Tag: study

Managing “socially admitted” patients in hospital: a qualitative study of health care providers’ perceptions

Abstract

Background: Emergency departments are a last resort for some socially vulnerable patients without an acute medical illness (colloquially known as “socially admitted” patients), resulting in their occupation of hospital beds typically designated for patients requiring acute medical care. In this study, we aimed to explore the perceptions of health care providers regarding patients admitted as “social admissions.”

Methods: This qualitative study was informed by grounded theory and involved semistructured interviews at a Nova Scotia tertiary care centre. From October 2022 to July 2023, we interviewed eligible participants, including any health care clinician or administrator who worked directly with “socially admitted” patients. Virtual or in-person individual interviews were audio-recorded and transcribed, then independently and iteratively coded. We mapped themes on the 5 domains of the Quintuple Aim conceptual framework.

Results: We interviewed 20 nurses, physicians, administrators, and social workers. Most identified as female (n = 11) and White (n = 13), and were in their mid to late career (n = 13). We categorized 9 themes into 5 domains: patient experience (patient description, provision of care); care team well-being (moral distress, hierarchy of care); health equity (stigma and missed opportunities, prejudices); cost of care (wait-lists and scarcity of alternatives); and population health (factors leading to vulnerability, system changes). Participants described experiences caring for “socially admitted” patients, perceptions and assumptions underlying “social” presentations, system barriers to care delivery, and suggestions of potential solutions.

Interpretation: Health care providers viewed “socially admitted” patients as needing enhanced care but identified individual, institutional, and system challenges that impeded its realization. Examining perceptions of the people who care for “socially admitted” patients offers insights to guide clinicians and policy-makers in caring for socially vulnerable patients.

Emergency departments have become a destination of last resort for some patients who are made vulnerable by social

Only Two Percent of TikTok’s Health Advice Is Accurate, Study Shows

SO Fiberglass in Mattress TikTok

Between a hilarious video of a smiling horse, or a makeup tutorial, you’ve likely encountered medical advice on “Dr. TikTok,” the newest doctor on your medical team who seems to know just about everything. But, like many things on the internet, you might not want to be so trusting. 

A recent study conducted by MyFitnessPal, a fitness app, and Dublin City University in Ireland, found that 2.1 percent of health and nutrition information on TikTok was accurate when compared to health and nutrition guidelines. (1) Using AI, the study looked at over 67,000 health and nutrition videos on the app.

Additionally, in October 2023, MyFitnessPal surveyed 2,000 Millennials and Gen Zs throughout the U.S., Canada, Australia, and the UK and found that 87 percent of them have turned to TikTok for health or nutrition advice and 67 percent use one of the health trends a few times a week.

This new research paints an even bleaker picture about the spread of misinformation than previous surveys. A previous study conducted by NewsGuard found that 1 in 5 videos, when searched by a specific topic, contained misinformation. (2) Another poll recently showed people consult AI and social media before medical providers. 

My Fitness Pal went on to speak to a few major medical trends circulating on TikTok, from “Oatzempic” to taking apple cider vinegar as a weight loss hack. They also looked into the claim that “swamp soup” can act as a flu vaccine.

In response to their results, MyFitnessPal and Dublin City University have partnered to put together a checklist to help users identify verifiable health information on social media. Here’s what they recommend:

  • Verify credentials — it shouldn’t be a secret whether a doctor is really a doctor or not, and it isn’t. A simple search

First Nations patients more often leave ER without care: study


First Nations patients are more likely to leave Alberta emergency departments before receiving care than other patients — and anti-Indigenous racism is a significant reason why, a new study says.


“The stories are incredibly powerful,” said Patrick McLane, the lead author of the study published Monday in the Canadian Medical Association Journal.


“First Nations people have said (that) sometimes it’s really obvious when there’s racism, but sometimes it’s not and it’s always present as a possibility,” McLane, an adjunct associate professor of emergency medicine with the University of Alberta, said in an interview.


Although the study was conducted in Alberta, the findings likely apply to emergency department visits across Canada, he said.


The researchers had previously analyzed data from more than 11.6 million emergency department visits in Alberta between April 2012 and March 2017. More than one million of those visits were made by First Nations patients.


The analysis found 6.8 per cent of First Nations patients left emergency departments either before being seen or against medical advice. That’s compared to just 3.7 per cent of non-First Nations patients.


In the current study, the researchers wanted to see if there were any other factors that could explain the discrepancy, so they went back to the data and controlled for several variables including patient demographics, reasons for coming to the emergency department and geography.


At the end of that analysis, First Nations status was the only apparent explanation for the difference in rates of leaving before receiving care, the study found.


“Leaving without completing care matters because it delays needed care and interrupts the care journey,” said Bonnie Healy, co-author of the study and former executive director of the Alberta First Nations Information Governance Centre, which was a partner in conducting the

Racism, discrimination may lead to First Nations patients leaving emergency rooms: Alberta study

Systemic racism and inequity in health care may be contributing to why First Nations patients in Alberta disproportionately leave emergency departments without being seen, or against medical advice, according to a new study published in the Canadian Medical Association Journal.

The peer-reviewed paper builds on a previous one that found nearly seven per cent of First Nations patients’ visits to emergency departments ended in them leaving without care, compared to nearly four per cent of visits by non-First Nations patients.

The team examined provincial administrative data for more than 11 million emergency department visits in Alberta from 2012 to 2017, controlling for patients’ ages, geography, visit reasons and facility types.

“First Nations people, when we control for all of these other factors, have higher odds of leaving without completing care,” said Patrick McLane, an adjunct associate professor in the University  of Alberta’s department of emergency medicine. He co-authored the study.

The researchers also asked 64 health directors, emergency-care providers and First Nations patients to comment on their quantitative findings through sharing circles, a focus group and telephone interviews from 2019 to 2022.

A man in a white shirt sits in an office.
Patrick McLane, an adjunct associate professor at the University of Alberta, has been studying the quality of emergency care for First Nations patients. (Peter Evans/CBC)

McLane co-led the study with Lea Bill, the executive director of the Alberta First Nations Information Governance Centre. Elders and First Nations partner organizations helped shape the study and interpret its results.

Racism and stereotypes

Study participants, while commenting on the quantitative findings, raised a number of reasons why First Nations patients leave emergency departments without receiving care.

They shared stories of providers discriminating against First Nations patients and relying on stereotypes about them.

One participant, who was quoted in the study, reported walking out of one health care facility and visiting another 

Study reveals the impact of prompt design on ChatGPT’s health advice accuracy

In a groundbreaking study, researchers from the Commonwealth Scientific and Industrial Research Organisation (CSIRO) and The University of Queensland have unveiled the critical impact of prompt variations on the accuracy of health information provided by Chat Generative Pre-trained Transformer (ChatGPT), a state-of-the-art generative large language model (LLM). This research marks a significant advancement in our understanding of how artificial intelligence (AI) technologies process health-related queries, emphasizing the importance of prompt design in ensuring the reliability of the information disseminated to the public.

Study: Dr ChatGPT tell me what I want to hear: How different prompts impact health answer correctness

Study: Dr ChatGPT tell me what I want to hear: How different prompts impact health answer correctness

As AI becomes increasingly integral to our daily lives, its ability to provide accurate and reliable information, particularly in sensitive areas such as health, is under intense scrutiny. The study conducted by CSIRO and The University of Queensland researchers brings to light the nuanced ways in which the formulation of prompts influences ChatGPT’s responses. In the realm of health information seeking, where the accuracy of the information can have profound implications, the findings of this study are especially pertinent.

Using the Text Retrieval Conference (TREC) Misinformation dataset, the study precisely evaluated ChatGPT’s performance across different prompting conditions. This analysis revealed that ChatGPT could deliver highly accurate health advice, with an effectiveness rate of 80% when provided with questions alone. However, this effectiveness is significantly compromised by biases introduced through the phrasing of questions and the inclusion of additional information in the prompts.

The study delineated two primary experimental conditions: “Question-only,” where ChatGPT was asked to provide an answer based solely on the question, and “Evidence-biased,” where the model was provided with additional information from a web search result. This dual approach allowed the researchers to simulate real-world scenarios where users either pose straightforward questions to the model or seek to inform

Good evidence confuses ChatGPT when used for health information, study finds

chatgpt
Credit: Pixabay/CC0 Public Domain

A world-first study has found that when asked a health-related question, the more evidence that is given to ChatGPT, the less reliable it becomes—reducing the accuracy of its responses to as low as 28%.

The study was recently presented at Empirical Methods in Natural Language Processing (EMNLP), a Natural Language Processing conference in the field. The findings are published in Proceedings of the 2023 Conference on Empirical Methods in Natural Language Processing.

As large language models (LLMs) like ChatGPT explode in popularity, they pose a potential risk to the growing number of people using online tools for key health information.

Scientists from CSIRO, Australia’s national science agency, and The University of Queensland (UQ) explored a hypothetical scenario of an average person (non-professional health consumer) asking ChatGPT if “X” treatment has a positive effect on condition “Y.”

The 100 questions presented ranged from “Can zinc help treat the common cold?” to “Will drinking vinegar dissolve a stuck fish bone?”

ChatGPT’s response was compared to the known correct response, or “ground truth,” based on existing medical knowledge.

CSIRO Principal Research Scientist and Associate Professor at UQ Dr. Bevan Koopman said that even though the risks of searching for health information online are well documented, people continue to seek health information online, and increasingly via tools such as ChatGPT.

“The widespread popularity of using LLMs online for answers on people’s health is why we need continued research to inform the public about risks and to help them optimize the accuracy of their answers,” Dr. Koopman said. “While LLMs have the potential to greatly improve the way people access information, we need more research to understand where they are effective and where they are not.”

The study looked at two question formats. The first was a question only.

Haredi Jews Prioritize Rabbinic Over Medical Advice, Study Finds

In an illuminating exploration of Haredi Jews’ approach to healthcare, researchers Rivka Neriya‐Ben Shahar, Fany Yuval, and Aviad Tur‐Sinai shed light on the complex interplay between religious authority and medical advice. Their study, published in the Journal of Religion and Health, reveals how Haredi communities in Israel often turn to rabbis as the ultimate decision-makers in health-related matters, even when their guidance conflicts with that of medical professionals.

Study Methodology and Findings

The researchers gathered insights through 16 focus groups, engaging 128 Haredi participants from key Israeli communities. The study aimed to understand the dynamics between patients, doctors, and rabbis within the ultra-Orthodox Jewish community. Findings suggest a profound loyalty to rabbinic authority, with participants indicating that in cases of disagreement between a doctor and a rabbi, the latter’s word is usually taken as final. This deference to religious leaders over health practitioners underscores the significance of spiritual guidance in the Haredi community, even at the expense of personal health.

Rabbinic Influence on Medical Decisions

Participants shared various anecdotes reflecting the nuanced relationship between faith and healthcare. For instance, some rabbis may advise seeking treatment at more advanced medical facilities, regardless of religious observances such as Shabbat, while others might prioritize adherence to religious laws over receiving the highest standard of medical care. This variance highlights the diverse perspectives within the Haredi community itself. Additionally, the study points out the community’s desire for healthcare professionals to better understand and respect their religious values and practices.

Community Dynamics and Healthcare Accessibility

The concept of ‘self-sacrifice’ emerged as a recurring theme, with community members willing to compromise on health decisions to maintain their standing within the ultra-Orthodox society. The researchers also discuss the existence of a ‘market’ for rabbinic advice, where those with more ‘capital’ – in terms of social or financial

Some virtual care companies putting patient data at risk, new study finds

This story is part of CBC Health’s Second Opinion, a weekly analysis of health and medical science news emailed to subscribers on Saturday mornings. If you haven’t subscribed yet, you can do that by clicking here.


If you visit a doctor virtually through a commercial app, the information you submit in the app could be used to promote a particular drug or service, says the leader of a new Canadian study involving industry insiders.

The industry insiders “were concerned that care might not be designed to be the best care for patients, but rather might be designed to increase uptake of the drug or vaccine to meet the pharmaceutical company objectives,” said Dr. Sheryl Spithoff, a physician and scientist at Women’s College Hospital in Toronto.

Virtual care took off as a convenient way to access health care during the COVID-19 pandemic, allowing patients to consult with a doctor by videoconference, phone call or text.

It’s estimated that more than one in five adults in Canada —  or 6.5 million people — don’t have a family physician or nurse practitioner they can see regularly, and virtual care is helping to fill the void.

But the study’s researchers and others who work in the medical field have raised concerns that some virtual care companies aren’t adequately protecting patients’ private health information from being used by drug companies and shared with third parties that want to market products and services.

A female doctor with long, brown hair standing in a medical office.
Dr. Sheryl Spithoff, a physician and scientist at Women’s College Hospital in Toronto, co-authored a new study that found the for-profit virtual care industry valued patient data and ‘appears to view data as a revenue stream.’ (Turgut Yeter/CBC)

Spithoff co-authored the study in this week’s BMJ Open, based on interviews with 18 individuals employed or affiliated with the Canadian virtual care

Acute health care use among children during the first 2.5 years of the COVID-19 pandemic in Ontario, Canada: a population-based repeated cross-sectional study

Abstract

Background: The effects of the decline in health care use at the start of the COVID-19 pandemic on the health of children are unclear. We sought to estimate changes in rates of severe and potentially preventable health outcomes among children during the pandemic.

Methods: We conducted a repeated cross-sectional study of children aged 0–17 years using linked population health administrative and disease registry data from January 2017 through August 2022 in Ontario, Canada. We compared observed rates of emergency department visits and hospital admissions during the pandemic to predicted rates based on the 3 years preceding the pandemic. We evaluated outcomes among children and neonates overall, among children with chronic health conditions and among children with specific diseases sensitive to delays in care.

Results: All acute care use for children decreased immediately at the onset of the pandemic, reaching its lowest rate in April 2020 for emergency department visits (adjusted relative rate [RR] 0.28, 95% confidence interval [CI] 0.28–0.29) and hospital admissions (adjusted RR 0.43, 95% CI 0.42–0.44). These decreases were sustained until September 2021 and May 2022, respectively. During the pandemic overall, rates of all-cause mortality, admissions for ambulatory care–sensitive conditions, newborn readmissions or emergency department visits or hospital admissions among children with chronic health conditions did not exceed predicted rates. However, after declining significantly between March and May 2020, new presentations of diabetes mellitus increased significantly during most of 2021 (peak adjusted RR 1.49, 95% CI 1.28–1.74 in July 2021) and much of 2022. Among these children, presentations for diabetic ketoacidosis were significantly higher than expected during the pandemic overall (adjusted RR 1.14, 95% CI 1.00–1.30). We observed similar time trends for new presentations of cancer, but we observed no excess presentations of severe cancer overall (adjusted RR 0.91, 95% CI 0.62–1.34).

Interpretation: In the first 30

Using ChatGPT for medical advice could put your health at risk, reveals study

Until now, it was commonly advised not to search for illness symptoms on Google, as the information might be inaccurate. Now, a similar caution is being raised about ChatGPT, the AI chatbot developed by OpenAI, which has gained popularity as a platform for users to seek answers to their queries. According to researchers, the free version of ChatGPT may provide inaccurate or incomplete responses, or even no response at all, to medication-related queries. This poses a potential risk to patients who depend on OpenAI’s popular chatbot for medical guidance.

In a recent study conducted by pharmacists at Long Island University, the free version of ChatGPT came under scrutiny for its responses to drug-related questions. A study by pharmacists found that chatbot, ChatGPT, provided inaccurate or incomplete answers to nearly three-fourths of drug-related questions. The study posed 39 questions to ChatGPT, and the study deemed only 10 responses as “satisfactory” based on established criteria. The remaining 29 drug-related questions either received incomplete responses, inaccurate information, or failed to directly address the query.

As reported by CNBC, researchers sought references from ChatGPT to verify the accuracy of its responses. And to the prompts, ChatGPT provided inaccurate or incomplete answers to nearly three-fourths of drug-related questions. Additionally, when requested to provide references for its responses, ChatGPT only included references in eight responses, and each of those references cited nonexistent sources.

One notable instance highlighted by the study involved ChatGPT inaccurately stating that there were no reported interactions between Pfizer’s Paxlovid and the blood-pressure-lowering medication verapamil. The reality is that these medications can excessively lower blood pressure when taken together, posing potential risks to patients.

Looking at the results, the study highlighted the importance of exercising caution for both patients and healthcare professionals who may consider using ChatGPT for drug-related information. Lead author Sara

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