Institute of Fundamental Technological Research

Background: Chatbots using the Large Language Model (LLM) generate human responses to questions from all
categories. Due to staff shortages in healthcare systems, patients waiting for an appointment increasingly use
chatbots to get information about their condition. Given the number of chatbots currently available, assessing the
responses they generate is essential.
Methods: Five chatbots with free access were selected (Gemini, Microsoft Copilot, PiAI, ChatGPT, ChatSpot) and
blinded using letters (A, B, C, D, E). Each chatbot was asked questions about cardiology, oncology, and psoriasis.
Responses were compared to guidelines from the European Society of Cardiology, American Academy of
Dermatology and American Society of Clinical Oncology. All answers were assessed using readability scales
(Flesch Reading Scale, Gunning Fog Scale Level, Flesch-Kincaid Grade Level and Dale-Chall Score). Using a 3-
point Likert scale, two independent medical professionals assessed the compliance of the responses with the
guidelines.
Results: A total of 45 questions were asked of all chatbots. Chatbot C gave the shortest answers, 7.0 (6.0 – 8.0), and Chatbot A the longest 17.5 (13.0 – 24.5). The Flesch Reading Ease Scale ranged from 16.3 (12.2 – 21.9)
(Chatbot D) to 39.8 (29.0 – 50.4) (Chatbot A). Flesch-Kincaid Grade Level ranged from 12.5 (10.6 – 14.6) (Chatbot A) to 15.9 (15.1 – 17.1) (Chatbot D). Gunning Fog Scale Level ranged from 15.77 (Chatbot A) to 19.73 (Chatbot D). Dale-Chall Score ranged from 10.3 (9.3 – 11.3) (Chatbot A) to 11.9 (11.5 – 12.4) (Chatbot D).
Conclusion: This study indicates that chatbots vary in length, quality, and readability. They answer each question
in their own way, based on the data they have pulled from the web. Reliability of the responses generated by
chatbots is high. This suggests that people who want information from a chatbot need to be careful and verify the answers they receive, particularly when they ask about medical and health aspects.

Chatbots,Readability,Cardiovascular health,Oncology

Background. The coronavirus disease 2019 (COVID-19) pandemic has significantly accelerated the development and use of new healthcare technologies. While younger individuals may have been able to quickly embrace virtual advancements, older adults may still have different needs in terms of health communication.

Objectives. To identify areas of interest and preferred sources of information related to the COVID-19 pandemic among older adults and to verify their eHealth competencies.

Materials and methods. The study was conducted between February 2022 and July 2022. It included listeners from the University of the Third Age (U3A) and younger students. Both groups received information about the HealthBuddy+ chatbot, a questionnaire that addressed respondents’ interests about COVID-19, and the PL-eHEALS (eHealth Literacy Scale) questionnaire to measure their eHealth competencies.

Results. There were 573 participants in the study (U3A listeners – 303 participants, median age: 73 years (interquartile range (IQR): 69–77); young adult students – 270, median age: 24 years (IQR: 23–24). The primary source of information about COVID-19 for older adults was television (84.5%), and for younger adults, internet (84.4%). Among the older adults, only 17% ever interacted with a chatbot (younger adults – 78% respectively), and 19% considered it a trustworthy source of information on COVID-19 compared to 79% of younger respondents. Older adults and younger adults in our study were most interested in COVID-19 treatment methods (45.5% and 69.3%, respectively), symptoms of the disease (36.6% and 35.2%, respectively) and chronic diseases coexisting with COVID-19 (35.0% and 51.5%, respectively). However, their eHealth competencies were generally low (median (Me): 34; IQR: 30–39) compared to younger adults (Me: 42; IQR: 40–47).

Conclusions. Health education for older adults should be appropriately tailored to their current needs and differentiated. The level of eHealth competencies of older adults suggests that much work remains to narrow the gap between the eHealth competencies of the younger and older generations.

health education,older adults,information seeking,COVID-19

Brachial aortic Pulse Wave Velocity (baPWV) and bone mineral density (BMD) are important indicators of cardiovascular health and bone strength, respectively. However, the gender-specific association between baPWV and BMD remains unclear. The aim of our study is to evaluate the relationship between baPWV and
BMD in men and women populations Methods: A comprehensive search was conducted in electronic databases for relevant studies published between the 1th and 30rd of April 2023. Studies reporting the correlation between baPWV and BMD in both males and
females were considered. A random-effects model was used to calculate pooled correlation coefficients (r). Results: Relevant data for both genders were found in six articles. In all publications included in the meta-analysis, the total number of studied individuals was 3800, with 2054 women and 1746 men. Pooled correlation coefficient was -0,24 (95% CI: -0.34; -0.15) in women population, and -0.12 (95%CI: -0.16, -0.06) in
men. Conclusions: Based on the published data, we found that baPWV is negatively correlated with bone density in women. However, in men we do not find such a
relationship. These findings suggest the importance of considering gender-specific factors when assessing the cardiovascular and bone health relationship.

Bone mineral density, osteoporosis, brachial aortic Pulse Wave Velocity, arterial stiffness, gender differences

Abstract: BackgroundDiet-related diseases remain leading causes of death in most developed countries around the world. The aim of the study was to compare opinions of patients and family physicians on receiving and providing recommendations about physical activity, diet and use of medication. Methods: The questionnaire study was conducted among patients of 36 primary health care clinics in Poland between September 2018 and February 2019. Patients and physicians were interviewed separately by trained researchers. Data from 509 patients and 167 family doctors were analyzed. Results: The median age of patients was 44 years (interquartile range: 29–55) and 70% were women. The majority of physicians were women (59%) and the median age was 37 years (IQR: 31–50). There was a significant difference between physicians’ declarations on providing recommendations on diet (92% vs. 39%) and activity (90% vs. 37%) versus patients’ declarations on receiving them. Conclusions: The results indicate that there is significant room for improvement in providing patients with proper recommendations on diet and physical activity by their family physicians. Primary care physicians should put more emphasis on clear communication of recommendations on diet and physical activity.

diet

AIMS: Bradyarrhythmias are potentially life-threatening medical conditions. The most widespread treatment for slow rhythms is artificial ventricular pacing. From the inception of the idea of artificial pacing, ventricular leads were located in the apex of the right ventricle. Right ventricular apical pacing (RVAP) was thought to have a deteriorating effect on left ventricular systolic function. The aim of this study was to systematically assess results of randomized controlled trials to determine the effects of right ventricular apical pacing on left ventricular ejection fraction (LVEF). Methods: we systematically searched the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE databases for studies evaluating the influence of RVAP on LVEF. Pooled mean difference (MD) with a 95% confidence interval (CI) was estimated using a random effect model. Results: 14 randomized controlled trials (RCTs) comprising 885 patients were included. In our meta-analysis, RVAP was associated with statistically significant left ventricular systolic function impairment as measured by LVEF. The mean difference between LVEF at baseline and after intervention amounted to 3.35% (95% CI: 1.80–4.91). Conclusion: our meta-analysis confirms that right ventricular apical pacing is associated with progressive deterioration of left ventricular systolic function.

artificial pacing

Objectives: Burnout among physicians is an increasingly recognized phenomenon affecting different aspects of patient care and safety. This meta-analysis quantifies association of burnout and its subscales with self-reported medical errors among physicians. Methods: This meta-analysis followed the principles formulated in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analyses of Observational Studies. The MEDLINE, PubMed, Web of Science, PsycInfo, and Eric databases were searched until February 5, 2019, using various combinations of key terms without any language restrictions: burnout, physicians, error, safety, and quality. Reference lists of selected studieswere hand searched. Datawere extracted frompublished reports. All quantitative studies reporting prevalence of burnout and its association with self-reported errors among physicians were considered. The analyses of heterogeneity (Cochran Q, I^2), publication bias (Begg- Mazumdar and Egger), three subgroups, and sensitivity were performed. The effect of overall burnout and Maslach Burnout Inventory subscales on self-reported errors was calculated as odds ratios with 95% confidence interval. Results: Thirteen studies on 20,643 physicians and residents were included. The overall burnout among participants was associated with a significantly increased risk of self-reported errors (odds ratio = 2.72, 95% confidence interval = 2.19–3.37). Emotional exhaustion, depersonalization, and personal accomplishment were all independently predicting factors of self-reported errors. Cochran Q test and inconsistency index I2 were as follows: Q = 27.2; P = 0.0013, I^2 = 67% (36%–83%). Conclusions: The results provide evidence that not only overall burnout but also its subscales independently are to be associated with a significantly increased risk of self-reported errors among physicians. As self-reported errors may translate into different types of adverse events, this strong and unequivocal association should be of major concern to healthcare organizations.

burnout, error, patient safety, quality of care

Introduction. To investigate the public interest in cancer screening before, during and after one year of the COVID-19 pandemic, in relation to the number of cases and deaths caused by the coronavirus. Material and methods. Google Trends (GT) was used to obtain data on online interest in screening for the most common cancer types during COVID-19 pandemic. Results. It was found that although online interest in screening collapsed during the early stages of the pandemic, it managed to gradually return to its pre-pandemic levels six months later despite a growing number of COVID-19 related deaths. Nevertheless, some data and reports suggest that this unprecedented crisis may result in increased mortality and incidence rates. Conclusions. The study raises the importance of continuous and active actions aimed at raising cancer awareness which appears to be crucially important during a public health crisis such as the COVID-19 pandemic.

cancer screening

Introduction: Real-time continuous glucose monitoring (CGM) has changed the way people with type 1 diabetes mellitus (T1DM) and health care providers perceive diabetes management and glucose control. Objectives: The purpose of this meta-analysis was to compare the emotional well-being of adults with T1DM who used CGM and those using conventional self-monitoring of blood glucose (SMBG). Patients and methods: The MEDLINE/PubMed, Cochrane Library / Embase, CINAHL, Scopus, Web of Science, and ProQuest databases were searched for relevant publications. Primary outcome measures were health-related quality of life, glycemic control, and fear of hypoglycemia. Randomized controlled trials and survey studies focused on the quality of life and fear of hypoglycemia among adult patients using CGM and SMBG were included in the analysis. Results: The meta-analysis included 11 studies involving a total of 1228 patients with T1DM. Analysis of the Worry subscale of the Hypoglycemia Fear Survey indicated a reduction of hypoglycemia fear in CGM users compared with SMBG users (Cohen d = –0.24; 95% CI, –0.41 to –0.07; mean difference, –3.15; 95% CI, –5.48 to –0.82). Outcome analysis of studies including the Diabetes Treatment Satisfaction Questionnaire showed Cohen d of 0.23 (95% CI, –0.18 to 0.63). The overall value of Cohen d equaled –0.24 (95% CI, –0.57 to 0.09), indicating a lack of effect of CGM use on improving HbA1c levels; however, after one of the studies was excluded from calculations, the reduction of HbA1c levels was significantly higher in CGM users (Cohen d = –0.33; 95% CI, –0.66 to 0.00; P = 0.047).
Conclusions: This is the first quantitative meta-analysis of studies involving adult patients exclusively with T1DM, providing further evidence for the ability of CGM systems to reduce fear of hypoglycemia and improve quality of life. Continuous glucose monitoring systems have advantage over SMBG in adults with T1DM and improve HbA1c levels.

adults, continuous glucose monitoring, quality of life, self-monitoring of blood glucose, type 1 diabetes

Introduction: In recent years, healthcare systems around the world have been subject to profound changes driven by advances in technology, new regulations as well as demographic and societal trends. This volatile and stressful environment has had its consequences for healthcare organizations and their employees. The resulting phenomena of burnout or lowered well-being may affect key aspects of healthcare delivery on individual, organizational, and financial levels. Objectives: The objective of this paper was to investigate the level of burnout and well-being in a group of Polish physicians, its impact on errors, and associations with other factors. Methods: This was a cross-sectional survey using a self-administered questionnaire with 65 questions and validated tools such as the Maslach Burnout Inventory and the World Health Organization–5 Well-being Index (WHO-5). Correlations between variables were investigated using Spearman rank correlation analysis. Univariable and multivariable logistic regression models were used to evaluate predictors of burnout and errors. The study included residents and physicians of various specialties. Results: A total of 125 residents and physicians, mostly internists and cardiologists, participated in the study, out of which 84 (67%) were found to be burned out. The median WHO-5 score was 40 points. Two-thirds of all physicians admitted to making an error in the last 3 months, which was strongly associated with burnout. Conclusions: The level of burnout among respondents was high and had numerous negative consequences that may affect the entire healthcare system. The results suggest there is an urgent need to address the problem of burnout among physicians.

burnout, errors, patient safety, suicidal ideation, well-being

Introduction: Depressive disorders are the most common mental health problem among patients undergoing dialysis. Furthermore, depression is an independent factor increasing the mortality and frequency of hospitalization in this group of patients, yet psychological intervention programs aimed at improving the mental health of dialysis patients have still not been developed. This meta-analysis aimed to assess the effects of cognitive-behavioral therapy on depressive symptoms in dialysis patients. The main hypothesis of this study is that cognitive-behavioral therapy is an effective psychological method of reducing the severity of depression symptoms among patients undergoing dialysis. Material and methods: A systematic search was conducted using Medline, PubMed, Web of Science, Scopus and Google Scholar. Data extraction was carried out by two independent researchers. The severity of depression symptoms in the included studies was measured by the Beck Depression Inventory. A random-effects model was used to estimate the pooled mean difference of these values between patients undergoing CBT and the controls. Results: Four of the 1841 search results met the inclusion criteria with data from 226 patients who had undergone dialysis therapy due to renal disorders and psychological intervention based on cognitive-behavioral therapy. This therapy significantly reduced the level of depression symptoms in all studies included in the meta-analysis (mean difference = –5.3, p = 0.001; 95% CI: –7.95 to –2.66). Conclusions: The study showed that the use of psychological intervention based on cognitive-behavioral therapy was an effective method of decreasing the severity of depressive symptoms in hemodialyzed patients. For the sake of patient well-being, it seems reasonable to extend renal replacement therapy with psychological intervention such as cognitive-behavioral therapy.

depression, dialysis, cognitive-behavioral therapy, renal replacement

Objective: To analyze accuracy of articles about COVID-19 prevention most frequently shared through social media platforms. Methods: Identifying, using the Buzzsumo analytic tool, 30 most frequently shared articles in April 2020 about COVID-19 prevention and classifying them according to number of shares, accuracy, topic and sharing platform. Calculations were made using descriptive statistics tools and chi-square test. Results: The top 30 articles about coronavirus prevention were shared 4904 160 times over a period of one month with 96.8% of all shares through Facebook. Most of the articles (80%) was found to be accurate, however they accounted for only 64% of shares. The inaccuracies referred mostly to handwashing. The most shared articles were about medications followed by masks and hand washing. Conclusions: Articles about coronavirus prevention are usually accurate, yet relatively less likely to be shared than inaccurate ones. Facebook remains a dominant social media platform for sharing content. Buzzsumo could be considered a tool in certain situations such as pandemic for health authorities to quickly investigate different health topics popular on social media. Lay Summary: Most of the articles about COVID-19 prevention, identified as most frequently shared through social media platform during the pandemic, was found to be accurate. However, inaccurate content was more likely to be shared than by Facebook users compared with accurate content. This suggests the need for health authorities to monitor content shared on social media in extraordinary situations such as pandemics.

coronavirus, COVID-19, social media, misinformation, public health

The aim of this study was to analyse knowledge on colon cancer prevention among patients of primary care and identify their sources of information. The questionnaire study was conducted among patients of 36 primary healthcare clinics in Poland between September 2018 and February 2019. Patients were interviewed separately by trained researchers. Over 39% of the primary health patients declared that their knowledge about colon cancer prevention is unsatisfactory. Information about colon cancer prevention varied according to sex, age and BMI. Men declared lower level of knowledge than women: 46% of men thought it was unsatisfactory compared with 36%of women (p = 0.003). Preventive recommendations weremore often provided to patients over 60 years old (p < 0.01). Overweight and obese patients were more likely to receive recommendations on diet (p < 0.001) and physical activity (p < 0.001) than patients with normal weight. Themost common source of information on colon cancer prevention was Internet (68%) and medical doctors (60%). There is a need for developing colon cancer prevention policy. Crucial aspect includes educational programs aimed at improving patient’s knowledge and involving medical staff. The policymakers should pay greater attention to cancer prevention policies and medical staff involved in prevention to quality of communication to make sure patients thoroughly understand information they are provided.

colon cancer, prevention, primary healthcare, education, communication