Testing ChatGPT ability to answer laypeople questions about cardiac arrest and cardiopulmonary resuscitation.

INTRODUCTION: Cardiac arrest leaves witnesses, survivors, and their relatives with a multitude of questions. When a young or a public figure is affected, interest around cardiac arrest and cardiopulmonary resuscitation (CPR) increases. ChatGPT allows everyone to obtain human-like responses on any topic. Due to the risks of accessing incorrect information, we assessed ChatGPT accuracy in answering laypeople questions about cardiac arrest and CPR. METHODS: We co-produced a list of 40 questions with members of Sudden Cardiac Arrest UK covering all aspects of cardiac arrest and CPR. Answers provided by ChatGPT to each question were evaluated by professionals for their accuracy, by professionals and laypeople for their relevance, clarity, comprehensiveness, and overall value on a scale from 1 (poor) to 5 (excellent), and for readability. RESULTS: ChatGPT answers received an overall positive evaluation (4.3 ± 0.7) by 14 professionals and 16 laypeople. Also, clarity (4.4 ± 0.6), relevance (4.3 ± 0.6), accuracy (4.0 ± 0.6), and comprehensiveness (4.2 ± 0.7) of answers was rated high. Professionals, however, rated overall value (4.0 ± 0.5 vs 4.6 ± 0.7; p = 0.02) and comprehensiveness (3.9 ± 0.6 vs 4.5 ± 0.7; p = 0.02) lower compared to laypeople. CPR-related answers consistently received a lower score across all parameters by professionals and laypeople. Readability was 'difficult' (median Flesch reading ease score of 34 [IQR 26-42]). CONCLUSIONS: ChatGPT provided largely accurate, relevant, and comprehensive answers to questions about cardiac arrest commonly asked by survivors, their relatives, and lay rescuers, except CPR-related answers that received the lowest scores. Large language model will play a significant role in the future and healthcare-related content generated should be monitored.

Coronary angiography findings in resuscitated and refractory out-of-hospital cardiac arrest: A systematic review and meta-analysis.

INTRODUCTION: Coronary angiography (CAG) frequently reveals coronary artery disease (CAD) after out-of-hospital cardiac arrest (OHCA), but its use is not standardized and often reported in different subpopulations. This systematic review and meta-analysis accurately describes angiographic features in resuscitated and refractory OHCA. METHODS: PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched up to October 31, 2022. Studies reporting coronary angiography findings after OHCA were considered eligible. The primary outcome was location and rate of coronary lesions. Coronary angiography findings with 95% confidence intervals were pooled with a meta-analysis of proportion. RESULTS: 128 studies (62,845 patients) were included. CAG, performed in 69% (63-75%) of patients, found a significant CAD in 75% (70-79%), a culprit lesion in 63% (59-66%), and a multivessel disease in 46% (41-51%). Compared to patients with return of spontaneous circulation, refractory OHCA was associated with more severe CAD due to a higher rate of left main involvement (17% [12-24%] vs 5.7% [3.1-10%]; p = 0.002) and acute occlusion of left anterior descending artery (27% [17-39%] vs 15% [13-18%]; p = 0.02). Nonshockable patients without ST-elevation were those receiving CAG less frequently, despite significant disease in 54% (31-76%). Left anterior descending artery was the most frequently involved (34% [30-39%]). CONCLUSIONS: Patients with OHCA have a high prevalence of significant CAD caused by acute and treatable coronary lesions. Refractory OHCA was associated with more severe coronary lesions. CAD was also present in patients with nonshockable rhythm and without ST elevation. However, heterogeneity of studies and selection of patients undergoing CAG limit the certainty of findings.

The Effect of Intensive Care Unit Diaries on Posttraumatic Stress Disorder, Anxiety, and Depression: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

INTRODUCTION: Patients discharged from the intensive care unit (ICU) suffer from long-term symptoms affecting the physical, psychological, and cognitive well-being and cannot understand memories and dreams. Intensive care unit diaries describe daily events about the patient and may allow them to reconstruct their experience. OBJECTIVE: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the effects of ICU diaries on posttraumatic stress disorder (PTSD), depression, and anxiety. METHODS: Five electronic databases were searched up to May 6, 2022. We included RCTs comparing patients admitted to the ICU who received a diary to those who did not receive a diary. The primary outcome was the rate of PTSD. Secondary outcomes were rates of depression and anxiety. RESULTS: We included 7 RCTs. Patients who received a diary during the ICU admission had reduced rate of PTSD (78/432 [18%] vs 106/422 [25%]; risk ratio [RR], 0.73; 95% confidence interval [CI], 0.57-0.94; P = .02; I2 = 0%; trial sequential analysis-adjusted CI, 0.55-0.97) when compared with patients who did not receive a diary. We found a non-statistically significant difference toward a reduction in the rate of depression (38/232 [16%] vs 54/224 [24%]; RR, 0.70; 95% CI, 0.49-1.01; P = .06; I2 = 0%) and anxiety (63/232 [27%] vs 70/224 [31%]; RR, 0.64; 95% CI, 0.29-1.40; P = .26; I2 = 67%). CONCLUSIONS: Providing an ICU diary to patients admitted to the ICU reduced the rate of PTSD symptoms compared with usual care.

Analysis of road traffic accidents involving standing electric scooters reported in newspapers in Italy.

OBJECTIVE: As the use of electric scooters increased in Italy in the last years, we aimed to estimate the burden of accidents caused by this micro-mobility vehicle and identify characteristics, severity, and type of injuries. METHODS: We conducted a case series analysis of news reports about electric scooter crashes occurring in Italy from January 1, 2019 to September 30, 2020. Events were included when a road traffic accident involved an electric scooter and caused damages or injuries to the driver or others. RESULTS: We identified 96 road accidents involving electric scooters in Italy. The mean age of patients was 30 ± 16 years, and 79% (n = 71/90) were male. Of the 96 patients, only two (2%) were driving an electric scooter with a helmet, and three (3%) were driving while intoxicated. In 68% (n = 62/94) of cases, the incident was caused by a collision with another vehicle or a pedestrian, and 30% (n = 18/96) were transported with life-threatening injuries to the emergency department. In 15% (n = 14/96), the emergency medical service physician was dispatched to the scene. Head trauma was the most common injury (60%, n = 32/53). Patients who had life-threatening conditions were more likely to have head trauma than those who did not (82% [n = 9/11] vs. 55% [n = 23/42], P = 0.10). Polytrauma was significantly more common in patients with life-threatening conditions than in patients with no life-threatening conditions (36% [n = 4/11] vs. 5% [n = 2/42], P < 0.01). Fifteen percent of patients (n = 12/81) were admitted to the intensive care unit; only one death was reported. CONCLUSION: Road traffic accidents involving electric scooters often result in serious injuries, including head trauma and polytrauma, necessitating the involvement of an emergency medical service physician and intensive care unit admission in a non-negligible percentage of instances.