Chronic Diseases and Translational Medicine最新文献

{"title":"Rapid Recognition of Carfilzomib-Induced Thrombotic Microangiopathy and Early Application of Eculizumab Successfully Rescued Two Relapsed Myeloma Patients","authors":"Zi Wang, Hua Zheng, Wei Wang, Xiaoxiao Shi, Yunpeng Wei, Chao Li, Junling Zhuang","doi":"10.1002/cdt3.70036","DOIUrl":"https://doi.org/10.1002/cdt3.70036","url":null,"abstract":"<p>Carfilzomib (CFZ) is an irreversible proteasome inhibitor currently approved for the treatment of relapsed multiple myeloma (MM). It has been implicated as a cause of thrombotic microangiopathy (TMA) and mostly occurs after two courses of chemotherapy. The incidence, risk factors, and treatment of CFZ-related TMA remain unclear. Here we describe two cases.</p><p>Carfilzomib (CFZ) is an irreversible proteasome inhibitor currently approved for the treatment of relapsed multiple myeloma (MM). It has been implicated as a cause of thrombotic microangiopathy (TMA) and mostly occurred after two courses of chemotherapy. The incidence, risk factors, and treatment of CFZ-related TMA remain unclear. Here we describe two cases.</p><p>Case 1 was a 70-year-old woman. She was diagnosed with MM in 2010, λ light chain with Durie–Salmon Stage III, international staging system (ISS)-stage I. kidney function was normal at baseline. Complete response was achieved after bortezomib-based front-line regimen (bortezomib, epirubicin, and dexamethasone, PAD) and thalidomide maintenance therapy. The first relapse occurred after 5 years, when she received thyroidectomy for papillocarcinoma. Subsequently, she underwent multiple courses of chemotherapy incorporating regimens containing bortezomib, lenalidomide and ixazomib, yielding unsatisfactory disease control. The 24-h urine λ levels fluctuated between 1000 and 2500 mg, and serum FLC-λ ranged from 350 to 500 mg/L. In pursuit of improved outcome, she was treated with a KPD regimen consisting of carfilzomib (30 mg intravenously on Days 1 and 2), pomalidomide (4 mg orally on Days 1–21), and prednisone (40 mg orally once weekly), at the age of 70 years in December 2023. Complete blood count (CBC) was in the normal range.</p><p>On the second day after first dose of CFZ and pomalidomide, she abruptly developed fatigue, dark urine, reduced urine output and fever with a peak body temperature of 38.5°C. Additionally, she experienced bilateral lower back pain and reduced urine output. She presented to the emergency room on Day 4 of chemotherapy, also exhibiting abdominal symptoms, notably nausea, vomiting, and diarrhea. Laboratory examinations revealed hemoglobin (Hb) level of 63 g/L, platelet (PLT) count of 8 × 10<sup>9</sup>/L, a significant presence of schizocytes in the peripheral blood smear, and a lactate dehydrogenase (LDH) level of 2499 U/L. The Direct Antiglobulin Test (DAT) yielded negative results. Percentage of reticulocyte was 7.3%. Serum free hemoglobin concentration was 39.6 mg/dl (reference range: 0–5 mg/dL). Her serum creatinine (SCr) sharply elevated from 60 to 510 μmol/L, and blood urea nitrogen (BUN) surged from 5.96 to 34.51 mmol/L. Urinalysis showed microscopic hematuria (200 cells/μL) and proteinuria increased from 275 mg/L before treatment to 1040 mg/L after treatment.</p><p>The patient exhibited prominent features of microangiopathic hemolytic anemia (MAHA) and acute kidney injury (AKI). Immediate single ","PeriodicalId":32096,"journal":{"name":"Chronic Diseases and Translational Medicine","volume":"12 1","pages":"63-68"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cdt3.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guide for Authors","authors":"","doi":"10.1002/cdt3.70029","DOIUrl":"https://doi.org/10.1002/cdt3.70029","url":null,"abstract":"","PeriodicalId":32096,"journal":{"name":"Chronic Diseases and Translational Medicine","volume":"11 4","pages":"323-330"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cdt3.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145652591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Associated Factors of Chronic Diseases Among Adults in Somaliland: A Multilevel Analysis From the 2020 SLHDS","authors":"Abdirahman Omer Ali,&nbsp;Yusuf Abdi Hared,&nbsp;Hodo Abdi Abdillahi,&nbsp;Muhyadin Yusuf Dahir,&nbsp;Abdisalam Mahdi Hassan,&nbsp;Md. Moyazzem Hossain","doi":"10.1002/cdt3.70027","DOIUrl":"https://doi.org/10.1002/cdt3.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic diseases represent a growing public health challenge globally, particularly in developing regions like Sub-Saharan Africa. Somaliland faces a dual burden of communicable and non-communicable diseases amidst post-conflict recovery, yet data on non-communicable disease (NCD) prevalence and determinants remain scarce. This study aimed to ascertain the prevalence and identify socio-demographic factors associated with self-reported chronic diseases among adults in Somaliland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study utilized data from the Somaliland Health and Demographic Survey (SLHDS) 2020. The final sample of 11,153 adults had a highly skewed age distribution (94.6% aged 35–44), a primary limitation of this analysis. The outcome was a self-reported physician diagnosis of any chronic disease. A multilevel mixed-effect logistic regression model was employed to identify significant determinants while adjusting for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis identified several factors associated with reporting a chronic disease. Higher odds were observed among female-headed households (adjusted odds ratio [AOR]: 1.26; 95% CI: 1.06–1.48) and divorced individuals (AOR: 1.92; 95% CI: 1.55–2.37). Conversely, lower odds were associated with higher education (AOR: 0.53; 95% CI: 0.34–0.82) and nomadic residence (AOR: 0.34; 95% CI: 0.22–0.51). Unexpectedly, lack of electricity and no savings were also associated with lower odds, likely reflecting diagnostic access bias and reverse causation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings suggest that self-reported chronic diseases are associated with specific socio-demographic vulnerabilities in Somaliland. The results should be interpreted with extreme caution and viewed as hypothesis-generating at best. Future research using objective measures and representative sampling is urgently needed to validate these associations and accurately quantify the NCD burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32096,"journal":{"name":"Chronic Diseases and Translational Medicine","volume":"11 4","pages":"306-315"},"PeriodicalIF":0.0,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cdt3.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145652502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Cultural Validation and Psychometric Properties Test of the Healthy Lifestyle Intention Scale for University Students","authors":"Outi Kähkönen,&nbsp;Janne Engblom,&nbsp;Ying Lau,&nbsp;Eliza Lai-Yi Wong,&nbsp;Cindy Yue Tian,&nbsp;Annie Wai-Ling Cheung,&nbsp;Ho Hin Henry Chan,&nbsp;Anne Oikarinen","doi":"10.1002/cdt3.70023","DOIUrl":"https://doi.org/10.1002/cdt3.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>University students are internationally recognized as a population at risk due to unhealthy lifestyle behaviors and elevated health risks. Supporting positive behavioral change requires understanding their intentions to adopt healthier habits. This study aimed to psychometrically evaluate and culturally validate the healthy lifestyle intention scale (HLIS) in three countries and regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional methodological study was conducted in 2023 among university students in Finland (<i>n</i> = 753), Singapore (<i>n</i> = 750), and Hong Kong, China (<i>n</i> = 767). The HLIS was developed based on the Adherence to Treatment of Patients with Chronic Disease Instrument. Psychometric evaluation included Spearman's <i>ρ</i>, Cronbach's <i>ɑ</i>, and both exploratory and confirmatory factor analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings from all three countries and regions indicated that Spearman's <i>ρ</i> values ranged from weak to high across the dimensions of self-readiness (0.23–0.69), family support (0.42–0.78), peer support (0.48–0.80), and social media influence (0.48–0.80). Cronbach's <i>ɑ</i> values demonstrated acceptable internal consistency (0.41–0.92). Structural validity was supported by confirmatory factor analysis. While the Finnish model suggested a need for further refinement (comparative fit index [CFI] = 0.81, root mean square error of approximation [RMSEA] = 0.11), the models for Singapore (CFI = 0.92, RMSEA = 0.07) and Hong Kong, China (CFI = 0.92, RMSEA = 0.07) showed strong fit indices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The current version of the HLIS demonstrates promising psychometric properties for assessing health-related behavioral intentions among university students in a cross-cultural context. Further validation with more diverse international samples is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32096,"journal":{"name":"Chronic Diseases and Translational Medicine","volume":"11 4","pages":"293-305"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cdt3.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145652710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gankyrin-Protein Interactions in GI Cancers: A Novel Target of New Therapeutics","authors":"Shuang Li,&nbsp;Yuky Lam,&nbsp;Aaron Muth,&nbsp;Zhe-Sheng Chen,&nbsp;Shanzhi Wang","doi":"10.1002/cdt3.70025","DOIUrl":"https://doi.org/10.1002/cdt3.70025","url":null,"abstract":"<p>Gankyrin (PSMD10) is a 25 kDa oncogenic protein and regulatory subunit of the 26S proteasome, characterized by a sevenfold ankyrin repeat domain. Gankyrin is overexpressed in various malignancies, particularly gastrointestinal (GI) cancers. Gankyrin contributes to tumorigenesis by modulating key signaling pathways and engaging in oncogenic protein–protein interactions with tumor suppressors, including p53 and Rb, thereby promoting cell proliferation, metastasis, and resistance to treatment. Recent advances have shed light on the structural basis of gankyrin's molecular interactions, its potential as a diagnostic and prognostic biomarker, and emerging therapeutic strategies. Together, targeting gankyrin represents a promising strategy for precision oncology in GI cancers.</p>","PeriodicalId":32096,"journal":{"name":"Chronic Diseases and Translational Medicine","volume":"11 4","pages":"269-278"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cdt3.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145652677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Aging Gut–Brain Axis: Effects of Dietary Polyphenols and Metal Exposure","authors":"Luqi Cao,&nbsp;Saurabh Kumar Jha,&nbsp;Neha Gupta,&nbsp;Xiang Chen,&nbsp;Renuka Soni,&nbsp;Luoxi Yuan,&nbsp;Rashi Srivastava,&nbsp;Zhe-Sheng Chen","doi":"10.1002/cdt3.70026","DOIUrl":"https://doi.org/10.1002/cdt3.70026","url":null,"abstract":"<p>Diet provides essential metals, which are required for the growth, development, and well-functioning of the body. Nonetheless, some natural and human activities add toxic heavy metals to the diet, consequently introducing them to our bodies, resulting in several disorders and death. The intestine, the metabolism and absorption site of metals, uptakes them through transporters, active processes, and passive processes. It harbors Enteric nervous system (ENS), connecting directly to central nervous system (CNS) and the micro-organisms acting as an endocrine organ, thus regulating the movement of metals into the host. Gut microbes mediate the uptake of essential metals and prohibit toxic metals. However, the imbalance in their concentration manifests into various neurodegenerative diseases via gut involving <i>Firmicutes/Bacteriodetes</i> ratio, <i>Akkermansia, Bifidobacteria, Escherichia</i>, <i>Enterococcus</i>, <i>Bacteroides,</i> and <i>Clostridium</i>. Most importantly, with population aging, the incidence of neurodegenerative disorders is rapidly flourishing, marking the need for novel theranostic approaches to overcome it. Several research have demonstrated the significance of gut microbial homeostasis and its influence on brain functions, often termed as gut–brain axis, necessary for the sustainment of overall health and well-being of the human body. This review presents the novel diagnostic potential of microbes for specific disorders and dietary metals in combination with the therapeutic approach. Furthermore, they propose its utilization as a theranostic tool to investigate the links between mentioned dietary metals and neurological illnesses via the gut.</p>","PeriodicalId":32096,"journal":{"name":"Chronic Diseases and Translational Medicine","volume":"11 4","pages":"251-268"},"PeriodicalIF":0.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cdt3.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145652678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Nicotine Metabolites and Serum Neurofilament Light Chain Levels in the General Population","authors":"Qianqian Ji,&nbsp;Erhan Tang,&nbsp;Yueting Liao,&nbsp;Jialei Yang,&nbsp;Yunzhang Wang,&nbsp;Yiqiang Zhan","doi":"10.1002/cdt3.70024","DOIUrl":"https://doi.org/10.1002/cdt3.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nicotine has been associated with cognitive functions such as memory and attention, with serum neurofilament light chain (sNfL) as a biomarker for neurological diseases such as Alzheimer's disease (AD) and multiple sclerosis (MS). However, the associations between nicotine and its metabolites and sNfL levels remain underexplored. This study aims to investigate the associations of serum and urine levels of cotinine and trans-3’-hydroxycotinine (hydroxycotinine) with sNfL levels in a broad population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Employing data from the National Health and Nutrition Examination Survey (NHANES) 2013–2014, this cross-sectional study applied multivariable linear regression models and restricted cubic splines to examine the links between cotinine, hydroxycotinine (both in serum and urine), and sNfL levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2052 participants were included in the serum analysis (mean age, 46.8 years; SD, 15.3; weighted 52.1% women) and 661 participants in the urine analysis (weighted 49.5% women). sNfL levels were positively associated with both serum and urine concentrations of cotinine and hydroxycotinine. Adjusted analyses revealed increases in sNfL levels in association with these substances, noting nonlinear associations for serum and urine cotinine and hydroxycotinine with sNfL levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings demonstrate robust positive associations between nicotine metabolites and sNfL levels and identify novel U-shaped associations at lower exposure levels. The results raise the hypothesis that very low nicotine metabolite levels may be associated with lower axonal injury markers, warranting further longitudinal and mechanistic studies to clarify causality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":32096,"journal":{"name":"Chronic Diseases and Translational Medicine","volume":"11 4","pages":"284-292"},"PeriodicalIF":0.0,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cdt3.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145652748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Insulin and Metformin Really Protective on Amyotrophic Lateral Sclerosis by Blocking the Astrocytic Cx43 Channel?","authors":"Josef Finsterer","doi":"10.1002/cdt3.70022","DOIUrl":"https://doi.org/10.1002/cdt3.70022","url":null,"abstract":"&lt;p&gt;We read with interest the article by Lehrer et al. on an in silico molecular docking and molecular dynamics simulation study with Cx43 channels, which investigated whether insulin or metformin can dock within the Cx43 channel and effectively block it, thereby reducing the risk of amyotrophic lateral sclerosis (ALS) [&lt;span&gt;1&lt;/span&gt;]. Based on data from the FDA Med Watch, it was found that the insulin heterodimer docks in the center of the Cx43 channel and effectively blocks it, and that this blockade is very stable, thereby achieving a protective effect on ALS [&lt;span&gt;1&lt;/span&gt;]. It has been found that metformin also docks in the Cx43 channel, but due to the small size of the molecule, it does not impede the passage of toxic waste products from astrocytes [&lt;span&gt;1&lt;/span&gt;]. The study is impressive, but some points should be discussed.&lt;/p&gt;&lt;p&gt;The first point is that the methods did not specify whether only patients with sporadic ALS (sALS) or also patients with familial ALS (fALS) were included in the study [&lt;span&gt;1&lt;/span&gt;]. Since the underlying pathophysiology may vary between these two groups, it must be clearly defined whether both categories or only sALS patients were included in the study.&lt;/p&gt;&lt;p&gt;The second point is that there is little evidence that sALS is mono-causally attributable to the influx of toxic substances produced by astrocytes in sALS patients. Only in SOD1 mice, an animal model for ALS, is Cx43 known to be overexpressed [&lt;span&gt;2&lt;/span&gt;]. Astrocytes from these mice exhibit enhanced gap junction coupling, increased hemichannel-mediated activity, and elevated intracellular calcium levels [&lt;span&gt;2&lt;/span&gt;]. It was also found that knocking out Cx43 in the SOD1 mouse model slowed disease progression, protected motor neurons, and improved motor neuron survival [&lt;span&gt;3&lt;/span&gt;]. There is also evidence that Cx43 expression is upregulated in postmortem tissues and cerebrospinal fluid from ALS patients [&lt;span&gt;4&lt;/span&gt;]. Cx43 is also upregulated in pluripotent stem cell-derived astrocytes from fALS and sALS patients (hiPSC), and Cx43 hemichannels are enriched in the astrocyte membrane [&lt;span&gt;3&lt;/span&gt;]. Pharmacological blockade of Cx43 channels with GAP-19 and tonabersat demonstrated neuroprotection of hiPSC and a reduction in astrocyte-mediated neuronal hyperexcitability [&lt;span&gt;3&lt;/span&gt;]. Administration of tonabersat to SOD1 mice also resulted in motor neuron protection and reduction of reactive astrocyte and microcyte gliosis [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The third point is that the quality of MedWatch data is dependent on the feeding with data by those who recognize or not recognize a causal relation between the administration of metformin or insulin. Therefore, only events that are identified as beneficial or adverse effects will enter into the database, making the quality of the entries highly dependent on the vigilance of the clinically active doctors and their willingness to report their observations. Furthermore, it is questionable that a ben","PeriodicalId":32096,"journal":{"name":"Chronic Diseases and Translational Medicine","volume":"11 4","pages":"318-319"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cdt3.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145652429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guide for Authors","authors":"","doi":"10.1002/cdt3.70021","DOIUrl":"https://doi.org/10.1002/cdt3.70021","url":null,"abstract":"","PeriodicalId":32096,"journal":{"name":"Chronic Diseases and Translational Medicine","volume":"11 3","pages":"241-248"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cdt3.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Readability of AI-Generated Patient Information on Chronic Diseases","authors":"Faheed Shafau,&nbsp;Chase Wahl","doi":"10.1002/cdt3.70020","DOIUrl":"https://doi.org/10.1002/cdt3.70020","url":null,"abstract":"&lt;p&gt;The use of artificial intelligence (AI) to generate patient information has become increasingly common in medicine. In radiology, AI has demonstrated potential in improving patient education and care [&lt;span&gt;1&lt;/span&gt;]. With the increased usage of AI and large language models (LLM) in medicine, it is important that their readability is evaluated. The Joint Commission states that the reading level of patient education material should be at or below a 5th grade reading level; thus, their outputs must meet established readability standards to support effective patient education [&lt;span&gt;2&lt;/span&gt;]. In this study, we evaluated the readability of information generated by LLMs ChatGPT, Gemini, and Copilot on chronic diseases such as diabetes, cancer, and heart disease.&lt;/p&gt;&lt;p&gt;We evaluated the readability of AI-generated responses to common patient questions about diabetes, cancer, and heart disease. Using standardized prompts, we collected 12 outputs (4 per disease) from ChatGPT, Gemini, and Copilot. Readability was assessed using three validated formulas: Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook (SMOG) Index, and Gunning Fog Index. A one-way analysis of variance (ANOVA) was performed to assess statistically significant differences in readability among the 3 LLMs for each readability formula.&lt;/p&gt;&lt;p&gt;Readability scores across the three LLMs exceeded recommended readability thresholds (Table 1). For the Flesch-Kincaid Grade Level, Gemini had the highest average score at 12.13, followed by Copilot at 11.87, and ChatGPT at 11.40. With the SMOG Index, Gemini again produced the highest score at 11.03, followed by Copilot at 10.75, and ChatGPT at 10.53. Gunning Fog also showed a consistent pattern, Gemini led with 12.97, followed by Copilot with 12.80, and ChatGPT was the lowest score with 12.10. ANOVA results showed no statistically significant differences in readability among the LLMs across the three formulas, with p-values of 0.604 for Flesch–Kincaid, 0.704 for SMOG, and 0.333 for Gunning Fog Index.&lt;/p&gt;&lt;p&gt;The scores produced by the reading level calculator correlate to the reading level associated with the text. Each LLM produced an average reading level greater than the 10th grade. Information generated by AI does not consider patient literacy levels, which can impact the care that patients receive. Systematic reviews have shown that patient education materials often fail to meet national readability recommendations, and the increased use of AI without consideration for literacy levels can further perpetuate challenges [&lt;span&gt;3&lt;/span&gt;]. These results underscore the importance of selecting AI tools that address the suggested 5th–6th-grade readability levels for health education materials.&lt;/p&gt;&lt;p&gt;While our study focused on readability metrics using validated formulas (Flesch-Kincaid, SMOG, and Gunning Fog), we acknowledge that these tools do not fully capture patient comprehension. Readability scores provide an estimate of the expected reading","PeriodicalId":32096,"journal":{"name":"Chronic Diseases and Translational Medicine","volume":"11 4","pages":"316-317"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cdt3.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145652526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}