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The British Journal of Ophthalmology Aug 2019Pars plana vitrectomy is a challenging, minimally invasive microsurgical procedure due to its intrinsic manoeuvres and physiological limits that constrain human... (Review)
Review
Pars plana vitrectomy is a challenging, minimally invasive microsurgical procedure due to its intrinsic manoeuvres and physiological limits that constrain human capability. An important human limitation is physiological hand tremor, which can significantly increase the risk of iatrogenic retinal damage resulting from unintentional manoeuvres that affect anatomical and functional surgical outcomes. The limitations imposed by normal physiological tremor are more evident and challenging during 'micron-scale' manoeuvres such as epiretinal membrane and internal limiting membrane peeling, and delicate procedures requiring coordinated bimanual surgery such as tractional retinal detachment repair. Therefore, over the previous three decades, attention has turned to robot-assisted surgical devices to overcome these challenges. Several systems have been developed to improve microsurgical accuracy by cancelling hand tremor and facilitating faster, safer and more effective microsurgeries. By markedly reducing tremor, microsurgical precision is improved to a level beyond present human capabilities. In conclusion, robotics offers potential advantages over free-hand microsurgery as it is currently performed during ophthalmic surgery and opens the door to a new class of revolutionary microsurgical modalities. The skills transfer that is beyond human capabilities to robotic technology is a logical next step in microsurgical evolution.
Topics: Humans; Microsurgery; Ophthalmologists; Robotics; Tremor; Vitrectomy
PubMed: 30573495
DOI: 10.1136/bjophthalmol-2018-313318 -
Journal of Neuro-ophthalmology : the... Dec 2023
Topics: Humans; Ophthalmologists; Optic Disk; Optic Nerve Diseases; Neurology
PubMed: 37974372
DOI: 10.1097/WNO.0000000000001993 -
Journal of Neuro-ophthalmology : the... Dec 2020
Topics: Diagnostic Tests, Routine; Eye Diseases; Humans; Neurology; Ophthalmologists; Ophthalmology
PubMed: 33186263
DOI: 10.1097/WNO.0000000000001149 -
Archivos de La Sociedad Espanola de... Nov 2023
Topics: Humans; Ophthalmologists; Ethics, Medical; Codes of Ethics
PubMed: 37643715
DOI: 10.1016/j.oftale.2023.07.006 -
Archivos de La Sociedad Espanola de... Jul 2018
Topics: Attitude of Health Personnel; Diagnostic Techniques, Ophthalmological; Humans; Medicalization; Ophthalmologists; Ophthalmology; Patients; Philosophy; Quality of Life
PubMed: 29398238
DOI: 10.1016/j.oftal.2017.11.008 -
JAMA Network Open Aug 2023Large language models (LLMs) like ChatGPT appear capable of performing a variety of tasks, including answering patient eye care questions, but have not yet been...
IMPORTANCE
Large language models (LLMs) like ChatGPT appear capable of performing a variety of tasks, including answering patient eye care questions, but have not yet been evaluated in direct comparison with ophthalmologists. It remains unclear whether LLM-generated advice is accurate, appropriate, and safe for eye patients.
OBJECTIVE
To evaluate the quality of ophthalmology advice generated by an LLM chatbot in comparison with ophthalmologist-written advice.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study used deidentified data from an online medical forum, in which patient questions received responses written by American Academy of Ophthalmology (AAO)-affiliated ophthalmologists. A masked panel of 8 board-certified ophthalmologists were asked to distinguish between answers generated by the ChatGPT chatbot and human answers. Posts were dated between 2007 and 2016; data were accessed January 2023 and analysis was performed between March and May 2023.
MAIN OUTCOMES AND MEASURES
Identification of chatbot and human answers on a 4-point scale (likely or definitely artificial intelligence [AI] vs likely or definitely human) and evaluation of responses for presence of incorrect information, alignment with perceived consensus in the medical community, likelihood to cause harm, and extent of harm.
RESULTS
A total of 200 pairs of user questions and answers by AAO-affiliated ophthalmologists were evaluated. The mean (SD) accuracy for distinguishing between AI and human responses was 61.3% (9.7%). Of 800 evaluations of chatbot-written answers, 168 answers (21.0%) were marked as human-written, while 517 of 800 human-written answers (64.6%) were marked as AI-written. Compared with human answers, chatbot answers were more frequently rated as probably or definitely written by AI (prevalence ratio [PR], 1.72; 95% CI, 1.52-1.93). The likelihood of chatbot answers containing incorrect or inappropriate material was comparable with human answers (PR, 0.92; 95% CI, 0.77-1.10), and did not differ from human answers in terms of likelihood of harm (PR, 0.84; 95% CI, 0.67-1.07) nor extent of harm (PR, 0.99; 95% CI, 0.80-1.22).
CONCLUSIONS AND RELEVANCE
In this cross-sectional study of human-written and AI-generated responses to 200 eye care questions from an online advice forum, a chatbot appeared capable of responding to long user-written eye health posts and largely generated appropriate responses that did not differ significantly from ophthalmologist-written responses in terms of incorrect information, likelihood of harm, extent of harm, or deviation from ophthalmologist community standards. Additional research is needed to assess patient attitudes toward LLM-augmented ophthalmologists vs fully autonomous AI content generation, to evaluate clarity and acceptability of LLM-generated answers from the patient perspective, to test the performance of LLMs in a greater variety of clinical contexts, and to determine an optimal manner of utilizing LLMs that is ethical and minimizes harm.
Topics: Humans; Artificial Intelligence; Ophthalmologists; Cross-Sectional Studies; Software; Language
PubMed: 37606922
DOI: 10.1001/jamanetworkopen.2023.30320 -
Irish Journal of Medical Science Dec 2023Healthcare systems have increasingly limited and stretched budgets. Clinicians have a key role in budget allocation. Awareness of the costs of high-use clinical items is...
BACKGROUND
Healthcare systems have increasingly limited and stretched budgets. Clinicians have a key role in budget allocation. Awareness of the costs of high-use clinical items is important.
AIMS
Assess awareness of the cost of commonly utilised clinical items amongst Irish Ophthalmologists METHODS: Irish ophthalmologists were contacted and asked to fill out an anonymous survey. We assessed knowledge of hospital costs of surgical materials, medications and anti VEGF drugs as well as retail pharmacy costs of commonly prescribed medications. The cost of items to the hospital was recorded from pharmacy and ward order receipts from a single university hospital. The costs of items to the patient were calculated by taking an average of 3 prices charged by local retail pharmacies. For each estimate we calculated the absolute error from the true price. We calculated the mean absolute errors (MAE) and percentage errors (MAPE) across the different groups.
RESULTS
We received responses from 47 participants (15 Senior House Officers, 11 Registrars, 21 Consultant/Community Ophthalmologists). Despite 70% of respondents agreeing that the cost of an item should have a major role in its use, the average estimate was 124% inaccurate. Less than 50% of responses were within 50% of the true cost of the item. Self-perceived knowledge was acknowledged to be limited or very limited in 73% of responses.
CONCLUSIONS
We demonstrate variable and limited levels of cost awareness. Seniority and better self-perceived knowledge were not found to be associated with better estimate accuracy.
Topics: Humans; Ophthalmologists; Surveys and Questionnaires; Health Personnel; Hospitals, University
PubMed: 37119367
DOI: 10.1007/s11845-023-03332-7 -
La Tunisie Medicale 2023The interaction between physicians and pharmaceutical industry highlighted many issues lately concerning their influence on physician's attitude and their prescribing...
INTRODUCTION
The interaction between physicians and pharmaceutical industry highlighted many issues lately concerning their influence on physician's attitude and their prescribing behavior.
AIM
To evaluate the attitudes of Tunisian ophthalmologist towards pharmaceutical promotion.
METHODS
Data was collected through an auto-administered anonymous questionnaire elaborated in French that was distributed to 160 ophthalmologists (residents and specialists) working in hospitals or private practices in four Tunisian governorates (Tunis, Sousse, Monastir and Sfax).
RESULTS
One hundred and two valid responses were received. Twenty-nine respondents (28.43%) estimated the number of visits by pharmaceutical representatives (PR) at 11 to 20 times during the last year. Most physicians considered guides (94%), drug samples (88%), articles (86%), stationery (81%), sponsorship of overseas conferences (72%) and international trips to symposia organized by pharmaceutical industries (58%), as appropriate gifts. Over 80% of doctors agreed that promotional activities by drug companies were appropriate. Accepting sponsorship from a pharmaceutical company for a partner to attend a meeting was considered inappropriate by 79% of ophthalmologists. Eighty-eight percent of the respondents agreed that receiving gifts will increase their prescription of the company's drug. However, they perceived themselves to be less influenced than their colleagues (p=0.011). Eighty-six percent of ophthalmologists reported training about how to interact with PR to be insufficient.
CONCLUSIONS
Despite the role of PR in supporting research, ethical issues may arise through their interactions with healthcare professionals. Training about pharmaceutical promotion and appropriate ways to deal with it are lacking in Tunisian medical schools' curricula, leaving future doctors unprepared to deal with pharmaceutical influences.
Topics: Humans; Ophthalmologists; Physicians; Curriculum; Health Personnel; Pharmaceutical Preparations
PubMed: 38445399
DOI: No ID Found -
Journal of Pediatric Ophthalmology and... Jan 2020
Topics: Child; Humans; Ophthalmologists; Ophthalmology
PubMed: 31972033
DOI: 10.3928/01913913-20191209-01 -
Ceska a Slovenska Oftalmologie :... 2022In December 2019, a novel coronavirus (CoV) epidemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged from China. Coronaviruses belong... (Review)
Review
In December 2019, a novel coronavirus (CoV) epidemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged from China. Coronaviruses belong to enveloped ssRNA viruses and are classified into four genera: Alpha coronavirus, Beta coronavirus, Gamma coronavirus and Delta coronavirus. It is assumed that SARS-CoV-2 is spread primarily during a personal contact via bigger respiratory droplets. These droplets with viruses can be directly inhaled by other people or can lend on the surfaces with the possibility of further spreading. The ocular surface has been suggested as one of possible infection entries. Human eye has its own renin-angiotensin system with present ACE2 receptors, which bind the virus through spike protein. The most common symptoms of the SARS-CoV-2 infection are fever, cough and dyspnoea. Several clinical entities, such as conjunctivitis, anterior uveitis, retinitis, and optic neuritis have been associated with this infection. The most common ophthalmologic symptom associated with COVID-19 disease is conjunctivitis. Some studies indicate that eye symptoms are commonly present in patients with severe COVID-19 pneumonia and that it is possible to detect viral RNA from the conjunctival sac of these patients. In ophthalmologic praxis, we manage not only the therapy of the eye structures` inflammation in relation with this infection, but also the overall management of the visits and the supervision of the patients who are at risk and positive for coronavirus. Ophthalmologists could potentially have a higher risk of SARS-CoV-2 infection due to personal communication with the patients, frequent exposure to tears and eye secrets and the use of devices. We would like to provide an ophthalmologist`s perspective on this topic.
Topics: COVID-19; Humans; Ophthalmologists; Pandemics; SARS-CoV-2
PubMed: 35105149
DOI: 10.31348/2022/1