Proportion Of Correct Answers Research Articles

Microsoft Bing outperforms five other generative artificial intelligence chatbots in the Antwerp University multiple choice medical license exam.

Recently developed chatbots based on large language models (further called bots) have promising features which could facilitate medical education. Several bots are freely available, but their proficiency has been insufficiently evaluated. In this study the authors have tested the current performance on the multiple-choice medical licensing exam of University of Antwerp (Belgium) of six widely used bots: ChatGPT (OpenAI), Bard (Google), New Bing (Microsoft), Claude instant (Anthropic), Claude+ (Anthropic) and GPT-4 (OpenAI). The primary outcome was the performance on the exam expressed as a proportion of correct answers. Secondary analyses were done for a variety of features in the exam questions: easy versus difficult questions, grammatically positive versus negative questions, and clinical vignettes versus theoretical questions. Reasoning errors and untruthful statements (hallucinations) in the bots' answers were examined. All bots passed the exam; Bing and GPT-4 (both 76% correct answers) outperformed the other bots (62-67%, p = 0.03) and students (61%). Bots performed worse on difficult questions (62%, p = 0.06), but outperformed students (32%) on those questions even more (p<0.01). Hallucinations were found in 7% of Bing's and GPT4's answers, significantly lower than Bard (22%, p<0.01) and Claude Instant (19%, p = 0.02). Although the creators of all bots try to some extent to avoid their bots being used as a medical doctor, none of the tested bots succeeded as none refused to answer all clinical case questions.Bing was able to detect weak or ambiguous exam questions. Bots could be used as a time efficient tool to improve the quality of a multiple-choice exam.

Analysis of factors influencing doctors' awareness of clinical guidelines for heart failure treatment

Aim. To find out the relationship between the awareness level of clinical guidelines on heart failure (HF) with reduced ejection fraction and a number of professional characteristics (specialty, work experience, self-assessment of awareness level, attitude towards the use of guidelines, the main way of document study). To improve the efficiency and development of the postgraduate education system, the factors that influence doctors' awareness of guidelines should be determined.Material and methods. The study included the results of an anonymous survey of 207 doctors (155 cardiologists, 44 therapists, 8 doctors of other specialties). To assess the significance of differences, Student's t-test, c2-test and Fisher's exact test were used.Results. The mean number of correct answers to the questionnaire among cardiologists was significantly higher than among general practitioners (p&lt;0,001). In the group of physicians with less than 5 years of work experience, there was a large variability in the mean number of correct answers — 6,2±4,0. Physicians with 6-10 years and 11-20 years of experience in their specialty were more likely to choose the correct answers than doctors with more than 20 years of experience. Professionals who considered themselves "fully informed" on clinical guidelines gave fewer correct answers than doctors who had less high self-rating (p&lt;0,001). The proportion of correct answers in the subgroup of doctors who consider guidelines to be mandatory was greater than in the subgroups of doctors who hold a different opinion (p&lt;0,05). The best results were shown by physicians who indicated direct text-oriented way as preferred for studying guidelines (p&lt;0,001).Conclusion. The awareness level of clinical guidelines on the treatment of HF by cardiologists should be considered insufficient, and by therapists — extremely low. Doctors are not sufficiently informed about the need to comply with clinical guidelines. When planning training, the specialty and work experience of the doctor should be taken into account. Unjustifiably high self-rating of knowledge interferes with professional development. The best way of self-education should be considered direct study of the text of clinical guidelines.

Exploring Capabilities of Large Language Models such as ChatGPT in Radiation Oncology

PurposeTechnological progress of machine learning and natural language processing has led to the development of large language models (LLMs), capable of producing well-formed text responses and providing natural language access to knowledge. Modern conversational LLMs such as ChatGPT have shown remarkable capabilities across a variety of fields, including medicine. These models may assess even highly specialized medical knowledge within specific disciplines, such as radiation therapy. We conducted an exploratory study to examine the capabilities of ChatGPT to answer questions in radiation therapy. Methods and MaterialsA set of multiple-choice questions about clinical, physics, and biology general knowledge in radiation oncology as well as a set of open-ended questions were created. These were given as prompts to the LLM ChatGPT, and the answers were collected and analyzed. For the multiple-choice questions, it was checked how many of the answers could be clearly assigned to one of the answers, and the proportion of correct answers was determined. For the open-ended questions, independent blinded radiation oncologists evaluated the quality of the answers regarding correctness and usefulness on a 5-point Likert scale. Furthermore, the evaluators were asked to provide suggestions for improving the quality of the answers. ResultsFor 70 multiple-choice questions, ChatGPT gave valid answers in 66 cases (94.3%). In 60.61% of the valid answers, the selected answer was correct (50.0% of clinical questions, 78.6% of physics questions, and 58.3% of biology questions). For 25 open-ended questions, 12 answers of ChatGPT were considered as “acceptable,” “good,” or “very good” regarding both correctness and helpfulness by all 6 participating radiation oncologists. Overall, the answers were considered “very good” in 29.3% and 28%, “good” in 28% and 29.3%, “acceptable” in 19.3% and 19.3%, “bad” in 9.3% and 9.3%, and “very bad” in 14% and 14% regarding correctness/helpfulness. ConclusionsModern conversational LLMs such as ChatGPT can provide satisfying answers to many relevant questions in radiation therapy. As they still fall short of consistently providing correct information, it is problematic to use them for obtaining medical information. As LLMs will further improve in the future, they are expected to have an increasing impact not only on general society, but also on clinical practice, including radiation oncology.

Large language models encode medical oncology knowledge: Performance on the ASCO and ESMO examination questions.

511 Background: Chatbots based on large language models (LLM) recently developed an unprecedented ability to answer questions across a broad range of applications. Whether LLMs encode sufficient knowledge to answer questions about medical oncology, a highly specialized domain requiring rapid integration of new evidence, is unknown. Methods: We presented ChatGPT (GPT-3.5 and GPT-4) with the American Society of Oncology (ASCO) Self Assessment Program and the European Society of Medical Oncology (ESMO) Examination Trial questions, excluding those that included images or required knowledge unavailable before the algorithm’s training cutoff date. The proportion of correct answers was compared against random chance. ChatGPT was prompted again for a different answer if the previous was incorrect. The reasoning provided by ChatGPT was qualitatively evaluated by two medical oncologists. Results: ChatGPT (GPT-4) correctly answered 84.4% (38/45, 95% confidence interval [CI] 70.5-93.5%, P&lt;0.0001 versus random answering) of ASCO and 86.7% (65/75, 95% CI 76.8-93.4%, P&lt;0.0001) of the ESMO examination questions. GPT-4 outperformed GPT-3.5 (57.8% [26/45, 95% CI 42.2%-72.3%, P=0.001] for ASCO and 65.3% [49/75, 95% CI 53.5%-76.0%, P=0.004] for ESMO). Including second attempts, GPT-4 correctly answered 93.3% (42/45, 95% CI 81.7-98.6%) of ASCO and 93.3% (70/75, 95% CI 85.1-97.8%) of the ESMO examination questions. Incorrect responses for ASCO questions were more common in questions whose answers referenced papers published after 2018 (22.2% [4/18] versus 11.1%, [3/27], P=0.03). Oncologists rated the reasoning behind correct answers by GPT-3.5 as complete for 93.3% of questions (70/75, CI 85.1-97.8%). Conclusions: LLMs can answer examination questions designed for medical oncology fellows with impressive and improving accuracy, alongside correct reasoning. These results imply broad potential applications of LLMs during cancer care to improve the patient and provider experience.

The first quick olfactory test specific for Alzheimer's disease and French culture.

Olfactory identification disorder is considered a promising early biomarker of Alzheimer's disease (AD). The QUICK TODA2 can be used as a short olfactory screening tool specific for French AD patients. The selection of AD specific odorants and the design of this screening were the main objectives of this twofold study. In study 1, the TODA2 olfactory test was administered to 43 mild-AD patients and 45 healthy controls (HC) in five memory centres in France. The selection of AD specific odorants was based on the differences in the proportion of correct answers and in the threshold means between AD and HC groups. In study 2, another set of 19 mild-AD patient were included at the memory centre of Nice Hospital. All participants completed the olfactory assessment pipeline including the QUICK TODA2, TODA2 and Sniffin' Sticks Identification sub-Test (SST-i). The individual scores of the three tests were correlated. In study 1, ten TODA2 odorants could significantly differentiate AD participants from controls. We selected the six most AD-sensitive items to design the QUICK TODA2. In study 2, we reported strong significant correlations between QUICK TODA2 and TODA2 (ρ(17) = 0.68, p = 0.001**), SST-i and QUICK TODA2 (ρ(17) = 0.65, p = 0.002**), SST-i and TODA2 (ρ(17) = 0.57, p = 0.01*). QUICK TODA2 is a 5-min non-invasive olfactory AD screening tool dedicated to French culture. Its results converge with those of longer, validated olfactory tests. It could be used as a quick screening tool in the general daily practice before an extensive assessment in memory centres.

Usability of Certain Symbols Indicating Automobile Safety Status Based on Youth Assessment

The research presented in this paper refers to the possibility to understand the information presented by symbols, which indicate safety status and possible troubles regarding automobiles and driving. The testing included sixteen symbols, six of which were ISO-verified and recommended symbols. The study included 204 youth respondents. The study used a multidisciplinary, ergonomic approach, based on research of the usability of symbols. The basic task of subjects was to recognize the symbols and to rate their confidence on the five-point scale that they gave exact answers. For each symbol, hypotheses about the proportion of correct answers at the population level were tested, applying the inferential statistics technique. The ISO criterion of 67% successful symbol recognition was adopted as the limit value for the justification of the use of symbols. The test results showed that eight out of sixteen symbols did not meet this criterion. The results of this research indicate that it is necessary to take certain measures in order to improve the understanding of the function of symbols on vehicle dashboards. One of the proposed measures consists in the improvement of training courses in driving schools, which from a theoretical but also a practical aspect should include education about symbols on car dashboards, primarily those responsible for informing about the safety status. In addition, a redesign of the symbols that had the lowest recognition rate can be recommended.

Vaccines - beliefs and concerns: the voice of patients with inflammatory immunomediated diseases.

Vaccination is a key issue in patients with immunomodulated inflammatory diseases on immune-mediated therapy. Still, vaccination rates in these patients are low. This study aimed to assess the knowledge and fears of patients with immune-mediated inflammatory diseases (IMIDs) regarding vaccines, with the ultimate goal of increasing vaccination rates through the definition and implementation of more effective communication strategies with the patient. This study was conducted in a Portuguese hospital, between January 2019-December 2020, and included adult patients with an IMID. A questionnaire was developed and applied to evaluate knowledge and fears regarding vaccines. From the 275 included patients, more than 90% answered correctly to all questions on general knowledge, with an exception for the question related to protection from severe disease, without differences between age groups or education levels, except for the question about vaccine contraindications (P = 0.017). Regarding vaccines in immunocompromised hosts, the proportion of correct answers was lower and significantly different between education levels (P = 0.00-0.042),. More than 50% of the participants showed moderate to very high concern about several aspects of vaccines, with differences between age groups (P = 0.018). Our patients have general knowledge of vaccines but regarding vaccines in immunocompromised patients knowledge is lower and dependent on the education level. In addition, age influences the pattern of concerns related to vaccines. The information gathered in this study shall be considered to identify potential local interventions targeted to improve vaccination.

Question Format Matters: Do Athletes Really Know the Signs and Symptoms of a Sport-Related Concussion?

Authors of previous studies commonly used a multiselect checklist method to assess an athlete's ability to recognize true sport-related concussion (SRC) signs and symptoms (S&S) among incorrect distractor options. However, this may overinflate the evaluation of participants' knowledge because the multiselect method does not test athletes' ability to retrieve knowledge from their long-term memory. To examine this hypothesis, we sent an online survey to registered members of the Japan Lacrosse Association (n = 8530) to assess differences in reported SRC S&S by open-ended-question and multiselect formats. We also evaluated whether previous exposure to SRC education and a history of SRC influenced athletes' SRC S&S knowledge. The numbers and proportions of responses were calculated using descriptive statistics. The Pearson correlation was calculated to analyze the relationship between scores from the 2 question formats. Unpaired-samples t tests were conducted to compare the mean scores for each question format by previous SRC education and history of diagnosed SRC. Odds ratios were computed to express the relationship between the proportion of correct answers by question format per symptom. The response rate of the survey was 35.9% (n = 3065), and scores from the 2 question formats were correlated (r = 0.34, 95% CI = 0.31, 0.37; P < .001). For both question formats, athletes with previous exposure to SRC education and a history of SRC had a greater number of correct answers; however, the mean differences were trivial. Researchers and clinicians should acknowledge the difference between multiselect (recognition) and open-ended (free recall) formats when assessing one's understanding of SRC and managing athletes with a suspected SRC.

Conocimientos adquiridos mediante una intervención educativa grupal en pacientes con tratamiento anticoagulante oral

Objective: to analyse the increase in knowledge and level of satisfaction achieved through an educational intervention for persons on anticoagulant therapy (OAT) followed up at Primary Care.Method: a before-and-after study without control arm. The population was formed by patients on OAT followed up at the Gran Canaria Health Area (40 primary care centres (PCCs); N=11,808). The sample was calculated at 250 persons. A theoretical education session (40 minutes), and a practical session (60 minutes) were led by a nurse with groups from eight to sixteen persons. The following variables were measured at baseline: sociodemographic, clinical, treatment-related, knowledge on anticoagulation measured with the OAK questionnaire (minimum score: 0, maximum score: 20 points), and satisfaction with the session. Knowledge was re-evaluated at four months. Descriptive and bivariate statistics was conducted. Results: the study included 145 persons from 23 PCCs (x= 66.9 years; 55.2% male). There was an increase in the proportion of correct answers and a reduction in blank answers for all questions; the change in 16 of them was statistically significant (p< 0.05). There was a statistically significant increase in the mean score for the OAK questionnaire [pre-test (= 9.6); post-test (=13.8); p= 0.000)]. In total, 845 of the subjects had improved their knowledge after their participation in the session; 80% or more found that different aspects of the session were very adequate, and 91% would recommend it to other patients. Conclusion: there was a higher level of knowledge regarding anticoagulation four months after participating in the group educational session led by a nurse.

Performance of ChatGPT-4 in answering questions from the Brazilian National Examination for Medical Degree Revalidation.

The aim of this study was to evaluate the performance of ChatGPT-4.0 in answering the 2022 Brazilian National Examination for Medical Degree Revalidation (Revalida) and as a tool to provide feedback on the quality of the examination. A total of two independent physicians entered all examination questions into ChatGPT-4.0. After comparing the outputs with the test solutions, they classified the large language model answers as adequate, inadequate, or indeterminate. In cases of disagreement, they adjudicated and achieved a consensus decision on the ChatGPT accuracy. The performance across medical themes and nullified questions was compared using chi-square statistical analysis. In the Revalida examination, ChatGPT-4.0 answered 71 (87.7%) questions correctly and 10 (12.3%) incorrectly. There was no statistically significant difference in the proportions of correct answers among different medical themes (p=0.4886). The artificial intelligence model had a lower accuracy of 71.4% in nullified questions, with no statistical difference (p=0.241) between non-nullified and nullified groups. ChatGPT-4.0 showed satisfactory performance for the 2022 Brazilian National Examination for Medical Degree Revalidation. The large language model exhibited worse performance on subjective questions and public healthcare themes. The results of this study suggested that the overall quality of the Revalida examination questions is satisfactory and corroborates the nullified questions.

Better antimicrobial resistance data analysis and reporting in less time.

Insights about local antimicrobial resistance (AMR) levels and epidemiology are essential to guide decision-making processes in antimicrobial use. However, dedicated tools for reliable and reproducible AMR data analysis and reporting are often lacking. We aimed to compare traditional data analysis and reporting versus a new approach for reliable and reproducible AMR data analysis in a clinical setting. Ten professionals who routinely work with AMR data were provided with blood culture test results including antimicrobial susceptibility results. Participants were asked to perform a detailed AMR data analysis in a two-round process: first using their software of choice and next using our newly developed software tool. Accuracy of the results and time spent were compared between both rounds. Finally, participants rated the usability using the System Usability Scale (SUS). The mean time spent on creating the AMR report reduced from 93.7 to 22.4 min (P < 0.001). Average task completion per round changed from 56% to 96% (P < 0.05). The proportion of correct answers in the available results increased from 37.9% in the first to 97.9% in the second round (P < 0.001). Usability of the new tools was rated with a median of 83.8 (out of 100) on the SUS. This study demonstrated the significant improvement in efficiency and accuracy in standard AMR data analysis and reporting workflows through open-source software. Integrating these tools in clinical settings can democratize the access to fast and reliable insights about local microbial epidemiology and associated AMR levels. Thereby, our approach can support evidence-based decision-making processes in the use of antimicrobials.

Bridging Knowledge Gaps in Anaphylaxis Management Through a Video-Based Educational Tool.

Introduction: We aimed to develop and test the effectiveness of an education tool to help pediatric patients and their families better understand anaphylaxis and its management, and to improve current knowledge and treatment guidelines adherence. Methods: From June 2019 to May 2022, 128 pediatric patients with history of food-triggered anaphylaxis who presented to the allergy outpatient clinics at the study institution were recruited. Consenting families were asked to complete 6 questions related to the triggers, recognition, and management of anaphylaxis at the time of presentation to the clinic. Participants were shown a 5-min animated video on the causes, presentation, and management of anaphylaxis. At the end of the video, the participants were redirected to the same 6 questions to respond again. The scores were recorded in proportion of correct answers (minimum 0.0; maximum 1.0). Results: The mean age of the patients was 5.8 ± 4.5 years (range: 0.5-18.8 years). The majority were males (70 patients; 54.7%). The mean baseline prevideo education questionnaire score was 0.76 ± 0.2 (range: 0.3-1.0), whereas the mean follow-up score was 0.82 ± 0.2 (range: 0.3-1.0). This score difference of 0.06 was statistically significant (P < 0.001). There were no significant associations between change in scores and age or gender of the participants. Conclusion: Our video teaching method was successful in educating patients and their families to better understand anaphylaxis and its management at the moment of the clinical encounter. Retention of knowledge at long-term follow-up should be assessed.

Bridging knowledge gaps in paediatric chronic urticaria through a video-based educational tool.

There is a lack of patient educational resources about chronic urticaria (CU). To develop and test the effectiveness of an education tool to help paediatric patients and their families better understand CU and its management. From July 2020 to May 2022, paediatric patients with a history of CU who presented to the allergy outpatient clinics at our institution were recruited. Consenting families and patients were asked to complete five questions related to the definition, causes and management of CU at the time of presentation to the clinic. Participants were shown a 5-min animated video addressing the main knowledge gaps about CU. At the end of the video, participants were redirected to the same five questions to respond again. The scores were recorded as a proportion of correct answers (range 0·0-1·0). In total, 53 patients [30 girls (56·6%), 23 boys (43·4%); mean age 9·7 ± 5·1 years, range 1·4-18·5 years] were recruited. The mean baseline pre-video education questionnaire score was 0·67 ± 0·2 (range 0·2-1·0), while the mean post-video score was 0·94 ± 0·1 (range 0·4-1·0), a mean score difference of 0·27, which was statistically significant (P < 0·001). At the 1-year follow-up, 14 (26·4%) patients answered the questionnaire again to assess retention of knowledge; the mean score was 0·83 ± 0·2 (range 0·2-1·0). Our educational video was successful in educating patients and their families to better understand urticaria. Future studies should aim to optimize patient education through nontraditional tools such as videos, and compare knowledge gain using different methods of education.

Assessment of Knowledge and Attitude of Dental Students towards HIV and Its Oral Manifestations in Saudi Arabia-A Cross-Sectional Study.

Background: It is essential for practicing dentists to have adequate knowledge of HIV/AIDS and its implications in the dental practice. Their attitudes should also be up to the professional expectations. This study aimed to assess knowledge of HIV/AIDS infection and attitudes towards its patients among dental students in Saudi Arabia. Methods: A questionnaire was prepared and distributed among a sample of dental students in Saudi Arabia. Twenty questions related to knowledge, attitudes, and oral manifestation of HIV were presented. Results: A total of 405 questionnaires were completed (67% response rate). Participants showed low knowledge of safety regarding HIV (39.5%) and 44.2% indicated that they would take an HIV test after needle stick injury. The proportion of correct answers regarding transmission of HIV through saliva, cardiopulmonary resuscitation, and aerosols by hand pieces was 41%, 37.5%, and 26.4%, respectively. Almost 50% of the surveyed dental students expressed unwillingness to treat HIV-positive patients. Poor knowledge was noted regarding oral manifestations of HIV (32.7%). Of the participants, 57.8% indicated that infection control procedures are very important for the treatment of HIV patients and 50.6% believed that a dentist can make a decision to reject the treatment of HIV patients. According to the participating dental students, the three major oral manifestations in HIV patients are hairy leukoplakia (47.4%), oral candidiasis (44.7%), and Kaposi’s sarcoma (43.5%). Conclusion: Inadequate knowledge and unprofessional attitude towards HIV/AIDS patients were identified among this group of dental students in Saudi Arabia. Dental educators and health care planners in Saudi Arabia should plan to promote the knowledge and attitudes of dental students in Saudi Arabia towards the treatment of HIV patients.

How much do Romanian medical students know about research ethics? A survey

Background: Although scientific research in Romania has continued to expand over the past 20 years, it is unclear how prepared the country&amp;rsquo;s students are to be involved in research and to publish the results of their work. Objectives: To assess Romanian medical students&amp;rsquo; level of knowledge about research integrity and research ethics. Methods: A cross-sectional survey of 187 medical students (of which 70% were women) from Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, was performed between September 2017 and June 2018. The survey consisted of self-evaluation with respect to three aspects, namely knowledge of research in general, that of research integrity, and that of publication integrity. The self-evaluation was followed by a set of 17 questions that tested the respondent&amp;rsquo;s knowledge. Results: On average, the proportion of correct answers was 34% (range, 12%&amp;ndash;65%). Whereas those who had assigned low grades to themselves (a score below 5) fared poorly (fewer correct answers) in the test that followed, those who rated themselves highly (a score of 5 or higher) did not fare as well as they were expected to. The majority of respondents (83%) were willing to learn more about research integrity through courses, workshops, training programmes, etc. Conclusion: The respondents showed a low level of knowledge related to both research integrity and current standards of reporting scientific research. This lacuna demonstrates the need to train students at the beginning of their academic life because more and more of them, both undergraduate and postgraduate, are likely to be involved in scientific research.

Comparative analysis of binary classifiers on an array of scientific publications

Binary classifiers are studies on balanced text samples. The samplings are formed from scientific publications in the field of Computer Science (Computer Science). The first class contains articles on «Text Data Mining» (the «TDM» class), the second one contains works on other topics of Computer Science (the «non-TDM» class). All the main stages of preliminary processing of text documents are considered, models of their presentation are analyzed. The problem of binary classification is formulated and the quality indicators used in the study are given. A method of sampling from the Russian digital library (Elibrary) is proposed. The generated sampling consists of bibliographic descriptions of documents (title, abstract and keywords). An exploratory analysis was carried out and the sampling structure was studied. «Term clouds» for two classes are constructed and analyzed, documents are visualized using the method of stochastic embedding of neighbors with t-distribution (t-SNE). Based on the review and analysis of known classifiers, the following methods were selected for the study: the K-nearest neighbor method, random forest, gradient boosting, logistic regression, and the support vector method. Profile methods based on the construction of a vector (profile) of the most informative terms determined by the frequency of occurrence of terms and classes are also used in the study. The parameters of the methods were configured using a five-fold cross-validation. The best quality of classification in our sampling demonstrated the methods using the ensemble (collective) decision-making principle (random forest, gradient boosting), as well as the support vector method. The best classifier, gradient boosting, had the proportion of correct answers (accuracy) about 0.98, recall and precision about 0.99. The other (simpler) methods used in the study also generally showed rather good quality of classification (for the least accurate k-nearest neighbor method accuracy, recall and precision were 0.90, 0.81, and 0.91, respectively).

Poor disease knowledge is associated with higher healthcare service use and costs among patients with cirrhosis: an exploratory study

BackgroundOptimal management of cirrhosis is complex, and patients often lack knowledge and skills, which can affect self-management. We assessed patient knowledge about cirrhosis and examined whether knowledge was associated with clinical outcomes, healthcare service use, and healthcare costs. A cross-sectional ‘knowledge survey’ was conducted during 2018–2020. We assessed patient knowledge about cirrhosis and explore whether knowledge was associated with clinical outcomes, healthcare service use, and costs.MethodsPatients with cirrhosis (n = 123) completed a ‘knowledge survey’. We calculated the proportion of correct answers to eight questions deemed to be “key knowledge” about cirrhosis by an expert panel, and dichotomized patients as ‘good knowledge’/‘poor knowledge’. Clinical data, healthcare costs, and health-related quality of life (SF-36) were available.Results58.5% of patients had ‘good knowledge’ about cirrhosis. Higher education level was associated with higher odds of having ‘good knowledge’ about cirrhosis (adjusted-OR = 5.55, 95%CI 2.40–12.84). Compared to patients with ‘poor knowledge’, those with ‘good knowledge’ had a higher health status in the SF-36 physical functioning domain (p = 0.011), fewer cirrhosis-related admissions (adjusted incidence rate ratio [IRR] = 0.59, 95%CI 0.35–0.99) and emergency presentations (adj-IRR = 0.34, 95%CI 0.16–0.72), and more planned 1-day cirrhosis admissions (adj-IRR = 3.96, 95%CI 1.46–10.74). The total cost of cirrhosis admissions was lower for patients with ‘good knowledge’ (adj-IRR = 0.30, 95%CI 0.29–0.30).ConclusionPoor disease knowledge is associated with increased use and total cost of healthcare services. Targeted educational interventions to improve patient knowledge may be an effective strategy to promote a more cost-effective use of healthcare services.

Scientific literacy and preferred resources used by Latin American medical students during the COVID-19 pandemic: A multinational survey

Background: This study aims to identify the preferred sources for acquiring knowledge about COVID-19 and to evaluate basic knowledge on critical scientific literature appraisal in students from medical schools located in Spanish speaking countries in Latin America. Methods: We designed an online survey of 15 closed-ended questions related to demographics, preferred resources for COVID-19 training, and items to assess critical appraisal skills. A snowball method was used for sampling. We conducted a descriptive analysis and Chi-squared tests to compare the proportion of correct identification of the concept of a preprint and a predatory journal when considering a) self-perceived level of knowledge, b) public vs private school, c) inclusion of a scientific literature appraisal subject in the curriculum, and d) progress in medical school. Results: Our sample included 770 valid responses, out of which most of the participants included were from Mexico (n=283, 36.8%) and Ecuador (n=229, 29.7%). Participants preferred using evidence-based clinical resources (EBCRs) to learn more about COVID-19 (n=182, 23.6%). The preferred study design was case report/series (n=218, 28.1%). We found that only 265 participants correctly identified the concept of a preprint (34.4%), while 243 students (31.6%) correctly identified the characteristics of a predatory journal. We found no significant differences in the proportion of correct answers regardless of the self-perceived level of knowledge, progress in medical school, or scientific literature critical appraisal classes. Conclusion: This study is novel in its approach of identifying sources of knowledge used by Latin American medical students and provides insights into the need to reinforce training in critical appraisal of scientific literature during medical school.

Knowledge of conversion disorder by primary care physician

IntroductionPrimary care physicians tend to examine patients with conversion disorder (CD) first. A good knowledge of this disorder will allow an early diagnosis and avoid unnecessary investigations for the patient.ObjectivesTo assess the knowledge of primary care physicians about patients with CD.MethodsWe conducted a cross-sectional and descriptive study among 90 primary care physicians in Sfax (Tunisia). We used an anonymous self-questionnaire for data collection.ResultsThe response rate to our questionnaire was 60%. The participants’ age ranged from 25 to 70 years, with a median of 41 years. The sex ratio (M/F) was 0.92. The majority of physicians (75.9%) have practiced in the public sector. Among the respondents, 75.9% had theoretical training in CD, 14.8% had continuing medical education (CME), and 42.6% had hospital experience in a psychiatric department. The overall proportion of correct answers was 71.8%. The most recognised symptoms of CD were: dysphonia-aphonia, paresthesia or paresis. All doctors mentioned at least one criterion to distinguish CD from epileptic seizures and loss of consciousness.ConclusionsThere are some gaps in primary care physicians’ knowledge of CD. Thus, we propose to reconsider the conduct of CME, to favour small group training workshops with role-playing and to improve the collaboration between the psychiatrist and the primary care physician.DisclosureNo significant relationships.

Efficacy of an educational comic book for HPV vaccination information in Nigeria.

e18577 Background: In Nigeria, cervical cancer is the second most common cancer in part due to disparities in education, access to screening, and access to treatment. In Nigeria, the HPV vaccine is planned for introduction into the public sector but will not be mandated. Given the preventable nature of the disease and need for public awareness, we developed an easy-to-understand teaching tool, the Global Oncology (GO) Comic Book focused on both general cancer education and about cervical cancer and HPV vaccination. Methods: The GO Comic Book is set in modern-day Lagos, Nigeria and aims to dispel myths and misconceptions associated with cancer in general and cervical cancer in particular. After developing the comic book, we developed a teaching guide and a plan for a pilot distribution of the comic book to students in Nigeria. In late 2019, GO and programmatic partners including the Clinton Health Access Initiative (CHAI), Cancer Education and Advocacy Foundation of Nigeria (CEAFON) and Panaramic Comics (based in Lagos, Nigeria) successfully conducted a pilot distribution of the GO Comic Book to nearly 5,000 students representing 18 junior secondary schools in Lagos and Rivers states. The comic books were distributed as part of 12 school assemblies which featured interactive, live-readings of the comic book by students and Nigerian physician volunteers. Pre-/post-tests with 9 questions were administered to a subset of the students (N = 202) to assess change in knowledge before and after the educational assemblies and data was analyzed using descriptive statistics. Results: The response rate of the 202 administered surveys was 98% (N = 198) with 193 female (97.5%) and 5 male (2.5%) respondents. Participants were an average of 11.2 years of age. All multiple-choice-type assessment items showed shifts to better-informed responses following the educational intervention. The item with the highest positive-percent change as assessed in the post survey queried: “what types of virus can cause cervical cancer?” (pre-test = 25.2%, post-test = 68.2%). The table below shows the cervical cancer related questions that were asked and the proportion of correct answers. Conclusions: The GO comic book in conjunction with school assemblies, improved the knowledge regarding cervical cancer causes and risk factors in Nigerian school children. Findings highlight the lack of knowledge regarding cervical cancer among the young population eligible for HPV vaccination, and describe an effective educational strategy in this setting.[Table: see text]