Journal of Clinical Medicine最新文献

{"title":"The Impact of Gender-Affirming Hormone Therapy on Seizure Occurrence in Transgender and Gender-Diverse Individuals.","authors":"Camille Blackman, Diane Saab, Danielle Mayorga-Young, Danielle Sim, Fan Liang, Emily L Johnson, Bashar A Hassan","doi":"10.3390/jcm14103550","DOIUrl":"10.3390/jcm14103550","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Gender-affirming hormone therapy (GAHT) is an essential component of care for transgender and gender-diverse (TGD) individuals, yet its impact on seizure occurrence remains unclear. Given the known influence of hormonal fluctuations on seizure activity, this study evaluates whether GAHT affects seizure frequency in TGD individuals with a history of seizures. <b>Methods</b>: We conducted a retrospective cohort study of TGD individuals with a documented history of seizures who initiated GAHT between January 2002 and November 2024. Patients with inadequate follow-up, poor anti-seizure medication adherence, or concurrent feminizing GAHT (FHT) and masculinizing GAHT (MHT) use were excluded. The primary outcome was seizure occurrence before and after GAHT, subdivided into FHT vs. MHT. <b>Results</b>: Of 4391 TGD individuals, 34 met the inclusion criteria. Among 28 patients who had seizures before GAHT, 10 (35.7%) continued to have seizures after, while 18 (64.3%) did not. Seizure occurrence significantly decreased after GAHT: the proportion of individuals who experienced seizures before but not after GAHT was significantly greater than the proportion of individuals who experienced seizures after but not before GAHT (18/34, 52.9%; 6/34, 17.6%; <i>p</i> = 0.025). Among 21 patients on MHT, the proportion of patients who experienced seizures before but not after MHT was greater than the proportion of patients who experienced seizures after but not before MHT, but the difference was not statistically significant (11/21, 52.4%; 3/21, 14.3%; <i>p</i> = 0.06). FHT had no significant impact on seizure occurrence. <b>Conclusions</b>: GAHT was not associated with increased seizure occurrence in this small study. New-onset seizures occurred equally in the FHT and MHT groups, suggesting no disproportionate effect of estrogen-containing regimens. Our results suggest that GAHT might be safe in TGD individuals with epilepsy, though those with poorly controlled seizures may require closer monitoring. Further research may clarify the impact of GAHT on seizure disorders.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12111937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single Injection of Highly Concentrated Hyaluronic Acid Provides Improvement of Knee Joint Arthrokinematic Motion and Clinical Outcomes in Patients with Osteoarthritis-Non-Randomized Clinical Study.","authors":"Krzysztof Falkowski, Dawid Bączkowicz","doi":"10.3390/jcm14103557","DOIUrl":"10.3390/jcm14103557","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Intra-articularly administered hyaluronic acid (HA) products improve the mechanical properties of the synovial fluid (SF) in an osteoarthritic (OA) joint and thus improve joint motion quality. However, current diagnostic methods, used to assess the clinical effectiveness of HA-based therapy are based on subjective tools, and are unable to deliver solid data about the actual impact of this molecule on joint functioning. Consequently, the aim of this study was to objectively assess the effect of HA IA injection on joint motion quality with vibroarthrography (VAG) and the subsequent evaluation of patient clinical status. <b>Methods</b>: A total of 40 patients with knee OA and 50 healthy individuals as the control group were enrolled in this non-randomized clinical and were subjected to therapy consisting of a single IA administration of highly concentrated HA gel (Biolevox™ HA ONE). The therapy assessment included an evaluation of joint motion quality with the VAG method and a subsequent evaluation of the knee joint function using the WOMAC questionnaire for up to 60 days after the therapy. <b>Results</b>: A single IA injection of HA led to an immediate and sustained improvement of the motion quality of OA-affected synovial joints, as proven by the significant reduction in all measured vibroacoustic emissions (VMS, R4, P1, and P2). Furthermore, this was followed by a significant improvement in all WOMAC sub-scales, observed at 30 and 60 days after the therapy. <b>Conclusions</b>: The results of this study demonstrate that an IA-HA injection can improve the motion quality of OA-affected joints. Importantly, the observed improvement in joint motion quality is directly correlated with early recovery of joint function. These findings provide objective evidence that HA effectively enhances OA-affected joint biomechanics, contributing to a better understanding of the actual impact of this prevalent OA therapy on knee joint motion quality.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Landscape in the Management of Aortic Stenosis.","authors":"Peng Liu, Hanzhe Wang, Shijie Wang, Yazheng Shan, Nianguo Dong, Yin Wang","doi":"10.3390/jcm14103542","DOIUrl":"10.3390/jcm14103542","url":null,"abstract":"<p><p>Aortic stenosis (AS) poses significant risks to patient survival and quality of life. The management of AS extends beyond restoring valve function to encompass lifelong disease management. While curative treatments exist, advancements in therapeutic approaches and prosthetic valve technology continue to evolve. This review synthesizes recent developments in AS treatment modalities, prosthetic valve innovations, and their clinical implications, delineating the current therapeutic landscape.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12111815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the Incidence and Severity of NEC over the Last Decade: A Single-Center Study.","authors":"Noa Ofek Shlomai, Meshy Tayeb, Rawan Abu Omar, Smadar Eventov Friedman","doi":"10.3390/jcm14103551","DOIUrl":"10.3390/jcm14103551","url":null,"abstract":"<p><p><b>Background:</b> Necrotizing enterocolitis is the leading gastrointestinal cause of morbidity and mortality in neonatal intensive care units. Despite advancements in neonatal care, the incidence of NEC remains unchanged. This study evaluated trends in NEC incidence and severity over the past decade and identified associated risk factors in our NICU population. <b>Methods:</b> This was a retrospective cohort study comparing the prevalence and severity of NEC among VLBW infants born before 32 weeks of gestation across the following two periods: 2012-2016 and 2017-2021. Clinical data were extracted from medical records, with NEC diagnosis and grading based on the modified Bell's criteria. <b>Results:</b> A total of 299 infants were included. Those born in the later period were significantly more preterm and had lower birth weights. While the overall NEC incidence increased in the later cohort, the rate of surgical NEC was lower. Logistic regression identified hemodynamic instability requiring pressor support, late-onset sepsis, and earlier gestational age as significant risk factors for NEC. <b>Conclusions:</b> Although the incidence of NEC was higher in the later cohort, its severity was lower compared to the earlier cohort. These findings suggest that advancements in neonatal care and feeding protocols may contribute to improved outcomes. Early NEC stages may represent alternative intestinal or systemic conditions warranting further research for better diagnosis.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Immune Prognostic Index-Based Predictive Score in Advanced Non-Small Cell Lung Cancer with a Programmed Death Ligand-1 Tumor Proportion Score ≥ 50.","authors":"Ari Raphael, Ayelet Kamm Feldman, Irina Lazarev, Waleed Kian, Nir Peled, Keren Hod, Walid Shalata, Elizabeth Dudnik","doi":"10.3390/jcm14103543","DOIUrl":"10.3390/jcm14103543","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The Lung Immune Prognostic Index (LIPI) has emerged as a promising biomarker for predicting outcomes in advanced non-small cell lung cancer (aNSCLC). We assessed whether LIPI, in combination with baseline clinical characteristics, can guide first-line treatment selection between pembrolizumab (P) and pembrolizumab plus platinum-based chemotherapy (PCT) in patients with PD-L1 tumor proportion score (TPS) ≥ 50% and EGFR/ALK/ROS1 wild-type. <b>Methods:</b> A predictive score was developed using baseline clinical variables, including age, sex, smoking status, and LIPI, in a proof-of-concept cohort (n = 241). This model was then validated in an independent cohort of 409 patients. OS was compared between patients treated with P versus PCT, stratified by predictive score. <b>Results:</b> In the proof-of-concept cohort, the median OS was 18.3 months for P and 26.6 months for PCT (<i>p</i> = 0.001). In the validation cohort, the median OS was 28.0 months for P and 22.2 months for PCT (<i>p</i> = 0.062). Stratification using the predictive score showed that patients with high scores (3-5) had improved OS with PCT compared to P (31.2 vs. 25.5 months, <i>p</i> = 0.001), while those with low scores (0-2) derived similar benefits from both treatments. <b>Conclusions:</b> This LIPI-based predictive score may assist in identifying aNSCLC patients who derive greater benefit from chemo-immunotherapy over immunotherapy. Its simplicity and clinical relevance support integration into treatment decision-making, pending prospective validation.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Delayed Admission on Treatment Modality and Outcomes of Aneurysmal Subarachnoid Hemorrhage: A Prefecture-Wide, Multicenter Japanese Study.","authors":"Yuma Hosokawa, Hitoshi Fukuda, Yuki Hyohdoh, Takako Kawamura, Ken Shinno, Yongran Yanase, Masaki Yokodani, Yu Hoashi, Akihito Moriki, Koji Bando, Nobuhisa Matsushita, Fumihiro Hamada, Yu Kawanishi, Yusuke Ueba, Naoki Fukui, Noritaka Masahira, Yo Nishimoto, Tetsuya Ueba","doi":"10.3390/jcm14103537","DOIUrl":"10.3390/jcm14103537","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Aneurysmal subarachnoid hemorrhage (SAH) requires prompt treatment, yet hospital admission is occasionally delayed, and the optimal treatment strategy for such patients remains to be established. We aimed to investigate treatment modality, treatment timing, and outcomes in patients with SAH with respect to early versus delayed admission. <b>Methods</b>: A total of 1080 patients with SAH and a defined onset date were included in this prefecture-wide, multicenter, registry-based study. Baseline characteristics, late SAH complications (including vasospasm), and functional outcomes were compared between early and delayed admission groups at Day 4 or later (Day 0 = SAH onset). Additionally, the association of treatment choice (endovascular therapy or direct surgery) with treatment timing was analyzed in the delayed admission group. <b>Results</b>: Delayed admission was observed in 69 (6.4%) patients. The neurological status upon admission was significantly better in the delayed admission group, with more World Federation of Neurological Societies grades I-II (89.8% vs. 56.2% in the early admission group). Delayed admission was significantly associated with an increased incidence of symptomatic vasospasm by multivariable logistic regression analysis (odds ratio 2.51: 95% confidence interval 1.26-5.00, <i>p</i> = 0.009), while a significant difference in poor functional outcomes (modified Rankin scale 3-6) was not revealed. Although endovascular therapy use did not increase in the delayed admission group, the interval from admission to endovascular therapy was significantly shorter than that in the direct surgery group (0 [0-1] days vs. 1 [1-8] days: median [interquartile range], <i>p</i> = 0.007, Mann-Whitney U test). <b>Conclusions</b>: Delayed admission was a risk factor for symptomatic vasospasm; however, functional outcomes were not exacerbated. These results were obtained under the treatment strategy of multiple institutions, where the timing of endovascular therapy was earlier than that of direct surgery in patients with delayed admission.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT2 Inhibitors in Glomerulonephritis: Beyond Nephroprotection?","authors":"Lucia Del Vecchio, Silvia Peiti, Giulio Pucci Bella, Francesco Locatelli","doi":"10.3390/jcm14103533","DOIUrl":"10.3390/jcm14103533","url":null,"abstract":"<p><p>Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for glycaemic control in type 2 diabetes, have demonstrated substantial renal and cardiovascular protective effects across various chronic kidney diseases (CKD), including glomerulonephritis. Beyond their established haemodynamic and metabolic benefits, recent evidence points to additional mechanisms of action potentially relevant to immune-mediated kidney diseases, such as the modulation of inflammation, immunometabolism, and oxidative stress. Randomised clinical trials (DAPA-CKD and EMPA-KIDNEY) and real-world observational studies consistently show that SGLT2 inhibitors reduce proteinuria and slow estimated glomerular filtration rate (eGFR) decline in patients with glomerulonephritis, including IgA nephropathy and focal segmental glomerulosclerosis. These benefits may extend to patients with stable immunosuppression. Further data are needed in this subgroup. Importantly, SGLT2 inhibitors display a favourable safety profile, even among those with immunosuppressed status. Again, further evidence is awaited in this respect. Despite these promising findings, unanswered questions remain regarding their efficacy in nephrotic syndrome, early-stage disease, and in comparison or combination with other supportive therapies. Overall, the evolving evidence supports the inclusion of SGLT2 inhibitors as a key component of supportive therapy in glomerulonephritis, with potential benefits extending beyond proteinuria reduction.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Virtual Planning Accuracy in Bimaxillary Advancement Surgery: A Retrospective Study Introducing the Planning Accuracy Coefficient.","authors":"Paweł Piotr Grab, Michał Szałwiński, Maciej Jagielak, Jacek Rożko, Dariusz Jurkiewicz, Aldona Chloupek, Maria Sobol, Piotr Rot","doi":"10.3390/jcm14103527","DOIUrl":"10.3390/jcm14103527","url":null,"abstract":"<p><p><b>Background:</b> Bimaxillary (BiMax) advancement surgeries are one of the most frequently performed procedures in the orthognathic subspecialty of craniomaxillofacial surgery. The growing digitalization of the planning process and the shift from physical to virtual settings in procedure design have allowed, among other things, for better visualization of surgeries, improved preparation, and a more profound understanding of individual anatomy. Therefore, the question of the accuracy of performed virtual planning (VP) as well as the available methods of its evaluation arises naturally. The aim of this study was to determine the accuracy of performed BiMax advancement surgeries and propose a new planning accuracy coefficient (PAC). <b>Methods:</b> A group of 35 patients who underwent BiMax surgery were included in the study. Computed tomography (CT) of the head and neck region was performed 2 weeks preoperatively and 6 months postoperatively. Acquired Digital Imaging and Communications in Medicine (DICOM) files were used to perform a VP and a 3-dimensional (3D) cephalometry analysis using IPS CASE DESIGNER^® software, v2.5.7.1 (KLS Martin Group, Tuttlingen, Germany). Statistical significance evaluation and basic measures of central tendency and dispersion of the analyzed variables were calculated. The accuracy of the performed planning was assessed based on the mean absolute error (MAE) between the planned and achieved cephalometric data variables. Additional assessment was performed based on the proposed PAC. <b>Results:</b> VP was found to be accurate in terms of cephalometric data assessing the height of the maxilla and mandible, the inclination of the occlusal plane, the position of the jaws in relation to the skull base, as well as overjet and overbite. There was a discrepancy in results between the classic and proposed methods of accuracy assessment in the case of several of the evaluated variables. <b>Conclusions:</b> The accuracy of the VP of BiMax advancement surgeries can be evaluated based on 3D cephalometry, and it is accurate in the assessment of the previously mentioned variables. There is a need for further analysis and potential development of the proposed PAC; however, the data obtained based on PAC are promising, and by taking into account the magnitude of planned movements, it can facilitate a fair comparison of results presented in different studies based on various assessment methods.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Limits of Conventional Coagulation Tests: A Comprehensive Overview of ACLF-Related Coagulopathies.","authors":"Dominika Kurpiewska, Artur Kośnik, Krzysztof Bieliński, Joanna Raszeja-Wyszomirska","doi":"10.3390/jcm14103539","DOIUrl":"10.3390/jcm14103539","url":null,"abstract":"<p><p>Acute-on-chronic liver failure (ACLF) is a complex and severe condition marked by multiple organ failure and high short-term mortality. Coagulopathy, a key component of ACLF, is characterized by rebalanced hemostasis with both hypo- and hypercoagulable features, increasing the risk of bleeding and thrombosis. Conventional coagulation tests, including prothrombin time (PT) and platelet count, fail to fully capture the complexity of coagulation dysfunction in ACLF. Advanced diagnostic tools, like viscoelastic tests (VETs), offer a more comprehensive assessment, yet they remain limited in evaluating endothelial dysfunction and fail to account for reduced levels of anticoagulant factors. Emerging therapeutic strategies targeting coagulopathies in ACLF hold promise, but their clinical efficacy remains unclear. A more nuanced approach to diagnosing and managing coagulopathy in ACLF is needed, incorporating advanced hemostatic profiling to better inform prognosis and guide treatment decisions.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Artificial Intelligence (ChatGPT-4o) in Supporting Tumor Board Decisions.","authors":"Berkan Karabuğa, Cengiz Karaçin, Mustafa Büyükkör, Doğan Bayram, Ergin Aydemir, Osman Bilge Kaya, Mehmet Emin Yılmaz, Elif Sertesen Çamöz, Yakup Ergün","doi":"10.3390/jcm14103535","DOIUrl":"10.3390/jcm14103535","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Artificial intelligence (AI) has emerged as a promising field in the era of personalized oncology due to its potential to save time and workforce while serving as a supportive tool in patient management decisions. Although several studies in the literature have explored the integration of AI into oncology practice across different tumor types, available data remain limited. In our study, we aimed to evaluate the role of AI in the management of complex cancer cases by comparing the decisions of an in-house tumor board and ChatGPT-4o for patients with various tumor types. <b>Methods:</b> A total of 102 patients with diverse cancer types were included. Treatment and follow-up decisions proposed by both the tumor board and ChatGPT-4o were independently evaluated by two medical oncologists using a 5-point Likert scale. <b>Results:</b> Analysis of agreement levels showed high inter-rater reliability (κ = 0.722, <i>p</i> < 0.001 for tumor board decisions; κ = 0.794, <i>p</i> < 0.001 for ChatGPT decisions). However, concordance between the tumor board and ChatGPT was low, as reflected in the assessments of both raters (Rater 1: κ = 0.211, <i>p</i> = 0.003; Rater 2: κ = 0.376, <i>p</i> < 0.001). Both raters more frequently agreed with the tumor board decisions, and a statistically significant difference between tumor board and AI decisions was observed for both (Rater 1: Z = +4.548, <i>p</i> < 0.001; Rater 2: Z = +3.990, <i>p</i> < 0.001). <b>Conclusions:</b> These findings suggest that AI, in its current form, is not yet capable of functioning as a standalone decision-maker in the management of challenging oncology cases. Clinical experience and expert judgment remain the most critical factors in guiding patient care.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 10","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}