The BMJ最新文献_第4页

Age against the machine—susceptibility of large language models to cognitive impairment: cross sectional analysis

The BMJ Pub Date : 2024-12-20 DOI: 10.1136/bmj-2024-081948

Roy Dayan, Benjamin Uliel, Gal Koplewitz

{"title":"Age against the machine—susceptibility of large language models to cognitive impairment: cross sectional analysis","authors":"Roy Dayan, Benjamin Uliel, Gal Koplewitz","doi":"10.1136/bmj-2024-081948","DOIUrl":"https://doi.org/10.1136/bmj-2024-081948","url":null,"abstract":"Objective To evaluate the cognitive abilities of the leading large language models and identify their susceptibility to cognitive impairment, using the Montreal Cognitive Assessment (MoCA) and additional tests. Design Cross sectional analysis. Setting Online interaction with large language models via text based prompts. Participants Publicly available large language models, or “chatbots”: ChatGPT versions 4 and 4o (developed by OpenAI), Claude 3.5 “Sonnet” (developed by Anthropic), and Gemini versions 1 and 1.5 (developed by Alphabet). Assessments The MoCA test (version 8.1) was administered to the leading large language models with instructions identical to those given to human patients. Scoring followed official guidelines and was evaluated by a practising neurologist. Additional assessments included the Navon figure, cookie theft picture, Poppelreuter figure, and Stroop test. Main outcome measures MoCA scores, performance in visuospatial/executive tasks, and Stroop test results. Results ChatGPT 4o achieved the highest score on the MoCA test (26/30), followed by ChatGPT 4 and Claude (25/30), with Gemini 1.0 scoring lowest (16/30). All large language models showed poor performance in visuospatial/executive tasks. Gemini models failed at the delayed recall task. Only ChatGPT 4o succeeded in the incongruent stage of the Stroop test. Conclusions With the exception of ChatGPT 4o, almost all large language models subjected to the MoCA test showed signs of mild cognitive impairment. Moreover, as in humans, age is a key determinant of cognitive decline: “older” chatbots, like older patients, tend to perform worse on the MoCA test. These findings challenge the assumption that artificial intelligence will soon replace human doctors, as the cognitive impairment evident in leading chatbots may affect their reliability in medical diagnostics and undermine patients’ confidence. No additional data available.","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142858525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dexterity assessment of hospital workers: prospective comparative study

The BMJ Pub Date : 2024-12-20 DOI: 10.1136/bmj-2024-081814

Tobin Joseph, Oliver I Brown, Sara Khalid, Marilena Giannoudi, Rebecca C Sagar, Elena Bunola-Hadfield, Stephen J Chapman, Thomas A Slater, Sam Straw, Michael Drozd

{"title":"Dexterity assessment of hospital workers: prospective comparative study","authors":"Tobin Joseph, Oliver I Brown, Sara Khalid, Marilena Giannoudi, Rebecca C Sagar, Elena Bunola-Hadfield, Stephen J Chapman, Thomas A Slater, Sam Straw, Michael Drozd","doi":"10.1136/bmj-2024-081814","DOIUrl":"https://doi.org/10.1136/bmj-2024-081814","url":null,"abstract":"Objectives To compare the manual dexterity and composure under pressure of people in different hospital staff roles using a buzz wire game. Design Prospective, observational, comparative study (Tremor study). Setting Leeds Teaching Hospitals NHS Trust, Leeds, UK, during a three week period in 2024. Participants 254 hospital staff members comprising of 60 physicians, 64 surgeons, 69 nurses, and 61 non-clinical staff. Main outcome measures Successful completion of the buzz wire game within five minutes and occurrence of swearing and audible noises of frustration. Results Of the 254 hospital staff that participated, surgeons had significantly higher success rates in completing the buzz wire game within five minutes (84%, n=54) compared with physicians (57%, n=34), nurses (54%, n=37), and non-clinical staff (51%, n=31) (P<0.001). Time-to-event analysis showed that surgeons were quicker to successfully complete the game, independent of age and gender. Surgeons exhibited the highest rate of swearing during the game (50%, n=32), followed by nurses (30%, n=21), physicians (25%, n=60), and non-clinical staff (23%, n=14) (P=0.004). Non-clinical staff showed the highest use of frustration noises (75%), followed by nurses (68%), surgeons (58%), and physicians (52%) (P=0.03). Conclusions Surgeons showed greater dexterity, but higher levels of swearing compared with other hospital staff roles, while nurses and non-clinical staff showed the highest rates of audible noises of frustration. The study highlights the diverse skill sets across hospital staff roles. Implementation of a surgical swear jar initiative should be considered for future fundraising events. The study data are available on reasonable request.","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142858253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

“Rookie factor”: why healthcare workforce policy needs to embrace experience

The BMJ Pub Date : 2024-12-20 DOI: 10.1136/bmj.q2836

Alison Leary

引用次数: 0

Peter Whaley Kershaw

The BMJ Pub Date : 2024-12-20 DOI: 10.1136/bmj.q2799

John Baird, Iain Smith

引用次数: 0

Nishi Gupta

The BMJ Pub Date : 2024-12-18 DOI: 10.1136/bmj.q2797

Hugh Jones

引用次数: 0

Good nights: optimising children’s health through bedtime stories

The BMJ Pub Date : 2024-12-18 DOI: 10.1136/bmj.q2548

Megan Thomas, Victoria Foxall, MacKayla Williams

{"title":"Good nights: optimising children’s health through bedtime stories","authors":"Megan Thomas, Victoria Foxall, MacKayla Williams","doi":"10.1136/bmj.q2548","DOIUrl":"https://doi.org/10.1136/bmj.q2548","url":null,"abstract":"Fairy tales offer opportunities to engage with children about healthy and disordered sleep, say Megan Thomas and colleagues Healthy sleep is a public health priority, with at least a third of children and adults reporting insufficient sleep.12 It is essential for children’s growth and development and optimal physical and mental wellbeing. Consistent bedtime routines, with a calming activity before bed, such as a bedtime story, can promote healthy sleep.3 Some traditional fairy tales and classic children’s fiction that have soothed many a child to sleep may also include information about the benefits of sleep and the characteristics of sleep disorders, providing accessible and engaging ways for parents or carers, healthcare providers, and educators to discuss healthy sleep with children. In perhaps the best known fairy tale about sleep, its healing and restorative powers are illustrated by Sleeping Beauty’s full recovery from a life threatening prick to her finger after a long and deep slumber. Snow White runs away from a wicked queen and lives with seven little men named by Walt Disney as Doc, Grumpy, Happy, Sleepy, Bashful, Sneezy, and Dopey. There are many different causes of short …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142858261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Leslie Bow Bartlet

The BMJ Pub Date : 2024-12-18 DOI: 10.1136/bmj.q2802

Cathy Hill, Victoria McGrigor, Josie Brown

引用次数: 0

Tedros Adhanom Ghebreyesus: peace is the best medicine

The BMJ Pub Date : 2024-12-18 DOI: 10.1136/bmj.q2629

Tedros Adhanom Ghebreyesus

{"title":"Tedros Adhanom Ghebreyesus: peace is the best medicine","authors":"Tedros Adhanom Ghebreyesus","doi":"10.1136/bmj.q2629","DOIUrl":"https://doi.org/10.1136/bmj.q2629","url":null,"abstract":"Conflict and attacks on healthcare must cease, as without peace there can be no health, writes WHO chief Tedros Adhanom Ghebreyesus War and disease are old friends. In the Napoleonic wars and the American Civil War, more soldiers died from disease than in battle. It was no coincidence that the 1918 influenza pandemic erupted during the first world war or that the final frontier for eradicating polio is in the most insecure regions of Afghanistan and Pakistan. In the Democratic Republic of the Congo, the Ebola outbreak in the relatively stable Équateur province in 2018 took just two months to control, whereas the outbreak in the insecure provinces of North Kivu and Ituri in 2020 took two years. Israel’s wars with Hamas and Hezbollah have had devastating consequences for the health of the people of both Gaza and Lebanon. At the time of writing, more than 43 000 people have been killed in Gaza, more than 10 000 are missing, and more than 102 000 are injured, at least one quarter of whom will need long term rehabilitation.1 In addition, harms to mental health can endure indefinitely. Almost all of Gaza faces severe food insecurity, and 60 000 children under 5 are estimated to have acute malnutrition.2 Every day, hundreds of women give birth in traumatic, unhygienic, and undignified conditions3; 1.2 million children need mental health and psychosocial support for depression, anxiety, and suicidal thoughts4; there are increasing reports of acute respiratory infections, acute jaundice, and diarrhoeal diseases; and a case of polio has been reported 25 years since it was last seen in Gaza.5 At the very time when Gaza’s health system needs to be supported, one of the legs on which it stands is being kicked out from underneath …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Weathering storms together: the stories behind Scandinavian support for high taxes

The BMJ Pub Date : 2024-12-18 DOI: 10.1136/bmj.q2700

Sandy Goldbeck-Wood

{"title":"Weathering storms together: the stories behind Scandinavian support for high taxes","authors":"Sandy Goldbeck-Wood","doi":"10.1136/bmj.q2700","DOIUrl":"https://doi.org/10.1136/bmj.q2700","url":null,"abstract":"Scandinavia’s high tax model thrives on shared narratives, experience, and priorities. Equality, trust, and a demand for good quality public services both create and reflect a cohesive and content society, writes Sandy Goldbeck-Wood The Scandinavian social democracies are widely admired for their world class public services, which are supported by high levels of taxation, productivity, and education, and equality of income and opportunity. In 2021, for example, Norway had a tax-to-GDP (gross domestic product) ratio of 42.2% compared with 33.5% in the UK and 24.5% in the US.12 Conversely, income inequality is notably low in Norway, which has a Gini coefficient—a measure of income distribution within a population—of just 22.7 compared with 32.6 in the UK and 39.8 in the US, where inequality approaches that in many Latin American and African countries.3 But is this egalitarianism translatable to other settings? Can other nations longing for better public services learn from this? In the Scandinavian virtuous cycle of welfare, equality, happiness, and trusted governments and institutions, it is hard to distinguish cause from effect. The fact that Scandinavians expect, and get, high quality public services “free” or with small co-payments, and baulk at paying privately for health and education, is both cause and effect of social democracy. Any lessons are likely to be complex and cultural, and perhaps contestable. The most striking aspect of Scandinavian taxation is not its top rate, which for example in Norway at 38% is not exceptionally high, but the number of people who pay this rate. The income level at which people start paying the higher rate in Norway is just 1.5 times the national average income, compared with 8.5 times in …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From friend at the bedside to health adviser to all: how hospital radio’s ambitions are expanding

The BMJ Pub Date : 2024-12-18 DOI: 10.1136/bmj.q2788

Richard Hurley

{"title":"From friend at the bedside to health adviser to all: how hospital radio’s ambitions are expanding","authors":"Richard Hurley","doi":"10.1136/bmj.q2788","DOIUrl":"https://doi.org/10.1136/bmj.q2788","url":null,"abstract":"Hospital radio is evolving from offering companionship on the wards to bringing health and wellbeing broadcasting to the community, finds Richard Hurley General practitioner (GP) Victoria Wilson presents a weekly live show on Hospital Radio Exeter after she visits the wards to take music requests and dedications. “It’s a nice way to interact with patients. Some patients want to chat but then don’t request a song,” she tells The BMJ . “But if they've enjoyed the conversation then that's equally as worthwhile.” Wilson explains: “Patients often have magazines and books, but when they’re feeling poorly, listening to something in bed, eyes closed, might take less energy yet it's still entertaining or distracting.” The Hospital Broadcasting Association supports 170 such UK stations, mostly charities, and several thousand volunteers like Wilson with the aim “to aid patient recovery and promote health and wellbeing to all listeners.” Many patients still access the radio through hospital bedside units: on average 1231 a day for 6.2 hours each across the UK in November 2024. But broken bedside units are often not replaced, and increasingly hospital radio is available on FM and DAB (digital audio broadcast), online, and through apps and smart speakers. Some patients may not have, or may struggle to use, their own device, and stations may also fundraise to distribute radios to wards. Many stations run on NHS sites—often in cupboards, given the high demand for space. Increasingly, however, stations have studios in the community, and some broadcast to GP surgeries, care homes, and the wider public, and with increasing programming …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0