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10. For any disease a human can imagine, ChatGPT can generate a fake report.

Author

Yokokawa, Daiki, Yanagita, Yasutaka, Li, Yu, Yamashita, Shiho, Shikino, Kiyoshi, Noda, Kazutaka, Tsukamoto, Tomoko, Uehara, Takanori, and Ikusaka, Masatomi

Subjects
GENERATIVE artificial intelligence, LANGUAGE models, INFORMATION technology, MEDICAL ethics, GLYCOGEN storage disease
Abstract

The article discusses the use of ChatGPT, a large language model created by OpenAI, to generate fake medical reports. The authors highlight the potential ethical concerns and challenges posed by AI-generated content in the field of healthcare. They present a case report of a fictitious disease called "Ikusaka disease" to demonstrate how easily ChatGPT can produce plausible yet medically inaccurate texts. The authors emphasize the need for improved validity and responsibility in the outputs of language models and call for high ethical standards among scientists using generative AI. They also discuss the importance of developing methods for detecting fake reports in peer review and publishing processes. [Extracted from the article]

Published
2024
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18. Frequency of Difficult Patient Encounters in a Japanese University Hospital and Community Hospitals: A Cross-sectional Study

Author

Shikino, Kiyoshi, primary, Mito, Tsutomu, additional, Ohira, Yoshiyuki, additional, Yokokawa, Daiki, additional, Katsuyama, Yota, additional, Ota, Takahiro, additional, Sato, Eri, additional, Hirose, Yuta, additional, Yamashita, Shiho, additional, Suzuki, Shingo, additional, Noda, Kazutaka, additional, Uehara, Takanori, additional, and Ikusaka, Masatomi, additional

Published
2023
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19. Hybrid PBL and Pure PBL: Which one is more effective in developing clinical reasoning skills for general medicine clerkship?—A mixed-method study

Author

Ishizuka, Kosuke, primary, Shikino, Kiyoshi, additional, Tamura, Hiroki, additional, Yokokawa, Daiki, additional, Yanagita, Yasutaka, additional, Uchida, Shun, additional, Yamauchi, Yosuke, additional, Hayashi, Yasushi, additional, Kojima, Jumpei, additional, Li, Yu, additional, Sato, Eri, additional, Yamashita, Shiho, additional, Hanazawa, Nao, additional, Tsukamoto, Tomoko, additional, Noda, Kazutaka, additional, Uehara, Takanori, additional, and Ikusaka, Masatomi, additional

Published
2023
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22. Additional file 2 of Do clinical interview transcripts generated by speech recognition software improve clinical reasoning performance in mock patient encounters? A prospective observational study

Author

Shikino, Kiyoshi, Tsukamoto, Tomoko, Noda, Kazutaka, Ohira, Yoshiyuki, Yokokawa, Daiki, Hirose, Yuta, Sato, Eri, Mito, Tsutomu, Ota, Takahiro, Katsuyama, Yota, Uehara, Takanori, and Ikusaka, Masatomi

Abstract

Additional file 2: Supplementary 2. Case list (Case A1–A4, B1–B4).

Published
2023
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29. Does scoring patient complexity using COMPRI predict the length of hospital stay? A multicentre case–control study in Japan

Author

Yokokawa, Daiki, primary, Shikino, Kiyoshi, additional, Kishi, Yasuhiro, additional, Ban, Toshiaki, additional, Miyahara, Shigeyoshi, additional, Ohira, Yoshiyuki, additional, Yanagita, Yasutaka, additional, Yamauchi, Yosuke, additional, Hayashi, Yasushi, additional, Ishizuka, Kosuke, additional, Hirose, Yuta, additional, Tsukamoto, Tomoko, additional, Noda, Kazutaka, additional, Uehara, Takanori, additional, and Ikusaka, Masatomi, additional

Published
2022
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30. Do Checklist-Induced Behavioral Changes Improve Self-Confidence in Fundoscopic Examination? A Mixed-Methods Study

Author

Yokokawa, Daiki, Shikino, Kiyoshi, Ikegami, Akiko, Tsukamoto, Tomoko, Noda, Kazutaka, Uehara, Takanori, Ohira, Yoshiyuki, and Ikusaka, Masatomi

Subjects
fundoscopic examination, self-confidence, education, International Journal of General Medicine, mixed-methods study, checklist, Original Research
Abstract

Daiki Yokokawa,1 Kiyoshi Shikino,1 Akiko Ikegami,1 Tomoko Tsukamoto,1 Kazutaka Noda,1 Takanori Uehara,1 Yoshiyuki Ohira,1,2 Masatomi Ikusaka1 1Department of General Medicine, Chiba University Hospital, Chiba, Japan; 2Department of General Medicine, International University of Health and Welfare, School of Medicine, Narita, JapanCorrespondence: Daiki YokokawaDepartment of General Medicine, Chiba University Hospital, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba 260-8677, JapanTel/Fax +81 43 224 4758Email dyokokawa6@gmail.comPurpose: Fundoscopic exams are conducted during outpatient consultations to assess intracranial disease and complications from chronic diseases. Low level of confidence in these skills which physicians have is one of the causes that implementation frequency is low. Research has not yet identified specific measures through which the healthcare system may increase the implementation of fundoscopic exams nor a qualitative process that enables physicians to gain confidence in their fundoscopic exam skills. We introduced a checklist and conducted a mixed-methods study.Methods: This study is a before-and-after study, within an embedded-experimental mixed-methods design. We sampled 15 physicians in the department of general medicine at a university hospital assigned to initial consultation. We introduced a checklist to verify whether the fundoscopic exam was implemented. Measures are implementation ratio of the fundoscopic exam to the total number of indication cases, and Visual Analog Scale (VAS) values for the confidence in procedure are measured before and after the intervention. We obtained qualitative data from interviews and used the Modified Grounded Theory Approach.Results: We observed significant increases in the implementation ratio (19.2% (29/151 cases) vs 64.8% (105/162 cases), p< 0.001) and in the VAS value for the confidence (1.89 mm vs 4.68 mm (p< 0.001)). Analysis of the interviews revealed the following. To increase the implementation, it is necessary to reduce the and , which is prevented by the checklist. The leads to a . Repeated executions result in .Conclusion: The intervention increased the implementation ratio, thereby increasing successful experiences and confidence among physicians. The growth of confidence boosted motivations to implement fundoscopic exams.Keywords: mixed-methods study, fundoscopic examination, checklist, self-confidence

Published
2020

39. Do Checklist-Induced Behavioral Changes Improve Self-Confidence in Fundoscopic Examination? A Mixed-Methods Study

Author

Yokokawa,Daiki, Shikino,Kiyoshi, Ikegami,Akiko, Tsukamoto,Tomoko, Noda,Kazutaka, Uehara,Takanori, Ohira,Yoshiyuki, Ikusaka,Masatomi, Yokokawa,Daiki, Shikino,Kiyoshi, Ikegami,Akiko, Tsukamoto,Tomoko, Noda,Kazutaka, Uehara,Takanori, Ohira,Yoshiyuki, and Ikusaka,Masatomi

Abstract

Daiki Yokokawa,1 Kiyoshi Shikino,1 Akiko Ikegami,1 Tomoko Tsukamoto,1 Kazutaka Noda,1 Takanori Uehara,1 Yoshiyuki Ohira,1,2 Masatomi Ikusaka1 1Department of General Medicine, Chiba University Hospital, Chiba, Japan; 2Department of General Medicine, International University of Health and Welfare, School of Medicine, Narita, JapanCorrespondence: Daiki YokokawaDepartment of General Medicine, Chiba University Hospital, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba 260-8677, JapanTel/Fax +81 43 224 4758Email dyokokawa6@gmail.comPurpose: Fundoscopic exams are conducted during outpatient consultations to assess intracranial disease and complications from chronic diseases. Low level of confidence in these skills which physicians have is one of the causes that implementation frequency is low. Research has not yet identified specific measures through which the healthcare system may increase the implementation of fundoscopic exams nor a qualitative process that enables physicians to gain confidence in their fundoscopic exam skills. We introduced a checklist and conducted a mixed-methods study.Methods: This study is a before-and-after study, within an embedded-experimental mixed-methods design. We sampled 15 physicians in the department of general medicine at a university hospital assigned to initial consultation. We introduced a checklist to verify whether the fundoscopic exam was implemented. Measures are implementation ratio of the fundoscopic exam to the total number of indication cases, and Visual Analog Scale (VAS) values for the confidence in procedure are measured before and after the intervention. We obtained qualitative data from interviews and used the Modified Grounded Theory Approach.Results: We observed significant increases in the implementation ratio (19.2% (29/151 cases) vs 64.8% (105/162 cases), p< 0.001) and in the VAS value for the confidence (1.89 mm vs 4.68 mm (p< 0.001)). Analysis of the interviews revealed the following. To increase the impleme

Published
2020

41. Feedback of patient survey on medication improves the management of polypharmacy: A pilot trial

Author

Hirose, Yuta, primary, Shikino, Kiyoshi, additional, Ohira, Yoshiyuki, additional, Matsuoka, Sumihide, additional, Mikami, Chihiro, additional, Tsuchiya, Hayami, additional, Yokokawa, Daiki, additional, Ikegami, Akiko, additional, Tsukamoto, Tomoko, additional, Noda, Kazutaka, additional, Uehara, Takanori, additional, and Ikusaka, Masatomi, additional

Published
2021
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43. The Clinical Key Features of Persistent Postural Perceptual Dizziness in the General Medicine Outpatient Setting: A Case Series Study of 33 Patients

Author

Ishizuka, Kosuke, primary, Shikino, Kiyoshi, additional, Yamauchi, Yosuke, additional, Yanagita, Yasutaka, additional, Yokokawa, Daiki, additional, Ikegami, Akiko, additional, Tsukamoto, Tomoko, additional, Noda, Kazutaka, additional, Uehara, Takanori, additional, and Ikusaka, Masatomi, additional

Published
2020
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45. Patient Survey on Polypharmacy in the Clinic and Its Impact on Health Professionals' Management of Polypharmacy: a Before-after Study

Author

Hirose, Yuta, primary, Shikino, Kiyoshi, additional, Ohira, Yoshiyuki, additional, Matsuoka, Sumihide, additional, Mikami, Chihiro, additional, Tsuchiya, Hayami, additional, Yokokawa, Daiki, additional, Ikegami, Akiko, additional, Tsukamoto, Tomoko, additional, Noda, Kazutaka, additional, Uehara, Takanori, additional, and Ikusaka, Masatomi, additional

Published
2020
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48. Relationship between the presence of primary care physicians and health‐related quality of life.

Author

Yokokawa, Daiki, Ohira, Yoshiyuki, Ikegami, Akiko, Shikino, Kiyoshi, Tsukamoto, Tomoko, Noda, Kazutaka, Uehara, Takanori, and Ikusaka, Masatomi

Subjects
PRIMARY care, QUALITY of life, PROPENSITY score matching, PHYSICIANS, HEALTH policy
Abstract

Background: The supply of primary care physicians is associated with better health outcomes and a lower total cost of health services. However, the effect of the presence or absence of primary care physicians on health‐related quality of life (QOL) is unknown. We comparatively investigated the health‐related QOL of ordinary citizens according to the presence or absence of a primary care physician. Methods: We conducted an observational cross‐sectional study using a propensity score analysis. A questionnaire on health‐related QOL (SF‐36v2, age, gender, presence or absence of a primary care physician, and chronic disease status) was mailed to 2200 individuals identified through stratified random sampling. We used propensity scores to compensate for covariates and analyzed three component SF‐36 summary scores and subscale scores of the "primary care physician" and "no primary care physician" groups. Results: Valid responses were received from 1095 individuals (49.8%). The "primary care physician group" comprised 653 individuals (59.6%). The physical health component scores of the "primary care physician group" were significantly lower than those of the "no primary care physician group," and the "mental health component" scores were significantly higher (p = 0.032, p = 0.009). For the subscales, scores for "vitality" and "mental health" were significantly higher in the "primary care physician group" (p = 0.014, p = 0.018). Conclusions: Patients who had a primary care physician with whom they could comfortably consult at any time had a high mental health component score, and low physical health component score in the health‐related QOL. [ABSTRACT FROM AUTHOR]

Published
2022
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49. Usefulness of a short training seminar on how to handle difficult patients in simulated education

Author

Shikino,Kiyoshi, Ito,Shoichi, Ohira,Yoshiyuki, Noda,Kazutaka, Asahina,Mayumi, and Ikusaka,Masatomi

Subjects
education, Advances in Medical Education and Practice
Abstract

Kiyoshi Shikino1,2, Shoichi Ito2,3, Yoshiyuki Ohira,1 Kazutaka Noda,1 Mayumi Asahina2,3, Masatomi Ikusaka1,21Department of General Medicine, Chiba University Hospital, Chiba, Japan; 2Health Professional Development Center, Chiba University Hospital, Chiba, Japan; 3Office of Medical Education, Chiba University Graduate School of Medicine, Chiba, JapanObjective: To evaluate a short-time simulation training seminar on how to handle difficult patients using professional simulated patients (SPs) such as actors.Participants: Sixty-three second-year residents at Chiba University Hospital between 2015 and 2017 who only attended the seminar once.Intervention: The participants were divided into small groups, each of which was assigned a supervisory doctor as facilitator. Those who were playing the doctor’s role enacted a medical interview with an SP. After the interview, the facilitator, the SP, and the observing residents participated in a debriefing while watching a recorded video of the interview.Outcome measures: Pre- and post-seminar questionnaires using a 7-point Likert scale (from 1: strongly disagree to 7: strongly agree) were used to examine the differences in “confidence in ability to handle difficult patients” and “learning motivation to handle difficult patients”. The two items examined by both pre- and post-seminar questionnaires, were analyzed by a paired t-test. The residents were also surveyed on their satisfaction with the seminar, acquisition of new knowledge, and impressions and comments (free-text answers).Results: The findings of the questionnaire showed a significant post-seminar increase in confidence (3.1±1.6 to 4.0±1.5 [p

Published
2019

50. The differential diagnosis of medical and psychogenic disease in primary care.

Author

Ishizuka, Kosuke, Shikino, Kiyoshi, Li, Yu, Yokokawa, Daiki, Tsukamoto, Tomoko, Yanagita, Yasutaka, Kojima, Jumpei, Yamashita, Shiho, Noda, Kazutaka, Uehara, Takanori, and Ikusaka, Masatomi

Subjects
DIAGNOSIS, DIFFERENTIAL diagnosis, PRIMARY care, HYPOCHONDRIA, MEDICALLY unexplained symptoms
Abstract

This article discusses the challenges of diagnosing and managing psychogenic diseases in primary care. Psychogenic diseases, such as conversion disorder and somatic symptom disorder, require a comprehensive biopsychosocial approach. The article proposes several points to differentiate medical diseases from psychogenic diseases, including the correspondence between symptoms and objective findings, the presence of a placebo effect, clear provocative or palliative factors, a progressive time course, paroxysmal or intermittent symptoms, unfamiliar but not strange expressions, and symptoms worsening during sleep or rest. The authors hope that these points will aid in distinguishing between medical and psychogenic diseases in primary care, but further research is needed to validate their effectiveness. [Extracted from the article]

Published
2024
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