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Article ; Online: Microsoft Bing outperforms five other generative artificial intelligence chatbots in the Antwerp University multiple choice medical license exam.

Morreel, Stefan / Verhoeven, Veronique / Mathysen, Danny

PLOS digital health

2024 Volume 3, Issue 2, Page(s) e0000349

Abstract: Recently developed chatbots based on large language models (further called bots) have promising features which could facilitate medical education. Several bots are freely available, but their proficiency has been insufficiently evaluated. In this study ... ...

Abstract	Recently developed chatbots based on large language models (further called bots) have promising features which could facilitate medical education. Several bots are freely available, but their proficiency has been insufficiently evaluated. In this study the authors have tested the current performance on the multiple-choice medical licensing exam of University of Antwerp (Belgium) of six widely used bots: ChatGPT (OpenAI), Bard (Google), New Bing (Microsoft), Claude instant (Anthropic), Claude+ (Anthropic) and GPT-4 (OpenAI). The primary outcome was the performance on the exam expressed as a proportion of correct answers. Secondary analyses were done for a variety of features in the exam questions: easy versus difficult questions, grammatically positive versus negative questions, and clinical vignettes versus theoretical questions. Reasoning errors and untruthful statements (hallucinations) in the bots' answers were examined. All bots passed the exam; Bing and GPT-4 (both 76% correct answers) outperformed the other bots (62-67%, p = 0.03) and students (61%). Bots performed worse on difficult questions (62%, p = 0.06), but outperformed students (32%) on those questions even more (p<0.01). Hallucinations were found in 7% of Bing's and GPT4's answers, significantly lower than Bard (22%, p<0.01) and Claude Instant (19%, p = 0.02). Although the creators of all bots try to some extent to avoid their bots being used as a medical doctor, none of the tested bots succeeded as none refused to answer all clinical case questions.Bing was able to detect weak or ambiguous exam questions. Bots could be used as a time efficient tool to improve the quality of a multiple-choice exam.
Language	English
Publishing date	2024-02-14
Publishing country	United States
Document type	Journal Article
ISSN	2767-3170
ISSN (online)	2767-3170
DOI	10.1371/journal.pdig.0000349
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Article: A scoping review on the use and usefulness of online symptom checkers and triage systems: How to proceed?

Pairon, Anthony / Philips, Hilde / Verhoeven, Veronique

Frontiers in medicine

2023 Volume 9, Page(s) 1040926

Abstract: Background: Patients are increasingly turning to the Internet for health information. Numerous online symptom checkers and digital triage tools are currently available to the general public in an effort to meet this need, simultaneously acting as a ... ...

Abstract	Background: Patients are increasingly turning to the Internet for health information. Numerous online symptom checkers and digital triage tools are currently available to the general public in an effort to meet this need, simultaneously acting as a demand management strategy to aid the overburdened health care system. The implementation of these services requires an evidence-based approach, warranting a review of the available literature on this rapidly evolving topic. Objective: This scoping review aims to provide an overview of the current state of the art and identify research gaps through an analysis of the strengths and weaknesses of the presently available literature. Methods: A systematic search strategy was formed and applied to six databases: Cochrane library, NICE, DARE, NIHR, Pubmed, and Web of Science. Data extraction was performed by two researchers according to a pre-established data charting methodology allowing for a thematic analysis of the results. Results: A total of 10,250 articles were identified, and 28 publications were found eligible for inclusion. Users of these tools are often younger, female, more highly educated and technologically literate, potentially impacting digital divide and health equity. Triage algorithms remain risk-averse, which causes challenges for their accuracy. Recent evolutions in algorithms have varying degrees of success. Results on impact are highly variable, with potential effects on demand, accessibility of care, health literacy and syndromic surveillance. Both patients and healthcare providers are generally positive about the technology and seem amenable to the advice given, but there are still improvements to be made toward a more patient-centered approach. The significant heterogeneity across studies and triage systems remains the primary challenge for the field, limiting transferability of findings. Conclusion: Current evidence included in this review is characterized by significant variability in study design and outcomes, highlighting the significant challenges for future research.An evolution toward more homogeneous methodologies, studies tailored to the intended setting, regulation and standardization of evaluations, and a patient-centered approach could benefit the field.
Language	English
Publishing date	2023-01-06
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2022.1040926
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Article ; Online: Aye, AI! ChatGPT passes multiple-choice family medicine exam.

Morreel, Stefan / Mathysen, Danny / Verhoeven, Veronique

Medical teacher

2023 Volume 45, Issue 6, Page(s) 665–666

MeSH term(s)	Humans ; Family Practice ; Artificial Intelligence
Language	English
Publishing date	2023-03-11
Publishing country	England
Document type	Letter
ZDB-ID	424426-6
ISSN	1466-187X ; 0142-159X
ISSN (online)	1466-187X
ISSN	0142-159X
DOI	10.1080/0142159X.2023.2187684
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Article ; Online: Non-Consensual Sex and Help-Seeking Behavior Among PrEP Users in Belgium: Findings from an Online Survey.

Vanbaelen, T / Rotsaert, A / Van Landeghem, E / Nöstlinger, C / Vuylsteke, B / Scheerder, G / Verhoeven, V / Reyniers, T

Journal of sex research

2023 , Page(s) 1–7

Abstract: Non-consensual sex poses a threat not only to sexual health but also to mental and physical health in general. HIV pre-exposure prophylaxis (PrEP) users might be particularly vulnerable to non-consensual sex because of interplaying factors such as mental ...

Abstract	Non-consensual sex poses a threat not only to sexual health but also to mental and physical health in general. HIV pre-exposure prophylaxis (PrEP) users might be particularly vulnerable to non-consensual sex because of interplaying factors such as mental health disorders, a high number of sex partners, engagement in chemsex, and the widespread use of dating apps. The objectives of this study were to assess the occurrence of non-consensual sex, its associated factors, and related help-seeking behavior among PrEP users. We analyzed data from an online survey among PrEP users in Belgium (09/2020-02/2022). Almost one in five participants (34/187, 18.2%) reported having ever experienced non-consensual sex. The most reported form was having sex against one's will, followed by having been given drugs against one's will, and having had sex without a condom against one's will. The vast majority of those who had experienced non-consensual sex (29/34, 85.3%) did not seek help afterward, mostly due to a lack of perceived need (21/29, 72.4%). Reported barriers to seeking help were shame (6/29, 20.7%) and lack of awareness of help services (3/29, 10.3%). Having experienced non-consensual sex in the past five years was associated with younger age and suicidal ideation in a multivariable logistic regression model. We conclude that addressing barriers to non-consensual sex help services is crucial to maximize their use and minimize the consequences of non-consensual sex experiences. PrEP consultations also represent an opportunity to offer such help given PrEP users are already familiar with these PrEP services and engaged in care.
Language	English
Publishing date	2023-07-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	220889-1
ISSN	1559-8519 ; 0022-4499
ISSN (online)	1559-8519
ISSN	0022-4499
DOI	10.1080/00224499.2023.2235330
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Article ; Online: Relationship between classic indicators of health behaviour and contraceptive choices in women in Flanders.

Van Eekert, Nina / Biegel, Naomi / De Kort, Leen / Verhoeven, Veronique / Gehrmann, Thies / Masquillier, Caroline / Ahannach, Sarah / Lebeer, Sarah

BMC women's health

2024 Volume 24, Issue 1, Page(s) 275

Abstract: Background: In this study we shed light on ongoing trends in contraceptive use in Flanders (Belgium). Building on the fundamental cause theory and social diffusion of innovation theory, we examine socio-economic gradients in contraceptive use and the ... ...

Abstract	Background: In this study we shed light on ongoing trends in contraceptive use in Flanders (Belgium). Building on the fundamental cause theory and social diffusion of innovation theory, we examine socio-economic gradients in contraceptive use and the relationship to health behaviours. Methods: Using the unique and recently collected (2020) ISALA data, we used multinomial logistic regression to model the uptake of contraceptives and its association to educational level and health behaviour (N:4316 women). Results: Higher educated women, and women with a healthy lifestyle especially, tend to use non-hormonal contraceptives or perceived lower-dosage hormonal contraceptives that are still trustworthy from a medical point of view. Moreover, we identified a potentially vulnerable group in terms of health as our results indicate that women who do not engage in preventive health behaviours are more likely to use no, or no modern, contraceptive method. Discussion: The fact that higher educated women and women with a healthy lifestyle are less likely to use hormonal contraceptive methods is in line with patient empowerment, as women no longer necessarily follow recommendations by healthcare professionals, and there is a growing demand for naturalness in Western societies. Conclusion: The results of this study can therefore be used to inform policy makers and reproductive healthcare professionals, since up-to-date understanding of women's contraceptive choices is clearly needed in order to develop effective strategies to prevent sexually transmitted infections and unplanned pregnancies, and in which women can take control over their sexuality and fertility in a comfortable and pleasurable way.
MeSH term(s)	Humans ; Female ; Adult ; Belgium ; Contraception Behavior/statistics & numerical data ; Contraception Behavior/psychology ; Health Behavior ; Young Adult ; Educational Status ; Middle Aged ; Adolescent ; Contraception/statistics & numerical data ; Contraception/methods ; Choice Behavior ; Health Knowledge, Attitudes, Practice
Language	English
Publishing date	2024-05-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2050444-5
ISSN	1472-6874 ; 1472-6874
ISSN (online)	1472-6874
ISSN	1472-6874
DOI	10.1186/s12905-024-03079-y
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Article ; Online: Efficacy of strategies to increase participation in cervical cancer screening: GPs offering self-sampling kits for HPV testing versus recommendations to have a pap smear taken - A randomised controlled trial.

Peeters, E / Cornet, K / Cammu, H / Verhoeven, V / Devroey, D / Arbyn, M

Papillomavirus research (Amsterdam, Netherlands)

2020 Volume 9, Page(s) 100194

MeSH term(s)	Adult ; Aged ; Cervical Intraepithelial Neoplasia/diagnosis ; Cervical Intraepithelial Neoplasia/prevention & control ; Early Detection of Cancer/methods ; Early Detection of Cancer/standards ; Female ; Humans ; Middle Aged ; Practice Patterns, Physicians'/standards ; Reagent Kits, Diagnostic/standards ; Self-Testing ; Specimen Handling/methods ; Specimen Handling/standards ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/prevention & control ; Vaginal Smears/methods ; Vaginal Smears/standards
Chemical Substances	Reagent Kits, Diagnostic
Language	English
Publishing date	2020-03-14
Publishing country	Netherlands
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2837553-1
ISSN	2405-8521 ; 2405-8521
ISSN (online)	2405-8521
ISSN	2405-8521
DOI	10.1016/j.pvr.2020.100194
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Article ; Online: Corrigendum to "Efficacy of strategies to increase participation in cervical cancer screening: GPs offering self-sampling kits for HPV testing versus recommendations to have a pap smear taken - A randomised controlled trial" [Papillomavirus Res. 9 (2020) 100194].

Peeters, E / Cornet, K / Cammu, H / Verhoeven, V / Devroey, D / Arbyn, M

Papillomavirus research (Amsterdam, Netherlands)

2020 Volume 9, Page(s) 100201

Language	English
Publishing date	2020-05-08
Publishing country	Netherlands
Document type	Journal Article ; Published Erratum
ZDB-ID	2837553-1
ISSN	2405-8521 ; 2405-8521
ISSN (online)	2405-8521
ISSN	2405-8521
DOI	10.1016/j.pvr.2020.100201
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Article ; Online: Organisation and characteristics of out-of-hours primary care during a COVID-19 outbreak: A real-time observational study.

Morreel, Stefan / Philips, Hilde / Verhoeven, Veronique

PloS one

2020 Volume 15, Issue 8, Page(s) e0237629

Abstract: Background: During the COVID-19 pandemic, general practitioners worldwide re-organise care in very different ways because of the lack of evidence-based protocols.: Objective: This paper describes the organisation and the characteristics of ... ...

Abstract	Background: During the COVID-19 pandemic, general practitioners worldwide re-organise care in very different ways because of the lack of evidence-based protocols. Objective: This paper describes the organisation and the characteristics of consultations in Belgian out-of-hours primary care during five weekends at the peak of a COVID-19 outbreak and compares it to a similar period in 2019. Methods: Real-time observational study using pseudonymised routine clinical data extracted out of reports from home visits, telephone- and physical consultations (iCAREdata). Nine general practice cooperatives (GPCs) participated covering a population of 1 513 523. Results: All GPCs rapidly re-organised care in order to handle the outbreak and provide a safe working environment. The average consultation rate was 222 per 100 000 citizens per weekend. These consultations were handled by telephone alone in 40% (N = 6293). A diagnosis at risk of COVID-19 was registered in 6692 (43%) consultations,. Out of 5311 physical consultations, 1460 were at risk of COVID-19 of which 443 (30%) did not receive prior telephone consultation to estimate this risk. Compared to 2019, the workload initially increased due to telephone consultations but afterwards declined drastically. The physical consultation rate declined by 45% with a marked decline in diagnoses unrelated to COVID-19. Conclusions: General practitioners can rapidly re-organise out-of-hours care to handle patient flows during a COVID-19 outbreak. Forty percent of the out-of-hours primary care contacts are handled by telephone consultations alone. We recommend to give a telephone consultation to all patients and not to rely on call takers to differentiate between infectious and regular care. The demand for physical consultations declined drastically provoking questions about patient's safety for care unrelated to COVID-19.
MeSH term(s)	Adolescent ; Adult ; After-Hours Care/organization & administration ; Aged ; Aged, 80 and over ; Belgium/epidemiology ; Betacoronavirus ; COVID-19 ; Child ; Coronavirus Infections/therapy ; Coronavirus Infections/virology ; Female ; General Practice/organization & administration ; General Practitioners ; House Calls ; Humans ; Male ; Middle Aged ; Pandemics ; Patient Safety ; Pneumonia, Viral/therapy ; Pneumonia, Viral/virology ; Primary Health Care/organization & administration ; Remote Consultation/methods ; SARS-CoV-2 ; Workload ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-08-13
Publishing country	United States
Document type	Journal Article ; Observational Study ; 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.0237629
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Article ; Online: Performance of a new guideline for telephone triage in out-of-hours services in Belgium: A pilot study using simulated patients.

Morreel, Stefan / Philips, Hilde / Colliers, Annelies / Verhoeven, Veronique

Health services management research

2020 Volume 33, Issue 4, Page(s) 166–171

Abstract: Background: Patients in Belgium needing out-of-hours care have two options: the emergency department or the general practitioner on call often organised in a general practitioner cooperative. Currently, there is no triage system in Belgium so patients ... ...

Abstract	Background: Patients in Belgium needing out-of-hours care have two options: the emergency department or the general practitioner on call often organised in a general practitioner cooperative. Currently, there is no triage system in Belgium so patients do not know where to go. Methods: Our primary objective was to examine the ability of a newly developed telephone guideline, called 1733, to adequately estimate the urgency of health problems presented by simulated patients. Ten clinical vignettes were presented to 12 operators in a simulated phone call. The operators had to assign a protocol, urgency level and resource to dispatch (ambulance, general practitioner house visit, etc.) to each case. Results: A total of 120 phone calls were analysed. The operators chose the right protocol in 69% and the correct urgency level in 35% of the cases. The proportion of under- and over-triage was 26% and 39%, respectively. There was important variation in between the operators. The sensitivity for detecting highly urgent cases was 0.42, the specificity 0.92. Conclusion: Using the new Belgian 1733 guideline for telephone triage, operators mostly chose the appropriate protocol but only chose the correct urgency in one out of three cases. In this phase of development, the studied telephone guideline is not ready for implementation.
MeSH term(s)	Adult ; After-Hours Care ; Belgium ; Emergencies ; Emergency Medical Service Communication Systems/organization & administration ; Emergency Service, Hospital ; Female ; General Practitioners ; Humans ; Male ; Patient Simulation ; Pilot Projects ; Telephone ; Triage/standards ; Triage/supply & distribution
Language	English
Publishing date	2020-05-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	645114-7
ISSN	1758-1044 ; 0951-4848
ISSN (online)	1758-1044
ISSN	0951-4848
DOI	10.1177/0951484820921809
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Article ; Online: Culturally adapted flowcharts in obstetric emergencies: a participatory action research study.

Bautista-Valarezo, Estefanía / Espinosa, María Elena / Michels, Nele R M / Hendrickx, Kristin / Verhoeven, Veronique

BMC pregnancy and childbirth

2022 Volume 22, Issue 1, Page(s) 772

Abstract: Introduction: Maternal mortality is a health problem in developing countries and is the result of several factors such as sociodemographic and economic inequalities and difficulties in accessing the health services. In addition, training strategies in ... ...

Abstract	Introduction: Maternal mortality is a health problem in developing countries and is the result of several factors such as sociodemographic and economic inequalities and difficulties in accessing the health services. In addition, training strategies in obstetric emergencies targeting the non-medical personnel such as traditional midwives are scarce. The focus of this study is to develop learning and communication bridges on the management of obstetric emergencies and on policies of patients' referral to the biomedical health system in rural areas. Methodology: A Participant Action Research (PAR) study with a mixed methods approach was set up to elaborate culturally adapted flowcharts. The project lasted approximately 3,5 years, from September 2016 to January 2021. Results: The study was conducted with 94 traditional midwives from southern Ecuador and is divided into 4 phases, namely: 1) Exploration: focus groups and interviews were conducted to document the management of obstetric emergencies through the presentation of "clinical case" scenarios in three important topics, namely: pre-eclampsia, shoulder dystocia and postpartum hemorrhage, 2) Planning: a number of reflective sessions were conducted between the researchers and the healers/midwives to elaborate flowcharts. 3) Action: the training was conducted in rooms dedicated to proficiency in the aforementioned topics and using the flowcharts, 4) Evaluation: 90% of the participants reported having used the flowcharts during the first year after the training. The most frequently used flowchart was that of pre-eclampsia for the recognition of warning signs during pregnancy control. Conclusion: This study documents common practices of pregnancy and delivery management by traditional midwives. Furthermore, cultural flowcharts were developed for and together with midwives to improve the clinical response to obstetric emergencies. The preliminary evaluation was favorable; the most frequently used flowchart concerned preeclampsia. In this process, establishing a partnership was crucial for successful intercultural collaboration.
MeSH term(s)	Emergencies ; Female ; Health Services Research ; Humans ; Midwifery/education ; Pre-Eclampsia/diagnosis ; Pre-Eclampsia/therapy ; Pregnancy ; Software Design
Language	English
Publishing date	2022-10-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2059869-5
ISSN	1471-2393 ; 1471-2393
ISSN (online)	1471-2393
ISSN	1471-2393
DOI	10.1186/s12884-022-05105-z
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