programs intended to help rural hospitals and healthcare providers survive and even thrive in the challenging landscape that is forcing many other rural…

OBJECTIVES: The management of patients at risk of severe alcohol withdrawal is challenging because conventional treatment with as-needed benzodiazepines may be ineffective. We created a fixed-dose phenobarbital protocol and compared patient outcomes using this protocol with an as-needed benzodiazepine protocol. METHODS: Patients admitted from the emergency department (ED) to General Medicine from January 1 to June 30, 2022 and treated for alcohol withdrawal with a novel phenobarbital protocol were compared with all of the patients admitted from the ED to General Medicine from January 1 to June 30, 2018, and treated with as-needed benzodiazepines. The primary outcome was a composite of intensive care unit (ICU) transfer or mortality. Secondary outcomes included mortality, ICU transfer, seizure, length of stay, excess sedation, delirium, against medical advice discharge, 30-day re-admission, 30-day ED reevaluation, and antipsychotic use. RESULTS: = 0.03). Secondary outcome trends favored phenobarbital, with lower mortality, ICU transfer, seizure, oversedation, against medical advice…