Background ChatGPT has substantial potential to revolutionize medical education. We aim to assess how medical students and laypeople evaluate information produced by ChatGPT compared to an evidence-based resource on the diagnosis and management of 5 common surgical conditions. Methods A 60-question anonymous online survey was distributed to third- and fourth-year U.S. medical students and laypeople to evaluate articles produced by ChatGPT and an evidence-based source on clarity, relevance, reliability, validity, organization, and comprehensiveness. Participants received 2 blinded articles, 1 from each source, for each surgical condition. Paired-sample t-tests were used to compare ratings between the 2 sources. Results Of 56 survey participants, 50.9% (n = 28) were U.S. medical students and 49.1% (n = 27) were from the general population. Medical students reported that ChatGPT articles displayed significantly more clarity (appendicitis: 4.39 vs 3.89, P = .020; diverticulitis: 4.54 vs 3.68, P < .001; SBO 4.43 vs 3.79, P = .003; GI bleed: 4.36 vs 3.93, P = .020) and better organization (diverticulitis: 4.36 vs 3.68, P = .021; SBO: 4.39 vs 3.82, P = .033) than the evidence-based source. However, for all 5 conditions, medical students found evidence-based passages to be more comprehensive than ChatGPT articles (cholecystitis: 4.04 vs 3.36, P = .009; appendicitis: 4.07 vs 3.36, P = .015; diverticulitis: 4.07 vs 3.36, P = .015; small bowel obstruction: 4.11 vs 3.54, P = .030; upper GI bleed: 4.11 vs 3.29, P = .003). Conclusion Medical students perceived ChatGPT articles to be clearer and better organized than evidence-based sources on the pathogenesis, diagnosis, and management of 5 common surgical pathologies. However, evidence-based articles were rated as significantly more comprehensive.

Introduction Since the onset of the Covid-19 Pandemic, Telehealth utilization has grown rapidly; however, little is known about its efficacy in specific areas of healthcare, including trauma care in the emergency department. We aim to evaluate telehealth utilization in the care of adult trauma patients within United States emergency departments and associated outcomes over the past decade. Methods PubMed, Google Scholar, EMBASE, ProQuest, and Cochrane were searched for relevant articles published from database conception to Dec 12th, 2022. Our review includes studies that assessed the utilization of telehealth practices within a United States emergency department for the treatment of adult (age ≥ 18) trauma patients. Evaluated outcomes included emergency department length of stay, transfer rates, cost incurred to patients and telehealthimplementing hospitals, patient satisfaction, and rates of left without being seen. Results A total of 11 studies, evaluating 59,319 adult trauma patients, were included in this review. Telehealth practices resulted in comparable or reduced emergency department length of stay for trauma patients admitted to the emergency department. Costs incurred to the patient and rates of leaving without being seen were significantly reduced following telehealth implementation. There was no difference in transfer rates or patient satisfaction for telehealth practices compared to in-person treatment. Conclusion Emergency department telehealth utilization significantly reduced trauma patient care-related costs, emergency department length of stay, and rates of leaving without being seen. No significant differences were found in patient transfer rates, patient satisfaction rates, or mortality rates following emergency department telehealth utilization.

PURPOSE:Hidradenitis Suppurativa (HS) is a chronic inflammatory disease characterized by painful and foulsmelling cystic nodules and sinus tracts in apocrine gland-bearing regions. The treatment ranges from topical, intralesional, systemic, and surgical modalities. Currently, the most novel therapy is the use of laser therapy to create a localized treatment without systemic side effects. However, there is limited data about patient outcomes of the laser treatment due to the low prevalence of the disease. The aim of this paper is to evaluate the efficacy of laser therapy as a treatment modality for patients with HS. METHODS:A retrospective review cohort analysis of HS patients undergoing laser treatment from 2016-2021 was conducted. Patient demographics, location of lesions, Hurley stage, age of onset and diagnosis, treatment length, type, outcomes, and complications were analyzed. RESULTS:Eighty-six patients met the inclusion criteria: On average, patients were treated with 5.6 laser sessions for 17 months without any complications and minor blood loss. HS progression commonly started during puberty, with a median onset of 13.8 years and diagnosis of HS at 16.3 years. All of the patients (n=86) showed an improvement of HS disease severity: 52% completed treatment, 16% currently ongoing treatment, and 31% were lost to follow up. CONCLUSION:Laser therapy is an effective and safe therapy for HS leading to improved quality of life and could be considered in the treatment algorithm for disease management.

Background We aim to investigate the costs associated with growth in the administrators, health care staff, and physicians to provide direction to establish a sustainable and cost-effective U.S. health care system. Methods Data from the U.S. Bureau of Labor Statistics, particularly the Labor Force Statistics from the Current Population Survey, were utilized from 2009 to 2020. Wages and employment of medical and health service managers (administrators), health care practitioners and technical operations (health care staff), and physicians were used to calculate the total cost. Results Administrator wages have grown similarly to health care staff wages (−4.40 vs −3.01%, P = .454) and physician wages (−4.40 vs −3.29%, P = .672). Additionally, there has been a similar increase in health care staff employment (9.91 vs 14.23%, P = .269) and physician employment (9.91 vs 15.35%, P = .252) compared to administrator employment. Overall, the total growth in administrator cost is similar to the growth in total health care staff cost (6.23 vs 11.80, P = .104) and total physician cost (6.23 vs 13.02%, P = .079). In 2020, physicians had the highest employment growth but the smallest wage increase. Conclusion Although health care staff experienced a greater percent growth in employment and cost per employee than administrators since 2009, the cost per administrator remains greater than that of health care staff. Understanding differences in wages and costs is essential to reduce health care spending without compromising access, delivery, and quality of health care services.

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