RyanC

@whammert @BgTalkinman Shows we are often working off quick impressions and no surprises - we are imperfect #jhsjc

@BgTalkinman Seems like the surgeons could ask a few key questions and then predictions would be closer #jhsjc

@DafangZhang @BgTalkinman Smart feature #jhsjc

@BgTalkinman Absolutely! For example if you ask "tell me about brachial plexus injuries" and answer is jargony, you can ask "explain that at a 6th grade reading level." #jhsjc

I will give an answer to my own question! I would say that this is a major upgrade over pts searching Google for information like we know they do up until now. Do others agree? #jhsjc

@BgTalkinman Fascinating for sure #jhsjc

My guess is that this use of #AI is going to become quickly ingrained into our day-to-day as pts use it more and more. I think it's promising. #jhsjc

@BgTalkinman Important to know for now that references aren’t reliable but that will likely change #jhsjc

AI lost points on the DISCERN scale were related to “the lack of attribution, reliability and currency of the source material”. Given that the data on which the AI responses are generated is continually upgraded is really that a relevant deficiency? #jhsjc

@BgTalkinman I agree. The advice was pretty reasonable and I like the recs to ask a surgeon. #jhsjc

@BgTalkinman Good to see that the scores used supported the quality of ASSH materials for patients #jhsjc

The evaluations used the DISCERN score, a validated measure of the quality of pt education materials, and the JAMA Benchmark criteria, a simple screening tool to assess websites for transparency and reliability, including authorship, attribution, disclosure, and currency #jhsjc

@BgTalkinman Certainly AI is a hot topic and likely to work its way into medicine many ways #jhsjc

This is another article on this topic that looked at how #ChatGPT performed in answering questions about common hand sx topics. #jhsjc

@BgTalkinman I think gets back to variation in deductibles and out of pocket max’s on plans #jhsjc

@RPCalfeeSTL Why are insured pts at such high risk for #CHE? #jhsjc

The study was done at a level I trauma center in the Midwest of the United States. The sample was almost 90% White and 70% of individuals had employer-sponsored insurance. Are the findings generalizable to the US population? #jhsjc

@BgTalkinman I haven’t encountered patients quoting this yet. #jhsjc

Are hand surgeons encountering patients who report information they’ve learned from consulting #LLMs? If so, is that information accurate and helpful or inaccurate and an impediment to counseling about CTS? #jhsjc

@BgTalkinman That may be quite true about bias

I say that LLMs will be better because they will not only have access to the information, but will be less prone to bias #jhsjc

@BgTalkinman Interesting as this seems to provide decent information - better than many sites - but at least currently evidence or references cited not correct #jhsjc

Given the ever-increasing volume of medical literature and the inability if humans to synthesize it, can LLMs like ChatGPT provide more evidence-based information to both patients than clinicians? #jhsjc

#jhsjc certainly this technology is evolving quickly and a hot topic

@DafangZhang @BgTalkinman @robgraymd I agree when patients can’t do longer post op restrictions but I am at mentioning stage as opposed to lots of experience with it #jhsjc

@BgTalkinman @robgraymd #jhsjc I find denervation sometimes creeps into my counseling precisely due to shorter time off work. Some patients can't commit to length of recovery from CMC arthroplasty.

In other words, patient choice notwithstanding, is there value in the intervention if a substantial proportion eventually require two procedures, or is a better strategy to offer the bigger, but more definitive procedure. #jhsjc

@BgTalkinman No idea about pain in long term. Would love to know from those experienced in cmc denervation #jhsjc

At the end of the follow-up period, most of the outcomes were similar in the two groups. Pain was slightly higher in the denervation group. Should that be expected to be a static situation or is it likely that pain would be greater with longer follow-up? #jhsjc

I certainly see this article as a conversation starter #jhsjc

@BgTalkinman @DafangZhang Good point about range of surgeons doing these in practice #jhsjc

@DafangZhang @RPCalfeeSTL #jhsjc I'm going to say that I think the complication rate has been underestimated in most other studies, especially when considering that many of these cases might not be done by hand surgeons.

How does limiting the study to only those investigation that were randomized trials affect that, if at all? #jhsjc

@BgTalkinman Agree with this being more accurate than each of our own impressions

So, I conclude that this estimate of a much higher complication rate following #VLP than previously reported should be thought of an accurate #jhsjc

@BgTalkinman #jhsjc. Methods strong to just use RCT’s but based on each trial inclusion criteria may not apply to all distal radius fractures in clinic

#jhsjc estimates for incidence of complications depend on definition of complications but seemingly well done in this