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Background & Aims: In 2018, the World Endoscopy Organization (WEO) introduced standardized methods for calculating post-colonoscopy colorectal cancer-3yr rates (PCCRC-3yr). This systematic review aimed to calculate the global PCCRC-3yr according to the WEO methodology, its change over time, and to measure the association between risk factors and PCCRC occurrences., Methods: We searched 5 databases from inception until January 2024 for PCCRC-3yr studies that strictly adhered to the WEO methodology. The overall pooled PCCRC-3yr was calculated. For risk factors and time-trend analyses, the pooled PCCRC-3yr and odds ratios (ORs) of subgroups were compared., Results: Several studies failed to adhere to the WEO methodology. Eight studies from 4 Western European and 2 Northern American countries were included, totalling 220,106 detected-colorectal cancers (CRCs) and 18,148 PCCRCs between 2002 and 2017. The pooled Western World PCCRC-3yr was 7.5% (95% confidence interval [CI], 6.4%-8.7%). The PCCRC-3yr significantly (P < .05) decreased from 7.9% (95% CI, 6.6%-9.4%) in 2006 to 6.7% (95% CI, 6.1%-7.3%) in 2012 (OR, 0.79; 95% CI, 0.72-0.87). There were significantly higher rates for people with inflammatory bowel disease (PCCRC-3yr, 29.3%; OR, 6.17; 95% CI, 4.73-8.06), prior CRC (PCCRC-3yr, 29.8%; OR, 3.03; 95% CI, 1.34-4.72), proximal CRC (PCCRC-3yr, 8.6%; OR, 1.51; 95% CI, 1.41-1.61), diverticular disease (PCCRC 3-yr, 11.6%; OR, 1.74; 95% CI, 1.37-2.10), and female sex (PCCRC-3yr, 7.9%; OR, 1.15; 95% CI, 1.11-1.20)., Conclusion: According to the WEO methodology, the Western World PCCRC-3yr was 7.5%. Reassuringly, this has decreased over time, but further work is required to identify the reasons for PCCRCs, especially in higher-risk groups. We devised a WEO methodology checklist to increase its adoption and standardise the categorization of patients in future PCCRC-3yr studies., (Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.) more...

Background: The introduction of large language models (LLMs) into clinical practice promises to improve patient education and empowerment, thereby personalizing medical care and broadening access to medical knowledge. Despite the popularity of LLMs, there is a significant gap in systematized information on their use in patient care. Therefore, this systematic review aims to synthesize current applications and limitations of LLMs in patient care., Methods: We systematically searched 5 databases for qualitative, quantitative, and mixed methods articles on LLMs in patient care published between 2022 and 2023. From 4349 initial records, 89 studies across 29 medical specialties were included. Quality assessment was performed using the Mixed Methods Appraisal Tool 2018. A data-driven convergent synthesis approach was applied for thematic syntheses of LLM applications and limitations using free line-by-line coding in Dedoose., Results: We show that most studies investigate Generative Pre-trained Transformers (GPT)-3.5 (53.2%, n = 66 of 124 different LLMs examined) and GPT-4 (26.6%, n = 33/124) in answering medical questions, followed by patient information generation, including medical text summarization or translation, and clinical documentation. Our analysis delineates two primary domains of LLM limitations: design and output. Design limitations include 6 second-order and 12 third-order codes, such as lack of medical domain optimization, data transparency, and accessibility issues, while output limitations include 9 second-order and 32 third-order codes, for example, non-reproducibility, non-comprehensiveness, incorrectness, unsafety, and bias., Conclusions: This review systematically maps LLM applications and limitations in patient care, providing a foundational framework and taxonomy for their implementation and evaluation in healthcare settings., Competing Interests: Competing interests: JNK declares consulting services for Owkin, France; DoMore Diagnostics, Norway; Panakeia, UK, and Scailyte, Basel, Switzerland; furthermore JNK holds shares in Kather Consulting, Dresden, Germany; and StratifAI GmbH, Dresden, Germany, and has received honoraria for lectures and advisory board participation by AstraZeneca, Bayer, Eisai, MSD, BMS, Roche, Pfizer and Fresenius. DT holds shares in StratifAI GmbH, Dresden, Germany and has received honoraria for lectures by Bayer. KKB reports grants from the European Union (101079894) and Wilhelm-Sander Foundation; participation on a Data Safety Monitoring Board or Advisory Board for the EU Horizon 2020 LifeChamps project (875329) and the EU IHI Project IMAGIO (101112053); speaker Fees for Canon Medical Systems Corporation and GE HealthCare. RK receives medical consultancy fees from Odin Vision. The remaining authors declare no competing interests., (© 2025. The Author(s).) more...