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Article ; Online: Comprehensiveness, Accuracy, and Readability of Exercise Recommendations Provided by an AI-Based Chatbot: Mixed Methods Study.

Zaleski, Amanda L / Berkowsky, Rachel / Craig, Kelly Jean Thomas / Pescatello, Linda S

JMIR medical education

2024 Volume 10, Page(s) e51308

Abstract: Background: Regular physical activity is critical for health and disease prevention. Yet, health care providers and patients face barriers to implement evidence-based lifestyle recommendations. The potential to augment care with the increased ... ...

Abstract	Background: Regular physical activity is critical for health and disease prevention. Yet, health care providers and patients face barriers to implement evidence-based lifestyle recommendations. The potential to augment care with the increased availability of artificial intelligence (AI) technologies is limitless; however, the suitability of AI-generated exercise recommendations has yet to be explored. Objective: The purpose of this study was to assess the comprehensiveness, accuracy, and readability of individualized exercise recommendations generated by a novel AI chatbot. Methods: A coding scheme was developed to score AI-generated exercise recommendations across ten categories informed by gold-standard exercise recommendations, including (1) health condition-specific benefits of exercise, (2) exercise preparticipation health screening, (3) frequency, (4) intensity, (5) time, (6) type, (7) volume, (8) progression, (9) special considerations, and (10) references to the primary literature. The AI chatbot was prompted to provide individualized exercise recommendations for 26 clinical populations using an open-source application programming interface. Two independent reviewers coded AI-generated content for each category and calculated comprehensiveness (%) and factual accuracy (%) on a scale of 0%-100%. Readability was assessed using the Flesch-Kincaid formula. Qualitative analysis identified and categorized themes from AI-generated output. Results: AI-generated exercise recommendations were 41.2% (107/260) comprehensive and 90.7% (146/161) accurate, with the majority (8/15, 53%) of inaccuracy related to the need for exercise preparticipation medical clearance. Average readability level of AI-generated exercise recommendations was at the college level (mean 13.7, SD 1.7), with an average Flesch reading ease score of 31.1 (SD 7.7). Several recurring themes and observations of AI-generated output included concern for liability and safety, preference for aerobic exercise, and potential bias and direct discrimination against certain age-based populations and individuals with disabilities. Conclusions: There were notable gaps in the comprehensiveness, accuracy, and readability of AI-generated exercise recommendations. Exercise and health care professionals should be aware of these limitations when using and endorsing AI-based technologies as a tool to support lifestyle change involving exercise.
MeSH term(s)	Humans ; Artificial Intelligence ; Comprehension ; Software ; Awareness ; Exercise
Language	English
Publishing date	2024-01-11
Publishing country	Canada
Document type	Journal Article
ISSN	2369-3762
ISSN (online)	2369-3762
DOI	10.2196/51308
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Comprehensiveness, Accuracy, and Readability of Exercise Recommendations Provided by an AI-Based Chatbot

Amanda L Zaleski / Rachel Berkowsky / Kelly Jean Thomas Craig / Linda S Pescatello

JMIR Medical Education, Vol 10, p e

Mixed Methods Study

2024 Volume 51308

Abstract: BackgroundRegular physical activity is critical for health and disease prevention. Yet, health care providers and patients face barriers to implement evidence-based lifestyle recommendations. The potential to augment care with the increased availability ... ...

Abstract	BackgroundRegular physical activity is critical for health and disease prevention. Yet, health care providers and patients face barriers to implement evidence-based lifestyle recommendations. The potential to augment care with the increased availability of artificial intelligence (AI) technologies is limitless; however, the suitability of AI-generated exercise recommendations has yet to be explored. ObjectiveThe purpose of this study was to assess the comprehensiveness, accuracy, and readability of individualized exercise recommendations generated by a novel AI chatbot. MethodsA coding scheme was developed to score AI-generated exercise recommendations across ten categories informed by gold-standard exercise recommendations, including (1) health condition–specific benefits of exercise, (2) exercise preparticipation health screening, (3) frequency, (4) intensity, (5) time, (6) type, (7) volume, (8) progression, (9) special considerations, and (10) references to the primary literature. The AI chatbot was prompted to provide individualized exercise recommendations for 26 clinical populations using an open-source application programming interface. Two independent reviewers coded AI-generated content for each category and calculated comprehensiveness (%) and factual accuracy (%) on a scale of 0%-100%. Readability was assessed using the Flesch-Kincaid formula. Qualitative analysis identified and categorized themes from AI-generated output. ResultsAI-generated exercise recommendations were 41.2% (107/260) comprehensive and 90.7% (146/161) accurate, with the majority (8/15, 53%) of inaccuracy related to the need for exercise preparticipation medical clearance. Average readability level of AI-generated exercise recommendations was at the college level (mean 13.7, SD 1.7), with an average Flesch reading ease score of 31.1 (SD 7.7). Several recurring themes and observations of AI-generated output included concern for liability and safety, preference for aerobic exercise, and potential bias and direct discrimination against ...
Keywords	Special aspects of education ; LC8-6691 ; Medicine (General) ; R5-920
Subject code	796
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	JMIR Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Relative Age Effects in Male Cricket: A Personal Assets Approach to Explain Immediate, Short-Term, and Long-Term Developmental Outcomes.

Kelly, Adam L / Brown, Thomas / Reed, Rob / Côté, Jean / Turnnidge, Jennifer

Sports (Basel, Switzerland)

2022 Volume 10, Issue 3

Abstract: The purpose of this study was to adopt the Personal Assets Framework (PAF) to examine the immediate, short-term, and long-term developmental outcomes associated with relative age effects (RAEs) in male cricket. As such, this study was comprised of three ... ...

Abstract	The purpose of this study was to adopt the Personal Assets Framework (PAF) to examine the immediate, short-term, and long-term developmental outcomes associated with relative age effects (RAEs) in male cricket. As such, this study was comprised of three aims: (a) examine the birth quarter (BQ) distribution of players throughout the England and Wales Cricket Board (ECB) national talent pathway (i.e., Regional U15, Regional U17, England U19, England Lions, England T20, England ODI, and England Test; n = 1800; immediate timescale), (b) explore the youth-to-senior transitions based on BQ and skill-set (i.e., batters and bowlers; short-term timescale), and (c) analyse the average number of games played at senior levels based on BQ and skill-set (i.e., long-term timescale). A chi-square goodness of fit test, Cramer’s V, odds ratios, and 95% confidence intervals were used to compare the BQ distributions of each cohort against the expected BQ distributions. In the immediate timescale, results showed that relatively older players were overrepresented throughout all the youth levels (p < 0.05, V = 0.16−0.30), whereas there were no differences at senior levels (p > 0.05, V = 0.05−0.15). In the short-term timescale, when the senior cohorts were compared to the expected BQ distributions based on the Regional U15 cohort, relatively younger players were more likely to transition from youth to senior levels (p < 0.05, V = 0.22−0.37). In the long-term timescale, relatively older batters were selected for more games (p < 0.05, V = 0.18−0.51), whereas relatively younger bowlers were selected for more games (p < 0.05, V = 0.17−0.39). Moving forward, it is important for researchers and practitioners to better understand how (bi)annual-age grouping shapes developmental outcomes in across different timescales (i.e., immediate, short-term, and long-term), as well as consider alternative grouping strategies and RAE solutions.
Language	English
Publishing date	2022-03-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2704239-X
ISSN	2075-4663 ; 2075-4663
ISSN (online)	2075-4663
ISSN	2075-4663
DOI	10.3390/sports10030039
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Article ; Online: Clinical use of artificial intelligence requires AI-capable organizations.

Novak, Laurie Lovett / Russell, Regina G / Garvey, Kim / Patel, Mehool / Thomas Craig, Kelly Jean / Snowdon, Jane / Miller, Bonnie

JAMIA open

2023 Volume 6, Issue 2, Page(s) ooad028

Abstract: Artificial intelligence-based algorithms are being widely implemented in health care, even as evidence is emerging of bias in their design, problems with implementation, and potential harm to patients. To achieve the promise of using of AI-based tools to ...

Abstract	Artificial intelligence-based algorithms are being widely implemented in health care, even as evidence is emerging of bias in their design, problems with implementation, and potential harm to patients. To achieve the promise of using of AI-based tools to improve health, healthcare organizations will need to be AI-capable, with internal and external systems functioning in tandem to ensure the safe, ethical, and effective use of AI-based tools. Ideas are starting to emerge about the organizational routines, competencies, resources, and infrastructures that will be required for safe and effective deployment of AI in health care, but there has been little empirical research. Infrastructures that provide legal and regulatory guidance for managers, clinician competencies for the safe and effective use of AI-based tools, and learner-centric resources such as clear AI documentation and local health ecosystem impact reviews can help drive continuous improvement.
Language	English
Publishing date	2023-05-03
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2574-2531
ISSN (online)	2574-2531
DOI	10.1093/jamiaopen/ooad028
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Article ; Online: Macrophage-mediated extracellular matrix remodeling controls host Staphylococcus aureus susceptibility in the skin.

Voisin, Benjamin / Nadella, Vinod / Doebel, Thomas / Goel, Shubham / Sakamoto, Keiko / Ayush, Otgonzaya / Jo, Jay-Hyun / Kelly, Michael C / Kobayashi, Tetsuro / Jiang, Jean X / Hu, Ying / Yan, Chunhua / Nagao, Keisuke

Immunity

2023 Volume 56, Issue 7, Page(s) 1561–1577.e9

Abstract: Hypodermis is the predominant site of Staphylococcus aureus infections that cause cellulitis. Given the importance of macrophages in tissue remodeling, we examined the hypodermal macrophages (HDMs) and their impact on host susceptibility to infection. ... ...

Abstract	Hypodermis is the predominant site of Staphylococcus aureus infections that cause cellulitis. Given the importance of macrophages in tissue remodeling, we examined the hypodermal macrophages (HDMs) and their impact on host susceptibility to infection. Bulk and single-cell transcriptomics uncovered HDM subsets with CCR2-dichotomy. HDM homeostasis required the fibroblast-derived growth factor CSF1, ablation of which abrogated HDMs from the hypodermal adventitia. Loss of CCR2
MeSH term(s)	Humans ; Staphylococcus aureus/physiology ; Cellulitis/metabolism ; Macrophages/metabolism ; Staphylococcal Infections ; Extracellular Matrix
Language	English
Publishing date	2023-07-03
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1217235-2
ISSN	1097-4180 ; 1074-7613
ISSN (online)	1097-4180
ISSN	1074-7613
DOI	10.1016/j.immuni.2023.06.006
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Article ; Online: Heparin-induced thrombocytopenia in end-stage renal disease: Reliability of the PF4-heparin ELISA.

Kelly, Julie / Sylvester, Katelyn W / Rimsans, Jessica / Bernier, Thomas D / Ting, Clara / Connors, Jean M

Research and practice in thrombosis and haemostasis

2021 Volume 5, Issue 5, Page(s) e12573

Abstract: Background: Diagnosing heparin-induced thrombocytopenia (HIT) in patients with end-stage renal disease (ESRD) can be difficult, as they are frequently exposed to heparin and have multiple etiologies for thrombocytopenia.: Objective: To correlate 4T ... ...

Abstract	Background: Diagnosing heparin-induced thrombocytopenia (HIT) in patients with end-stage renal disease (ESRD) can be difficult, as they are frequently exposed to heparin and have multiple etiologies for thrombocytopenia. Objective: To correlate 4T scores, IgG heparin-platelet factor 4 (PF4-heparin) ELISA results, and serotonin release assay (SRA) results in patients with ESRD. Methods: We performed a retrospective review of patients with ESRD (creatinine clearance < 15 mL/min or on renal replacement therapy [RRT]) who underwent PF4-heparin ELISA testing from October 2015 to September 2019. True-positive PF4s required an intermediate to high 4T score (≥4), a positive SRA, and receipt of treatment for a HIT diagnosis. False-positive PF4s were defined as a positive PF4 with a negative SRA, low 4T score (<4), or lack of treatment for HIT. Indeterminant cases were classified on the basis of clinical assessment by the treating team (eg, hematology or vascular medicine). Results: Of 254 patients with ESRD (92% on RRT), 29 patients (11.4%) had a positive PF4. Eleven (37.9%) had a confirmed diagnosis of HIT: 10 patients who met all of the above criteria, and one who met the 4T criteria and was treated for HIT but did not have SRA testing due to high clinical suspicion and a positive PF4 test. False-positive PF4 values occurred in 8 patients (27.5%). Of 10 (34.5%) indeterminant cases of patients with a negative SRA but intermediate to high 4T and positive PF4, only 3 patients were treated for HIT, whereas the other 7 were judged not to have HIT as assessed by the treating clinician. In patients with an intermediate to high 4T score and PF4 optical density > 0.4 but negative SRA, who were not treated for HIT, there were no adverse outcomes documented such as new or progressive thrombosis. Conclusion: In our ESRD population, 4T scores and PF4 testing were not predictive of a clinical diagnosis of HIT.
Language	English
Publishing date	2021-08-04
Publishing country	United States
Document type	Journal Article
ISSN	2475-0379
ISSN (online)	2475-0379
DOI	10.1002/rth2.12573
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Article ; Online: The Potential and the Imperative: the Gap in AI-Related Clinical Competencies and the Need to Close It.

Garvey, Kim V / Craig, Kelly Jean Thomas / Russell, Regina G / Novak, Laurie / Moore, Don / Preininger, Anita M / Jackson, Gretchen P / Miller, Bonnie M

Medical science educator

2021 Volume 31, Issue 6, Page(s) 2055–2060

Language	English
Publishing date	2021-09-09
Publishing country	United States
Document type	Editorial
ISSN	2156-8650
ISSN (online)	2156-8650
DOI	10.1007/s40670-021-01377-w
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Article ; Online: Monitoring plasma nucleosome concentrations to measure disease response and progression in dogs with hematopoietic malignancies.

Wilson-Robles, Heather / Warry, Emma / Miller, Tasha / Jarvis, Jill / Matsushita, Matthew / Miller, Pamela / Herzog, Marielle / Turatsinze, Jean-Valery / Kelly, Theresa K / Butera, S Thomas / Michel, Gaetan

PloS one

2023 Volume 18, Issue 5, Page(s) e0281796

Abstract: Background: Hematopoietic malignancies are extremely common in pet dogs and represent nearly 30% of the malignancies diagnosed in this population each year. Clinicians commonly use existing tools such as physical exam findings, radiographs, ultrasound ... ...

Abstract	Background: Hematopoietic malignancies are extremely common in pet dogs and represent nearly 30% of the malignancies diagnosed in this population each year. Clinicians commonly use existing tools such as physical exam findings, radiographs, ultrasound and baseline blood work to monitor these patients for treatment response and remission. Circulating biomarkers, such as prostate specific antigen or carcinoembryonic antigen, can be useful tools for monitoring treatment response and remission status in human cancer patients. To date, there has a been a lack of useful circulating biomarkers available to veterinary oncology patients. Methods: Circulating plasma nucleosome concentrations were evaluated at diagnosis, throughout treatment and during remission monitoring for 40 dogs with lymphoma, acute myelogenous leukemia and multiple myeloma. Additionally, C-reactive protein and thymidine kinase-1 levels were recorded. Results: Plasma nucleosome concentrations were significantly higher at diagnosis and progressive disease than they were when dogs were in remission. All but two dogs had plasma nucleosome concentrations that returned to the low range during treatment. These two dogs had the shortest progression free and overall survival times. Dogs with the highest plasma nucleosome concentrations had a significantly shorter first progression free survival than dogs with lower plasma nucleosome concentrations at diagnosis. Plasma nucleosome concentrations correlated better with disease response and progression than either thymidine kinase or C reactive protein. Conclusions: Plasma nucleosome concentrations can be a useful tool for treatment monitoring and disease progression in dogs with hematopoietic malignancies.
MeSH term(s)	Male ; Humans ; Dogs ; Animals ; Nucleosomes ; Thymidine Kinase ; Biomarkers ; Neoplasms ; Hematologic Neoplasms/veterinary ; C-Reactive Protein ; Dog Diseases/diagnosis
Chemical Substances	Nucleosomes ; Thymidine Kinase (EC 2.7.1.21) ; Biomarkers ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2023-05-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0281796
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Article ; Online: Effectiveness of Contact Tracing for Viral Disease Mitigation and Suppression: Evidence-Based Review.

Thomas Craig, Kelly Jean / Rizvi, Rubina / Willis, Van C / Kassler, William J / Jackson, Gretchen Purcell

JMIR public health and surveillance

2021 Volume 7, Issue 10, Page(s) e32468

Abstract: Background: Contact tracing in association with quarantine and isolation is an important public health tool to control outbreaks of infectious diseases. This strategy has been widely implemented during the current COVID-19 pandemic. The effectiveness of ...

Abstract	Background: Contact tracing in association with quarantine and isolation is an important public health tool to control outbreaks of infectious diseases. This strategy has been widely implemented during the current COVID-19 pandemic. The effectiveness of this nonpharmaceutical intervention is largely dependent on social interactions within the population and its combination with other interventions. Given the high transmissibility of SARS-CoV-2, short serial intervals, and asymptomatic transmission patterns, the effectiveness of contact tracing for this novel viral agent is largely unknown. Objective: This study aims to identify and synthesize evidence regarding the effectiveness of contact tracing on infectious viral disease outcomes based on prior scientific literature. Methods: An evidence-based review was conducted to identify studies from the PubMed database, including preprint medRxiv server content, related to the effectiveness of contact tracing in viral outbreaks. The search dates were from database inception to July 24, 2020. Outcomes of interest included measures of incidence, transmission, hospitalization, and mortality. Results: Out of 159 unique records retrieved, 45 (28.3%) records were reviewed at the full-text level, and 24 (15.1%) records met all inclusion criteria. The studies included utilized mathematical modeling (n=14), observational (n=8), and systematic review (n=2) approaches. Only 2 studies considered digital contact tracing. Contact tracing was mostly evaluated in combination with other nonpharmaceutical interventions and/or pharmaceutical interventions. Although some degree of effectiveness in decreasing viral disease incidence, transmission, and resulting hospitalizations and mortality was observed, these results were highly dependent on epidemic severity (R0 value), number of contacts traced (including presymptomatic and asymptomatic cases), timeliness, duration, and compliance with combined interventions (eg, isolation, quarantine, and treatment). Contact tracing effectiveness was particularly limited by logistical challenges associated with increased outbreak size and speed of infection spread. Conclusions: Timely deployment of contact tracing strategically layered with other nonpharmaceutical interventions could be an effective public health tool for mitigating and suppressing infectious outbreaks by decreasing viral disease incidence, transmission, and resulting hospitalizations and mortality.
MeSH term(s)	COVID-19/prevention & control ; Communicable Disease Control/methods ; Contact Tracing ; Humans ; Virus Diseases/prevention & control
Language	English
Publishing date	2021-10-06
Publishing country	Canada
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ISSN	2369-2960
ISSN (online)	2369-2960
DOI	10.2196/32468
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Article: Considering Clinician Competencies for the Implementation of Artificial Intelligence-Based Tools in Health Care: Findings From a Scoping Review.

Garvey, Kim V / Thomas Craig, Kelly Jean / Russell, Regina / Novak, Laurie L / Moore, Don / Miller, Bonnie M

JMIR medical informatics

2022 Volume 10, Issue 11, Page(s) e37478

Abstract: Background: The use of artificial intelligence (AI)-based tools in the care of individual patients and patient populations is rapidly expanding.: Objective: The aim of this paper is to systematically identify research on provider competencies needed ... ...

Abstract	Background: The use of artificial intelligence (AI)-based tools in the care of individual patients and patient populations is rapidly expanding. Objective: The aim of this paper is to systematically identify research on provider competencies needed for the use of AI in clinical settings. Methods: A scoping review was conducted to identify articles published between January 1, 2009, and May 1, 2020, from MEDLINE, CINAHL, and the Cochrane Library databases, using search queries for terms related to health care professionals (eg, medical, nursing, and pharmacy) and their professional development in all phases of clinical education, AI-based tools in all settings of clinical practice, and professional education domains of competencies and performance. Limits were provided for English language, studies on humans with abstracts, and settings in the United States. Results: The searches identified 3476 records, of which 4 met the inclusion criteria. These studies described the use of AI in clinical practice and measured at least one aspect of clinician competence. While many studies measured the performance of the AI-based tool, only 4 measured clinician performance in terms of the knowledge, skills, or attitudes needed to understand and effectively use the new tools being tested. These 4 articles primarily focused on the ability of AI to enhance patient care and clinical decision-making by improving information flow and display, specifically for physicians. Conclusions: While many research studies were identified that investigate the potential effectiveness of using AI technologies in health care, very few address specific competencies that are needed by clinicians to use them effectively. This highlights a critical gap.
Language	English
Publishing date	2022-11-16
Publishing country	Canada
Document type	Journal Article ; Review
ZDB-ID	2798261-0
ISSN	2291-9694
ISSN	2291-9694
DOI	10.2196/37478
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