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Article ; Online: Personalized Care in Eye Health

Mantapond Ittarat / Wisit Cheungpasitporn / Sunee Chansangpetch

Journal of Personalized Medicine, Vol 13, Iss 12, p

Exploring Opportunities, Challenges, and the Road Ahead for Chatbots

2023 Volume 1679

Abstract: In modern eye care, the adoption of ophthalmology chatbots stands out as a pivotal technological progression. These digital assistants present numerous benefits, such as better access to vital information, heightened patient interaction, and streamlined ... ...

Abstract	In modern eye care, the adoption of ophthalmology chatbots stands out as a pivotal technological progression. These digital assistants present numerous benefits, such as better access to vital information, heightened patient interaction, and streamlined triaging. Recent evaluations have highlighted their performance in both the triage of ophthalmology conditions and ophthalmology knowledge assessment, underscoring their potential and areas for improvement. However, assimilating these chatbots into the prevailing healthcare infrastructures brings challenges. These encompass ethical dilemmas, legal compliance, seamless integration with electronic health records (EHR), and fostering effective dialogue with medical professionals. Addressing these challenges necessitates the creation of bespoke standards and protocols for ophthalmology chatbots. The horizon for these chatbots is illuminated by advancements and anticipated innovations, poised to redefine the delivery of eye care. The synergy of artificial intelligence (AI) and machine learning (ML) with chatbots amplifies their diagnostic prowess. Additionally, their capability to adapt linguistically and culturally ensures they can cater to a global patient demographic. In this article, we explore in detail the utilization of chatbots in ophthalmology, examining their accuracy, reliability, data protection, security, transparency, potential algorithmic biases, and ethical considerations. We provide a comprehensive review of their roles in the triage of ophthalmology conditions and knowledge assessment, emphasizing their significance and future potential in the field.
Keywords	ophthalmology ; artificial intelligence ; machine learning ; language processing ; large language models ; chatbot ; Medicine ; R
Subject code	170
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Recent Advances in Understanding of Cardiovascular Diseases in Patients with Chronic Kidney Disease

Pajaree Krisanapan / Pattharawin Pattharanitima / Charat Thongprayoon / Wisit Cheungpasitporn

Journal of Clinical Medicine, Vol 11, Iss 16, p

2022 Volume 4653

Abstract: Chronic kidney disease (CKD) is a major public health problem, affecting between 8% and 16% of the population worldwide [.] ...

Abstract	Chronic kidney disease (CKD) is a major public health problem, affecting between 8% and 16% of the population worldwide [.]
Keywords	n/a ; Medicine ; R
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Innovating Personalized Nephrology Care

Jing Miao / Charat Thongprayoon / Supawadee Suppadungsuk / Oscar A. Garcia Valencia / Fawad Qureshi / Wisit Cheungpasitporn

Journal of Personalized Medicine, Vol 13, Iss 12, p

Exploring the Potential Utilization of ChatGPT

2023 Volume 1681

Abstract: The rapid advancement of artificial intelligence (AI) technologies, particularly machine learning, has brought substantial progress to the field of nephrology, enabling significant improvements in the management of kidney diseases. ChatGPT, a ... ...

Abstract	The rapid advancement of artificial intelligence (AI) technologies, particularly machine learning, has brought substantial progress to the field of nephrology, enabling significant improvements in the management of kidney diseases. ChatGPT, a revolutionary language model developed by OpenAI, is a versatile AI model designed to engage in meaningful and informative conversations. Its applications in healthcare have been notable, with demonstrated proficiency in various medical knowledge assessments. However, ChatGPT’s performance varies across different medical subfields, posing challenges in nephrology-related queries. At present, comprehensive reviews regarding ChatGPT’s potential applications in nephrology remain lacking despite the surge of interest in its role in various domains. This article seeks to fill this gap by presenting an overview of the integration of ChatGPT in nephrology. It discusses the potential benefits of ChatGPT in nephrology, encompassing dataset management, diagnostics, treatment planning, and patient communication and education, as well as medical research and education. It also explores ethical and legal concerns regarding the utilization of AI in medical practice. The continuous development of AI models like ChatGPT holds promise for the healthcare realm but also underscores the necessity of thorough evaluation and validation before implementing AI in real-world medical scenarios. This review serves as a valuable resource for nephrologists and healthcare professionals interested in fully utilizing the potential of AI in innovating personalized nephrology care.
Keywords	artificial intelligence ; chatbot ; ChatGPT ; nephrology ; kidney disease ; application ; Medicine ; R
Subject code	650
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Equity or Equality? Which Approach Brings More Satisfaction in a Kidney-Exchange Chain?

Arian Hosseinzadeh / Mehdi Najafi / Wisit Cheungpasitporn / Charat Thongprayoon / Mahdi Fathi

Journal of Personalized Medicine, Vol 11, Iss 1383, p

2021 Volume 1383

Abstract: In United States (U.S.), government-funded organizations, such as NLDAC, reimburse travel and subsistence expenses incurred during living-organ donation process. However, in Iran, there is a non-governmental organization called Iranian Kidney Foundation ( ...

Abstract	In United States (U.S.), government-funded organizations, such as NLDAC, reimburse travel and subsistence expenses incurred during living-organ donation process. However, in Iran, there is a non-governmental organization called Iranian Kidney Foundation (IKF) that funds the direct and indirect costs of donors through charitable donations and contributions from participants in the exchange program. In this article, for countries outside the U.S. that currently use an equality approach, we propose a potential new compensation-apportionment approach (equitable approach) for kidney-exchange chains and compare it with the currently available system (equality approach) in terms of the apportionment of compensation in a kidney-exchange chain to cover the expenses incurred by the initiating living donor of the chain in the act of donation. To this end, we propose a mechanism to apportion compensation among all participating pairs based on the equity approach by utilizing a prediction model to calculate the probability of graft survival in each transplant operation. These probabilities are then used to define the utility of any transplantation, considering the quality of each pair’s donated and received kidney in the chain. Afterward, the corresponding cost is apportioned by a mechanism based on the normalized differences between the utility of donated and received kidneys for each incompatible pair of the chain. In summary, we demonstrate that by utilizing the equitable approach, there is more fairness and equity in the allocation of resources in organ-procurement systems, which results in more satisfaction among incompatible pairs. Additional future prospective studies are needed to assess this proposed equitable approach for kidney-exchange chains in countries outside the U.S., such as Iran, that currently use an equality approach.
Keywords	kidney exchange ; kidney chain donation ; equity ; graft survival prediction ; financial neutrality ; Medicine ; R
Language	English
Publishing date	2021-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Beckwith–Wiedemann syndrome and recurrent bilateral renal calculi

Wisit Cheungpasitporn / Stephen B Erickson

Urology Annals, Vol 9, Iss 1, Pp 113-

2017 Volume 114

Keywords	Diseases of the genitourinary system. Urology ; RC870-923 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
Language	English
Publishing date	2017-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Distinct Subtypes of Hepatorenal Syndrome and Associated Outcomes as Identified by Machine Learning Consensus Clustering

Supawit Tangpanithandee / Charat Thongprayoon / Pajaree Krisanapan / Michael A. Mao / Wisit Kaewput / Pattharawin Pattharanitima / Boonphiphop Boonpheng / Wisit Cheungpasitporn

Diseases, Vol 11, Iss 18, p

2023 Volume 18

Abstract: Background: The utilization of multi-dimensional patient data to subtype hepatorenal syndrome (HRS) can individualize patient care. Machine learning (ML) consensus clustering may identify HRS subgroups with unique clinical profiles. In this study, we aim ...

Abstract	Background: The utilization of multi-dimensional patient data to subtype hepatorenal syndrome (HRS) can individualize patient care. Machine learning (ML) consensus clustering may identify HRS subgroups with unique clinical profiles. In this study, we aim to identify clinically meaningful clusters of hospitalized patients for HRS using an unsupervised ML clustering approach. Methods: Consensus clustering analysis was performed based on patient characteristics in 5564 patients primarily admitted for HRS in the National Inpatient Sample from 2003–2014 to identify clinically distinct HRS subgroups. We applied standardized mean difference to evaluate key subgroup features, and compared in-hospital mortality between assigned clusters. Results: The algorithm revealed four best distinct HRS subgroups based on patient characteristics. Cluster 1 patients (n = 1617) were older, and more likely to have non-alcoholic fatty liver disease, cardiovascular comorbidities, hypertension, and diabetes. Cluster 2 patients (n = 1577) were younger and more likely to have hepatitis C, and less likely to have acute liver failure. Cluster 3 patients (n = 642) were younger, and more likely to have non-elective admission, acetaminophen overdose, acute liver failure, to develop in-hospital medical complications and organ system failure, and to require supporting therapies, including renal replacement therapy, and mechanical ventilation. Cluster 4 patients (n = 1728) were younger, and more likely to have alcoholic cirrhosis and to smoke. Thirty-three percent of patients died in hospital. In-hospital mortality was higher in cluster 1 (OR 1.53; 95% CI 1.31–1.79) and cluster 3 (OR 7.03; 95% CI 5.73–8.62), compared to cluster 2, while cluster 4 had comparable in-hospital mortality (OR 1.13; 95% CI 0.97–1.32). Conclusions: Consensus clustering analysis provides the pattern of clinical characteristics and clinically distinct HRS phenotypes with different outcomes.
Keywords	acute kidney injury ; AKI ; cirrhosis ; clustering ; hepatorenal syndrome ; HRS ; Medicine ; R
Subject code	610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Enhancing Kidney Transplant Care through the Integration of Chatbot

Oscar A. Garcia Valencia / Charat Thongprayoon / Caroline C. Jadlowiec / Shennen A. Mao / Jing Miao / Wisit Cheungpasitporn

Healthcare, Vol 11, Iss 2518, p

2023 Volume 2518

Abstract: Kidney transplantation is a critical treatment option for end-stage kidney disease patients, offering improved quality of life and increased survival rates. However, the complexities of kidney transplant care necessitate continuous advancements in ... ...

Abstract	Kidney transplantation is a critical treatment option for end-stage kidney disease patients, offering improved quality of life and increased survival rates. However, the complexities of kidney transplant care necessitate continuous advancements in decision making, patient communication, and operational efficiency. This article explores the potential integration of a sophisticated chatbot, an AI-powered conversational agent, to enhance kidney transplant practice and potentially improve patient outcomes. Chatbots and generative AI have shown promising applications in various domains, including healthcare, by simulating human-like interactions and generating contextually appropriate responses. Noteworthy AI models like ChatGPT by OpenAI, BingChat by Microsoft, and Bard AI by Google exhibit significant potential in supporting evidence-based research and healthcare decision making. The integration of chatbots in kidney transplant care may offer transformative possibilities. As a clinical decision support tool, it could provide healthcare professionals with real-time access to medical literature and guidelines, potentially enabling informed decision making and improved knowledge dissemination. Additionally, the chatbot has the potential to facilitate patient education by offering personalized and understandable information, addressing queries, and providing guidance on post-transplant care. Furthermore, under clinician or transplant pharmacist supervision, it has the potential to support post-transplant care and medication management by analyzing patient data, which may lead to tailored recommendations on dosages, monitoring schedules, and potential drug interactions. However, to fully ascertain its effectiveness and safety in these roles, further studies and validation are required. Its integration with existing clinical decision support systems may enhance risk stratification and treatment planning, contributing to more informed and efficient decision making in kidney transplant care. Given the importance of ethical ...
Keywords	kidney transplantation ; end-stage kidney disease ; patient outcomes ; AI-powered chatbot ; decision making ; patient communication ; Medicine ; R
Subject code	650
Language	English
Publishing date	2023-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A network meta-analysis and systematic review of change in QRS duration after left bundle branch pacing, His bundle pacing, biventricular pacing, or right ventricular pacing in patients requiring permanent pacemaker

Nithi Tokavanich / Narut Prasitlumkum / Wimwipa Mongkonsritragoon / Wisit Cheungpasitporn / Charat Thongprayoon / Saraschandra Vallabhajosyula / Ronpichai Chokesuwattanaskul

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 8

Abstract: Abstract Cardiac dyssynchrony is the proposed mechanism for pacemaker-induced cardiomyopathy, which can be prevented by biventricular pacing. Left bundle branch pacing and His bundle pacing are novel interventions that imitate the natural conduction of ... ...

Abstract	Abstract Cardiac dyssynchrony is the proposed mechanism for pacemaker-induced cardiomyopathy, which can be prevented by biventricular pacing. Left bundle branch pacing and His bundle pacing are novel interventions that imitate the natural conduction of the heart with, theoretically, less interventricular dyssynchrony. One of the surrogate markers of interventricular synchrony is QRS duration. Our study aimed to compare the change of QRS duration before and after implantation between types of cardiac implantable electronic devices (CIEDs): left bundle branch pacing versus His bundle pacing versus biventricular pacing and conventional right ventricular pacing. A literature search for studies that reported an interval change of QRS duration after CIED implantation was conducted utilizing the MEDLINE, EMBASE, and Cochrane databases. All relevant works from database inception through November 2020 were included in this analysis. A random-effects model, Bayesian network meta-analysis was used to analyze QRS duration changes (eg, electrical cardiac synchronization) across different CIED implantations. The mean study sample size, from 14 included studies, was 185 subjects. The search found 707 articles. After exclusions, 14 articles remained with 2,054 patients. The His bundle pacing intervention resulted in the most dramatic decline in QRS duration (mean difference, − 53 ms; 95% CI − 67, − 39), followed by left bundle branch pacing (mean difference, − 46 ms; 95% CI − 60, − 33), and biventricular pacing (mean difference, − 19 ms; 95% CI − 37, − 1.8), when compared to conventional right ventricle apical pacing. When compared between LBBP and HBP, showed no statistically significant wider QRS duration in LBBP with mean different 6.5 ms. (95% CI − 6.7, 21). Our network meta-analysis found that physiologic pacing has the greatest effect on QRS duration after implantation. Thus, HBP and LBBP showed no significant difference between QRS duration after implantation. Physiologic pacing interventions result in improved ...
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Role of Ranolazine in the Prevention and Treatment of Atrial Fibrillation in Patients with Left Ventricular Systolic Dysfunction

Pattranee Leelapatana / Charat Thongprayoon / Narut Prasitlumkum / Saraschandra Vallabhajosyula / Wisit Cheungpasitporn / Ronpichai Chokesuwattanaskul

Diseases, Vol 9, Iss 31, p

A Meta-Analysis of Randomized Clinical Trials

2021 Volume 31

Abstract: Background: Ranolazine has the potential to prevent atrial fibrillation (AF) and plays a role in rhythm control strategy for atrial fibrillation in various clinical settings. However, data on the use of ranolazine in patients with left ventricular (LV) ... ...

Abstract	Background: Ranolazine has the potential to prevent atrial fibrillation (AF) and plays a role in rhythm control strategy for atrial fibrillation in various clinical settings. However, data on the use of ranolazine in patients with left ventricular (LV) systolic dysfunction are limited. The aims of this meta-analysis of randomized clinical trials are to investigate the efficacy and safety of ranolazine in AF patients with LV systolic dysfunction. PubMed and the Cochrane Database of Systematic Reviews were searched until July 2020. The efficacy outcomes included the incidence of new-onset AF, the rate of sinus rhythm restoration, and the time until sinus rhythm restoration. Safety endpoints were at death, and any adverse events were reported in the enrolled studies. We initially identified 204 studies and finally retrieved 5 RCTs. Three studies were analyzed in the meta-analysis. Among AF patients with LV systolic dysfunction, our meta-analysis showed that the combination of ranolazine to amiodarone significantly increased the sinus rhythm restoration rate compared to amiodarone alone (risk ratio (RR) 2.87, 95% confidence interval (CI) 2.48–3.32). Moreover, the time to sinus rhythm restoration was 2.46 h shorter in the ranolazine added to amiodarone group (95% CI: 2.27–2.64). No significant adverse events and proarrhythmias in the ranolazine group were identified. In conclusion, in AF patients with LV systolic dysfunction, ranolazine as an add-on therapy to amiodarone potentiates and accelerates the conversion of AF to sinus rhythm. Moreover, ranolazine shows good safety profiles. Further studies to investigate the effectiveness of ranolazine in the prevention of new-onset AF among patients with LV systolic dysfunction are needed.
Keywords	atrial fibrillation ; ranolazine ; systolic dysfunction ; heart failure ; meta-analysis ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Body Mass Index and In-Hospital Management and Outcomes of Acute Myocardial Infarction

Sri Harsha Patlolla / Gayathri Gurumurthy / Pranathi R. Sundaragiri / Wisit Cheungpasitporn / Saraschandra Vallabhajosyula

Medicina, Vol 57, Iss 926, p

2021 Volume 926

Abstract: Background and Objectives : Contemporary data on the prevalence, management and outcomes of acute myocardial infarction (AMI) in relation to body mass index (BMI) are limited. Materials and Methods : Using the National Inpatient Sample from 2008 through ... ...

Abstract	Background and Objectives : Contemporary data on the prevalence, management and outcomes of acute myocardial infarction (AMI) in relation to body mass index (BMI) are limited. Materials and Methods : Using the National Inpatient Sample from 2008 through 2017, we identified adult AMI hospitalizations and categorized them into underweight (BMI < 19.9 kg/m 2 ), normal BMI and overweight/obese (BMI > 24.9 kg/m 2 ) groups. We evaluated in-hospital mortality, utilization of cardiac procedures and resource utilization among these groups. Results : Among 6,089,979 admissions for AMI, 38,070 (0.6%) were underweight, 5,094,721 (83.7%) had normal BMI, and 957,188 (15.7%) were overweight or obese. Over the study period, an increase in the prevalence of AMI was observed in underweight and overweight/obese admissions. Underweight AMI admissions were, on average, older, with higher comorbidity, whereas overweight/obese admissions were younger and had lower comorbidity. In comparison to the normal BMI and overweight/obese categories, significantly lower use of coronary angiography (62.3% vs. 74.6% vs. 37.9%) and PCI (40.8% vs. 47.7% vs. 19.6%) was observed in underweight admissions (all p < 0.001). The underweight category was associated with significantly higher in-hospital mortality (10.0% vs. 5.5%; OR 1.23 (95% CI 1.18–1.27), p < 0.001), whereas being overweight/obese was associated with significantly lower in-hospital mortality compared to normal BMI admissions (3.1% vs. 5.5%; OR 0.73 (95% CI 0.72–0.74), p < 0.001). Underweight AMI admissions had longer lengths of in-hospital stay with frequent discharges to skilled nursing facilities, while overweight/obese admissions had higher hospitalization costs. Conclusions : In-hospital management and outcomes of AMI vary by BMI. Underweight status was associated with worse outcomes, whereas the obesity paradox was apparent, with better outcomes for overweight/obese admissions.
Keywords	acute myocardial infarction ; obesity ; cardiovascular risk factors ; outcomes research ; underweight ; Medicine (General) ; R5-920
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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