ABSTRACT
BACKGROUND AND OBJECTIVES: Advances in AI-based virtual assistants provide a potential opportunity for older adults to use this technology in the context of health information-seeking. Meta-analysis on trust in AI shows that users are influenced by the accuracy and reliability of the AI trustee. We evaluated these dimensions for responses to Medicare queries. RESEARCH DESIGN AND METHODS: During the summer of 2023, we assessed the accuracy and reliability of, Alexa, Google Assistant, Bard, and ChatGPT-4, on Medicare terminology and general content from a large, standardized question set. We compared the accuracy of these AI systems to that of a large representative sample of Medicare beneficiaries who were queried twenty years prior. RESULTS: Alexa and Google Assistant were found to be highly inaccurate when compared to beneficiaries' mean accuracy of 68.4% on terminology queries and 53.0% on general Medicare content. Bard and ChatGPT-4 answered Medicare terminology queries perfectly and performed much better on general Medicare content queries (Bard = 96.3%, ChatGPT-4 = 92.6%) than the average Medicare beneficiary. About one month to a month-and-a-half later, we found that Bard and Alexa's accuracy stayed the same, while ChatGPT-4's performance nominally decreased, and Google Assistant's performance nominally increased. DISCUSSION AND IMPLICATIONS: LLM-based assistants generate trustworthy information in response to carefully phrased queries about Medicare, in contrast to Alexa and Google Assistant. Further studies will need to determine what factors beyond accuracy and reliability influence the adoption and use of such technology for Medicare decision-making.
ABSTRACT
The practice of female genital mutilation (FGM) is performed for historically engrained cultural beliefs with no recognized health benefits. FGM continues to be practiced secondary to motivating factors based on cultural beliefs, the majority of which aim to maintain the "purity" of the female victim. The World Health Organization has classified FGM into 4 types ranging from partial clitoral resection to complete clitoral excision along with the majority of the vulva. The list of short and long-term complications is extensive and morbid, including injury to the patient's sexuality and feminine identity. Reconstructive surgery can be an important addition to psychotherapy for these women with the goal of correcting the appearance of the vulva to achieve a more normal appearance, and to restore clitoral function. We suggest that this represents an opportunity for plastic surgeons to use our wealth of reconstructive knowledge to provide restoration of form and function to FGM victims.
