American Journal Research Articles

Global scholarly output on orthodontic temporary anchorage devices (TADs): A silver jublee scientometric analysis.

This study aimed to analyze the global scholarly production of articles related to temporary anchorage devices (TADs) from 1998-2023 in peer-reviewed dental journals indexed in the Web of Science. Adatabase of TADs-related articles was created via aWeb of Sciences structured search. The bibliometric characteristics of the studies, including the number of citations, publication year, journal title, journal impact factor (IF), authorship, contributing institutions and countries, thematic field, and study design, were extracted. Keyword co-occurrence network analyses and the correlation between the number of citations and the article age, journal IF, and journal quartile of each article were performed. The top50 cited articles were published from 1999-2016, and the total number of citations ranged from 82-602, with 160.36 citations/paper on average. Most of the articles originated from Japan (n = 12), with the most remarkable contributions from Nihon and Okayama Universities, Japan (n = 5, each). The American Journal of Orthodontics and Dentofacial Orthopedics had the most cited articles, with 196.57 citations/paper on average. Asignificant positive correlation occurred between the number of citations and publication age (rho = 0.392, P = 0.005). Our scientometric analysis reported the characteristics of TADs-related articles published over 25years. Most highly-cited articles were published between 2005 and 2008. The positive correlation between articles' publication date and the number of citations might impact the top50 within the next 5-10years.

In Case You Haven't Heard…

Rapid induction with naltrexone, and children who lost parents to drug overdoses, are two important studies that were released last week in the midst of the American Psychiatric Association's (APA) annual meeting. Both studies were funded by the National Institute on Drug Abuse and will be covered in next week's issue. Meanwhile, reflecting at the APA's addiction‐themed conference covered in this issue, ADAW was reminded of another APA conference years ago, in which we were in the audience surrounded by psychiatrists who were listening, somewhat distractedly, to a presentation about addiction. “Why do we have to hear this addiction stuff,” we overheard one audience member say to another. So for those who think progress isn't taking place, it is. Kudos to outgoing APA president Petros Levounis, M.D., for his work on this and also to American Journal of Psychiatry editor Kathleen Brady for the current addiction‐themed issue. There are probably some psychiatrists who still wonder why they need to know about addiction. If they were at last week's conference, though, they don't have any more questions.

APA theme for annual meeting and current journal: Addiction

Last week's annual meeting of the American Psychiatric Association (APA) featured much more than the usual addiction‐focused programming, which has been growing year by year. It was, under the direction of outgoing president Petros Levounis, M.D., himself an addiction psychiatrist, based on addiction. So is the current issue of the APA's flagship journal, the American Journal of Psychiatry, which featured three major articles on addiction. Two were presented last week; one, a commentary by Keith Humphreys, Ph.D., and colleagues, focused on the barriers to Medicaid reimbursement for treatment, mainly erected by a few states (ADAW will cover that in depth next week).

APA research examines substance use predictors in youth

Sociodemographic factors are considered the most robust predictors — followed by cultural and environmental factors — of the likelihood of substance use initiation among youth according to a new study that examined substance use initiation predictors and was published in the May issue of the American Journal of Psychiatry.

New task-new results? How the gaze cone is influenced by the method of measurement.

Perceiving direct gaze-the perception of being looked at-is important in everyday life. The gaze cone is a concept to define the area in which observers perceive gaze as direct. The most frequently used methods to measure direct gaze threshold fall into two broad groups: First, a variant of the method of constant stimuli, firstly introduced by Gibson and Pick (The American Journal of Psychology, 76, 386-394, 1963). Second, a variant of the method of adjustment, firstly introduced by Gamer and Hecht (Journal of Experimental Psychology: Human Perception and Performance, 33, 705-715, 2007). Previous studies found a considerable range of thresholds, and although some influences on thresholds are already known (uncertainty, clinical groups), thresholds often vary for no apparent reason. Another important method is a triadic gaze-perception task, which usually finds triadic gaze direction judgments to be overestimated. In two experiments, we compare the method of adjustment with the method of constant stimuli. Experiment 1additionally examines the influence of the overestimation effect found in the triadic task. Results indicate that thresholds are larger when measured by the method of adjustment than by constant stimuli. Furthermore, Experiment 1finds a nonlinear overestimation factor, indicating that gaze directions near 0° are less overestimated than larger eccentricities. Correcting the thresholds with individually obtained overestimation factors widens the gaze cone but does not eliminate the average difference between the methods of adjustments and constant stimuli.

Towards Improved Radiological Diagnostics: Investigating the Utility and Limitations of GPT-3.5 Turbo and GPT-4 with Quiz Cases.

The rise of large language models such as generative pre-trained transformers (GPTs) has sparked significant interest in radiology, especially in interpreting radiological reports and image findings. While existing research has focused on GPTs estimating diagnoses from radiological descriptions, exploring alternative diagnostic information sources is also crucial. This study introduces the use of GPTs (GPT-3.5 Turbo and GPT-4) for information retrieval and summarization, searching relevant case reports via PubMed, and investigates their potential to aid diagnosis. From October 2021 to December 2023, we selected 115 cases from the "Case of the Week" series on the American Journal of Neuroradiology website. Their Description and Legend sections were presented to the GPTs for the two tasks. For the Direct Diagnosis task, the models provided three differential diagnoses that were considered correct if they matched the diagnosis in the diagnosis section. For the Case Report Search task, the models generated two keywords per case, creating PubMed search queries to extract up to three relevant reports. A response was considered correct if reports containing the disease name stated in the diagnosis section were extracted. McNemar's test was employed to evaluate whether adding a Case Report Search to Direct Diagnosis improved overall accuracy. In the Direct Diagnosis task, GPT-3.5 Turbo achieved a correct response rate of 26% (30/115 cases), whereas GPT-4 achieved 41% (47/115). For the Case Report Search task, GPT-3.5 Turbo scored 10% (11/115), and GPT-4 scored 7% (8/115). Correct responses totaled 32% (37/115) with three overlapping cases for GPT-3.5 Turbo, whereas GPT-4 had 43% (50/115) of correct responses with five overlapping cases. Adding Case Report Search improved GPT-3.5 Turbo's performance (p = 0.023) but not that of GPT-4 (p = 0.248). The effectiveness of adding Case Report Search to GPT-3.5 Turbo was particularly pronounced, suggesting its potential as an alternative diagnostic approach to GPTs, particularly in scenarios where direct diagnoses from GPTs are not obtainable. Nevertheless, the overall performance of GPT models in both direct diagnosis and case report retrieval tasks remains not optimal, and users should be aware of their limitations.ABBREVIATIONS: AI = Artificial Intelligence, GPT = generative pretrained transformer, LLM = large language model.

Global research progress of endothelial cells and ALI/ARDS: a bibliometric analysis

BackgroundAcute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are severe respiratory conditions with complex pathogenesis, in which endothelial cells (ECs) play a key role. Despite numerous studies on ALI/ARDS and ECs, a bibliometric analysis focusing on the field is lacking. This study aims to fill this gap by employing bibliometric techniques, offering an overarching perspective on the current research landscape, major contributors, and emerging trends within the field of ALI/ARDS and ECs.MethodsLeveraging the Web of Science Core Collection (WoSCC) database, we conducted a comprehensive search for literature relevant to ALI/ARDS and ECs. Utilizing Python, VOSviewer, and CiteSpace, we performed a bibliometric analysis on the corpus of publications within this field.ResultsThis study analyzed 972 articles from 978 research institutions across 40 countries or regions, with a total of 5,277 authors contributing. These papers have been published in 323 different journals, spanning 62 distinct research areas. The first articles in this field were published in 2011, and there has been a general upward trend in annual publications since. The United States, Germany, and China are the principal contributors, with Joe G. N. Garcia from the University of Arizona identified as the leading authority in this field. American Journal of Physiology-Lung Cellular and Molecular Physiology has the highest publication count, while Frontiers in Immunology has been increasingly focusing on this field in recent years. “Cell Biology” stands as the most prolific research area within the field. Finally, this study identifies endothelial glycocalyx, oxidative stress, pyroptosis, TLRs, NF-κB, and NLRP3 as key terms representing research hotspots and emerging frontiers in this field.ConclusionThis bibliometric analysis provides a comprehensive overview of the research landscape surrounding ALI/ARDS and ECs. It reveals an increasing academic focus on ALI/ARDS and ECs, particularly in the United States, Germany, and China. Our analysis also identifies several emerging trends and research hotspots, such as endothelial glycocalyx, oxidative stress, and pyroptosis, indicating directions for future research. The findings can guide scholars, clinicians, and policymakers in targeting research gaps and setting priorities to advance the field.

Cultural heritage tourism at film-related tourism sites: staged and existential authenticity at Hengdian World Studios

ABSTRACT The trend of incorporating culture and heritage into various aspects of tourism, such as film-related tourism, is gaining momentum. In addition to the film-related attractions, film-related tourism can encourage tourists’ engagement with cultural heritage tourism and consumption of heritage products at the destination. Examining the case of Hengdian World Studios (China), the world’s largest outdoor film studio and film shooting base, this paper discusses how cultural heritage tourism is induced at a film-related tourism destination as well as how the tourism destination represents authenticity and how tourists perceive such representations. Hengdian World Studios simulates several real heritage sites in different areas of China for screen media productions as well as for tourist consumption. This paper examines the concepts of ‘staged authenticity’ (MacCannell [1973]. Staged authenticity: Arrangements of social space in tourist settings. American Journal of Sociology, 79(3), 589–603. https://doi.org/10.1086/225585) and ‘existential authenticity’ (Wang [1999]. Rethinking authenticity in tourism experience. Annals of Tourism Research, 26(2), 349–370. https://doi.org/10.1016/s0160-7383(98)00103-0) in the context of tourism studies to understand cultural heritage tourism at film-related tourism sites. The discussion is based on research undertaken at Hengdian World Studios between 2018 and 2023 drawing on ethnographic methods and online interviews with 50 tourists. This paper contributes to the understanding of authenticity issues in tourism studies from different perspectives and the interconnections between film-related tourism and cultural heritage tourism.

Analysis of Hip Preservation Questions on the Orthopaedic In-Training Examination Over the Past 20 Years.

The orthopaedic in-training examination (OITE) is a 275-question test for orthopaedic residents administered annually. As the field of orthopaedics changes, the OITE evolves its content. The incidence of hip preservation-related procedures has increased substantially over the past decade; nonetheless, an analysis of the trends of hip preservation questions on the OITE has not yet been performed. The purpose of the study was to evaluate the number and type of questions on the OITE related to hip preservation to determine whether trends over time paralleled the increases in hip-related care in clinical practice. It was hypothesized that the frequency of hip preservation questions on the OITE would increase with time. Cross-sectional study. Each OITE between 2002 and 2021 was reviewed for questions related to hip preservation. The types of questions included under "hip preservation" were those related to femoroacetabular impingement (FAI), athletic soft tissue injuries of the hip, acetabular labral tears, hip arthroscopy, and surgical management of adult hip dysplasia-excluding arthroplasty. Questions were quantified and categorized by topic, taxonomy level, associated imaging, and cited sources. There were 30 hip preservation-related questions between 2002 and 2021. Of these, 77% occurred within the past 10 years. Also, 14 questions (47%) had associated images in the question stem-the most common being radiographs (n = 8 questions). The most commonly tested subcategories were FAI (n = 11 questions [37%]), athletic injuries (n = 7 questions [23%]), and anatomy (n = 7 questions [23%]). Over the last 10 years, 97.9% of citations were from journal articles-the most common being the Journal of the American Academy of Orthopaedic Surgeons, Clinical Orthopedics and Related Research, and the American Journal of Sports Medicine. The frequency of hip preservation-related questions on the OITE has increased with time, reflecting trends in clinical practice.

The American Journal of Psychiatry: Table of Contents

The American Journal of Psychiatry: Table of Contents

Research hotspots and evolving trends of barrier dysfunction in acute lung injury and acute respiratory distress syndrome

Endothelial and epithelial barrier dysfunction due to increased permeability and heightened inflammatory reactions influences the emergence of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Nevertheless, bibliometric research comparing endothelial and epithelial barriers is limited. Therefore, this bibliometric study analyzed the Web of Science Core Collection (WoSCC) of the Science Citation Index Expanded literature to explore present research priorities and development tendencies within this field. We conducted a comprehensive search (October 18, 2023) on WoSCC from January 1, 2010, to October 18, 2023, focusing on articles related to endothelial and epithelial barriers in ALI and ARDS. Retrieved data were visualized and analyzed using R-bibliometrix, VOS viewer 1.6.19, and CiteSpace 6.2. R4. Functional enrichment analysis of gene targets identified in the keyword list using Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene ontology databases, and based on the STRING database to construct a PPI network to predict core genes. A total of 941 original articles and reviews were identified. The United States had the highest number of publications and citations and the highest H-index and G-index. According to the Collaboration Network Analysis graph, the United States and China had the strongest collaboration. Birukova AA had the most publications and citations among all authors, while eight of the top ten institutions with mediator centrality were located in the United States. The American Journal of Physiology-Lung Cellular and Molecular Physiology was the leading journal and had the most well-established publication on endothelial and epithelial barriers in ALI and ARDS. Bibliometric analysis revealed that the most frequently used keywords were acute lung injury, ARDS, activation, expression, and inflammation. RHOA appeared most frequently among gene-related keywords, and the PI3K-AKT signaling pathway had the highest count in KEGG pathway enrichment. Research on endothelial versus epithelial barriers in ALI and ARDS remains preliminary. This bibliometric study examined cooperative network connections among countries, authors, journals, and network associations in the cited references. Investigation of the functions of the endothelial and epithelial barriers in ALI/ARDS associated with COVID-19 has recently gained significant attention.

Treatment of late‐life depression improves cognitive function, review finds

A systematic review and meta‐analysis based on 22 studies has concluded that antidepressant treatment for late‐life depression improves cognitive function, particularly in the domains of memory and learning. Results supported an association between reduced depressive symptoms and improvement in cognition. Results of the review and meta‐analysis were published online Feb. 7, 2024, in the American Journal of Psychiatry.

RETRACTION: A predictive model of herpes zoster after allogeneic hematopoietic stem cell transplantation: VZV reactivation following antiviral prophylaxis discontinuation.

Retraction: Feng, C-J. , Zhao, P. , Fu, H-X. , Yan, C-H. , Wang, C-C. , Zhu, X-L. , He, Y. , Wang, F-R. , Zhang, Y-Y. , Mo, X-D. , Kong, Y. , Han, W. , Wang, J-Z. , Wang, Y. , Chen, H. , Chen, Y-H. , Zhao, X-Y. , Chang, Y-J. , Xu, L-P. , Liu, K-Y. , Huang, X-J. , Zhang, X-H. (2023) A predictive model of herpes zoster after allogeneic hematopoietic stem cell transplantation: VZV reactivation following antiviral prophylaxis discontinuation. American Journal of Hematology. https://doi.org/10.1002/ajh.27090. The above article, published online on 29 September 2023 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief Carlo Brugnara and Wiley Periodicals LLC. The retraction has been agreed following notification by a third party who identified methodological errors in the published article. The journal conducted an investigation including post-publication review by an independent expert, who confirmed that the errors were substantial. The authors provided a point-for-point response to the journal about these concerns. However, the journal concluded that while some errors could be corrected, the methodology and data still would contain fundamental errors that invalidate the conclusions. The authors disagree with this retraction."

“Allowing Space for Voice…All Our Voices”: Understanding Ho‘ouna Pono Implementation Through Educational Leadership Perspectives in Rural Hawai‘i Schools

AbstractEpidemiological research over the past two decades has highlighted substance use disparities that affect Native Hawaiian and Pacific Islander youth, and the lack of effective approaches to address such disparities (Okamoto et al. in Asian American Journal of Psychology 10(3):239–248, 2019). The Ho‘ouna Pono curriculum is a culturally grounded, teacher-implemented, video-enhanced substance use prevention program that has demonstrated efficacy in rural Hawaiʻi in a large-scale trial (Okamoto in Asian American Journal of Psychology 10(3):239–248, 2019). Despite its potential to ameliorate health disparities and address youth substance use, prevention programs such as Ho‘ouna Pono have been poorly disseminated and implemented across Hawaiʻi, raising the question: Why are effective prevention programs not used in communities that most need them? The present study used concept mapping to understand previously identified implementation barriers and develop implementation strategies for Ho‘ouna Pono. Seven Hawaiʻi Department of Education (HIDOE) educational leaders and administrators sorted Ho‘ouna Pono implementation barriers (e.g., “There is a lack of HIDOE funding to support prevention curricula”), named concepts, and rated barriers’ perceived impact and difficulty. Multidimensional scaling and cluster analysis yielded a five-cluster solution: (1) Kumu (Hawaiian word for teacher) Controlled, (2) School Level Buy-in, (3) Curriculum, (4) Student Attitudes + Mindsets (Family + Community), and (5) Policy. Participant ratings identified eight high-impact and low-difficulty barriers. Discussion revealed important intersections among barriers indicating the need for coordinated and cross-level implementation strategies to support Ho‘ouna Pono sustainment. Brainstormed implementation strategies using participants’ own language highlighted a need for participatory methods in school settings to bidirectionally share ways to best sustain substance use prevention programs.

Assessing the impact of the COVID-19 pandemic on the quality of evidence reported in the leading orthodontic journals

Objectives: The objective of this study was to assess the effect of the COVID-19 pandemic on the quality of research reporting of the most recent orthodontic literature published in three of the highest impact factor orthodontic journals. Material and Methods: The American Journals of Orthodontics and Dentofacial Orthopedics (AJODO), European Journal of Orthodontics (EJO), and Angle Orthodontist (AO) were searched for randomized controlled trials (RCTs) published from January 2018 to March 2022. Trials were evaluated using the consolidated standards of reporting trial (CONSORT) checklist. Independent t-test was used to compare pre-COVID and post-COVID RCTs across CONSORT percentages and to compare journals where those trials were published. Multiple linear regressions were used to study the association of different characteristics with the CONSORT percentage scores. P < 0.05 was considered statistically significant. Results: A total of 117 RCTs were retrieved from the three journals between January 2018 and March 2022. Thesample was classified as 63 pre-COVID studies (53.8%) and 54 (46.2%) post-COVID studies published in three orthodontics journals (27 in AJODO [23.1%], 45 [38.5%] in AO, and 45 [38.5%] in the EJO). The mean percentage of CONSORT compliance was 84.51% ± 14.34%. There was a statistically significant association of CONSORT scores with journals where the trials were published. Compared to AJODO, AO had a lower CONSORT percentage by an average of 18.81, P < 0.001. Independent t-test was performed to compare RCTs pre/post-COVID across CONSORT percentages. It showed no statistically significant difference as the mean compliance was 84.96 ± 16.01 for the pre-COVID studies and 83.99 ± 12.25 for post-COVID (P = 0.711). Conclusion: Overall, CONSORT mean score was 84.51% ± 14.34%. AJODO had the highest CONSORT compliance score while AO had the least compliance score. The quality of reporting of RCTs in orthodontic journals was not affected by the pandemic.

The Top 100 Cited Articles Focusing on Acute Lung Injury and ARDS: Bibliometric and Visualization Analyses.

In recent years, acute lung injury (ALI) and ARDS have emerged as critical health concerns, drawing considerable attention from clinicians. The volume of published articles on ALI/ARDS is on the rise, indicating the expanding research interest in this field. However, the precise quantity and quality of studies on ALI/ARDS remain unclear. Consequently, we employed bibliometric and visual techniques to comprehensively analyze the patterns and focal points of these articles. To investigate the characteristics of highly referenced papers on ALI/ARDS and offer insights into the progress and advancements in research on ALI/ARDS, we conducted a comprehensive search in the core Web of Science database for cited articles using the terms "ALI," "acute lung injury," "ARDS," or "acute respiratory distress syndrome." A total of 60,282 citations were retrieved by narrowing the scope to reviews, articles, and publications in English. From the obtained citations, we selected materials for analysis from the top 100 articles with the highest number of citations. Subsequently, the articles were visualized and analyzed using VOSviewer, CiteSpace, and bibliometric techniques. This analysis focused on identifying trends related to authors, journals, countries, institutions, collaborative networks, key words, and other relevant factors in the field of ALI/ARDS research. Among the top 100 cited articles, the highest and lowest number of citations were 6,957 and 451, respectively. A total of 100 articles were published between 1991-2020, with a peak in publications observed in 2004, 2005, and 2012 (no. = 7). Among 29 journals, The New England Journal of Medicine (no. = 21) had the highest number of publications, followed by the American Journal of Respiratory and Critical Care Medicine (no. = 14). Among the 29 countries represented in the top 100 cited articles, the United States (no. = 51) emerged as the leading country in the number of publications, followed by Canada (no. = 19) (there was some overlap in paper output between countries due to co-publication). The 3 predominant keywords identified in studies within the ALI/ARDS domain were ALI, mechanical ventilation, and PEEP. This study provides a historical perspective on the scientific advancements in ALI/ARDS research, highlighting the need for further investigation and development in specific areas within the field. Bibliometric analyses reveal that the United States is the predominant force in the field of ALI/ARDS, contributing significantly to its development. Through an examination of highly cited papers on ALI/ARDS, we have identified global research trends, assessed the quality of studies, and identified hot topics in the field of ALI/ARDS.

Italian research on anterior cruciate ligament: a bibliometric analysis.

This study analysed thetrend of publications on anterior cruciate ligament(ACL) in Italy. It was hypothesised that publications on this topic have quickly increased in recent years due to increased knowledge of both clinical and radiological pathology. PubMed and Scopus were accessed on 29/11/2023. This retrieved 838 articles from PubMed and 1050 from Scopus. We analysed the top 10 authors, and journals in publication numbers, citation numbers, and citations per year. We have also looked at the top 10 institutions publishing on anterior cruciate ligament from Scopus as PubMed does not give this information in the output. Data mining was performed using the Orange software, Mac version 3.32.0 ( https://orangedatamining.com/ ) from the titles of all articles. A word cloud analysis of titles, authors, journals and universities was performed. The peak of citations was in 2017 with 1529, whilst the peak of publications was in 2019 with 59 articles published. Analysing the number of publications and citations for the journal, the most impacted journal is Knee Surgery, Sports Traumatology, Arthroscopy with 5472 citations and 183 articles, followed by The American Journal of Sports Medicine, with 2722 citations and 56 articles and Arthroscopy with 1990 citations and 62 articles. Considering also international collaborations, the most cited author is Della Villa F. in 2020 with 43.67 citationsper year.The Italian author with the major number of publications is Zaffagnini S. with 39 articles, whilst the author with the higher number of citations is Aglietti P. with 1612 citations. ACL reconstruction has gained growing interest amongst the scientific community. Publications and citations presented a rising trend, the majority of the highly cited papers were contributed by few centres, and clinical trials were the most cited study designs. The long-term outcomes of ACL lesions have attracted interest. The authors hypothesised that shortly there will be an increase in articles analysing the results of ACL revisions, the use of lateral extra-articular tenodesis, and meniscus transplants. Cross-Sectional Study.

Sex estimation research trends in forensic anthropology between 2000 and 2022 in five prominent journals.

In forensic anthropology, osteological sex estimation methods are continuously reevaluated and updated to improve classification accuracies. Therefore, to gain a comprehensive understanding of recent trends in sex estimation research in forensic anthropology, a content analysis of articles published between 2000 and 2022 in Forensic Science International, the Journal of Forensic Sciences, the International Journal of Legal Medicine, the American Journal of Biological Anthropology, and Forensic Anthropology, was performed. The main goals of this content analysis were to (1) examine trends in metric versus morphological research, (2) examine which areas of the skeleton have been explored, (3) examine which skeletal collections and population affinities have been most frequently utilized, and (4) determine which statistical methods were commonly implemented. A total of 440 articles were coded utilizing MAXQDA and the resulting codes were exported for analysis. Statistical analyses were conducted utilizing the Cochran-Armitage and Jonckheere-Terpstra tests for trends, as well as Fisher-Freeman-Halton tests. The results demonstrate that sex estimation research published in these journals has prioritized metric over morphological methods. Further, the most utilized skeletal regions continue to be the skull and pelvis, while the most popular classification statistics continue to be discriminant function analysis and logistic regression. This study also demonstrates that a substantial portion of research has been conducted utilizing U.S. and Europe-based collections and limited populations. Based on these results, future sex estimation research must continue exploring the use of long bones and other postcranial elements, testing newer methods of analysis, as well as developing population-inclusive methods.

Evaluating ChatGPT-4's Diagnostic Accuracy: Impact of Visual Data Integration.

In the evolving field of health care, multimodal generative artificial intelligence (AI) systems, such as ChatGPT-4 with vision (ChatGPT-4V), represent a significant advancement, as they integrate visual data with text data. This integration has the potential to revolutionize clinical diagnostics by offering more comprehensive analysis capabilities. However, the impact on diagnostic accuracy of using image data to augment ChatGPT-4 remains unclear. This study aims to assess the impact of adding image data on ChatGPT-4's diagnostic accuracy and provide insights into how image data integration can enhance the accuracy of multimodal AI in medical diagnostics. Specifically, this study endeavored to compare the diagnostic accuracy between ChatGPT-4V, which processed both text and image data, and its counterpart, ChatGPT-4, which only uses text data. We identified a total of 557 case reports published in the American Journal of Case Reports from January 2022 to March 2023. After excluding cases that were nondiagnostic, pediatric, and lacking image data, we included 363 case descriptions with their final diagnoses and associated images. We compared the diagnostic accuracy of ChatGPT-4V and ChatGPT-4 without vision based on their ability to include the final diagnoses within differential diagnosis lists. Two independent physicians evaluated their accuracy, with a third resolving any discrepancies, ensuring a rigorous and objective analysis. The integration of image data into ChatGPT-4V did not significantly enhance diagnostic accuracy, showing that final diagnoses were included in the top 10 differential diagnosis lists at a rate of 85.1% (n=309), comparable to the rate of 87.9% (n=319) for the text-only version (P=.33). Notably, ChatGPT-4V's performance in correctly identifying the top diagnosis was inferior, at 44.4% (n=161), compared with 55.9% (n=203) for the text-only version (P=.002, χ2 test). Additionally, ChatGPT-4's self-reports showed that image data accounted for 30% of the weight in developing the differential diagnosis lists in more than half of cases. Our findings reveal that currently, ChatGPT-4V predominantly relies on textual data, limiting its ability to fully use the diagnostic potential of visual information. This study underscores the need for further development of multimodal generative AI systems to effectively integrate and use clinical image data. Enhancing the diagnostic performance of such AI systems through improved multimodal data integration could significantly benefit patient care by providing more accurate and comprehensive diagnostic insights. Future research should focus on overcoming these limitations, paving the way for the practical application of advanced AI in medicine.

Corrigendum to ‘Objectively Measured Night-Time Sleep Efficiency and Quality of Life in Patients With Heart Failure With Preserved Ejection Fraction’ [American Journal of Cardiology 208 (2023) 124-125]

Corrigendum to ‘Objectively Measured Night-Time Sleep Efficiency and Quality of Life in Patients With Heart Failure With Preserved Ejection Fraction’ [American Journal of Cardiology 208 (2023) 124-125]