Journal of the Chinese Medical Association : JCMA最新文献

{"title":"High muscle-to-fat ratio predicts slow muscle strength decline in middle-aged and older adults: Longitudinal aging study of Taipei.","authors":"Ching-Jen Chang, Ming-Hsien Lin, Liang-Yu Chen, Sung-Hua Tseng, An-Chun Hwang, Chung-Yu Huang, Ko-Han Yen, Liang-Kung Chen, Li-Ning Peng","doi":"10.1097/JCMA.0000000000001229","DOIUrl":"10.1097/JCMA.0000000000001229","url":null,"abstract":"<p><strong>Background: </strong>Handgrip strength is a vital marker of muscle function and predictor of health outcomes in older adults. This study investigated the relationship between the muscle-to-fat ratio and 3-year decrease in handgrip strength in community-dwelling adults aged ≥50 years.</p><p><strong>Methods: </strong>Data were obtained from the Longitudinal Aging Study of Taipei (LAST), a cohort study of adults aged 50 years and older. Measurements from two waves, 3 years apart, were analyzed. Demographics, laboratory data, and handgrip strength data were collected. Appendicular skeletal muscle mass was assessed using bioimpedance analysis, and the relative appendicular skeletal muscle mass index was calculated by dividing appendicular muscle mass by height squared. The muscle-to-fat ratio was derived by dividing appendicular muscle mass by total body fat. Handgrip strength decrease was divided into quartiles; slow decliners experienced the smallest decrease, whereas rapid decliners had the greatest decrease. Associations between the muscle-to-fat ratio and other risk factors were analyzed.</p><p><strong>Results: </strong>Over 3 years, the Charlson Comorbidity Index, medication use, waist-to-hip ratio, and fat percentage increased, whereas skeletal muscle mass, the muscle-to-fat ratio, and handgrip strength decreased. Rapid decliners were less likely to be male (21.6% vs 33.3%, p = 0.008) or alcohol drinkers (53.8% vs 66.2%, p = 0.01) and had lower skeletal muscle mass (6.3 ± 0.9 vs 6.6 ± 1.0, p = 0.006) and muscle-to-fat ratios (1.0 ± 0.4 vs 1.1 ± 0.5, p = 0.004) but greater fat percentages (30.4 ± 6.6 vs 29.0 ± 7.6, p = 0.045). A greater muscle-to-fat ratio (odds ratio [OR] = 3.751, p = 0.047), greater physical activity (OR = 1.694, p = 0.04), and lower glycated hemoglobin (HbA1c; OR = 0.61, p = 0.008) reduced the risk of rapid decline.</p><p><strong>Conclusion: </strong>The muscle-to-fat ratio, together with physical activity and glycemic control, predicts a decrease in handgrip strength, highlighting its potential as a biomarker of intrinsic capacity and muscle-fat interplay. Further research is needed to explore the underlying biological mechanisms involved.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"367-374"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702505","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}

{"title":"Effectiveness of multiple mnemonic strategies for improving verbal memory in older adults.","authors":"Yu-Ruei Lin, Yu-Hsiang Cheng, Dai-Wei Lin, Yu-Chen Chuang, Hsiu-Ling Huang, Yann-Ying Hsiao, Chieh-Ning Huang, Ting-Jung Hsu, Jong-Ling Fuh","doi":"10.1097/JCMA.0000000000001228","DOIUrl":"10.1097/JCMA.0000000000001228","url":null,"abstract":"<p><strong>Background: </strong>Cognitive training is an evidence-based intervention for preserving memory in older adults. The effectiveness of cognitive training varies, depending on the approach used. This study examined the efficiency of cognitive training using multiple mnemonic strategies in older adults.</p><p><strong>Methods: </strong>This study adopted a pretest-posttest control group design, with all participants undergoing two neuropsychological assessments. The cognitive training program consisted of four 60-minute sessions over a month. In the interventions, participants practiced the mnemonic strategies of elaboration and self-reference. The effect of cognitive training was analyzed using both dependent and independent t tests.</p><p><strong>Results: </strong>The mean ages were 69.7 ± 12.0 for the control group (n = 23) and 70.7 ± 5.6 for the intervention group (n = 27), with educational attainment of 11.9 ± 3.2 and 12.1 ± 3.9 years, respectively. Both groups showed an overall improvement in memory tests, but only the intervention group's learning and delayed recall aspects of the verbal memory test remained statistically significant after adjusting for multiple comparisons ( p < 0.00625).</p><p><strong>Conclusion: </strong>Our study demonstrates that multiple mnemonic strategy-based cognitive training effectively enhances memory function in older adults and should be regarded as an alternative intervention for older adults.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"375-382"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733831","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}

{"title":"Epidemiology and practice patterns of achalasia in Taiwan: A nationwide population-based cohort study.","authors":"Kai-Liang Lin, Wei-Yu Lin, Yen-Po Wang, Jiing-Chyuan Luo, Ming-Chih Hou, Hui-Chu Lang, Ching-Liang Lu","doi":"10.1097/JCMA.0000000000001214","DOIUrl":"10.1097/JCMA.0000000000001214","url":null,"abstract":"<p><strong>Background: </strong>Achalasia is a rare disease of gastrointestinal motility characterized by impaired esophageal peristalsis and reduced esophageal sphincter relaxation. However, data on its epidemiology and outcomes in Taiwan are limited. This study aimed to assess the incidence, characteristics, and clinical management of achalasia in Taiwan.</p><p><strong>Methods: </strong>Patients who were newly diagnosed with achalasia between 2001 and 2013 were recruited from the Taiwan National Health Insurance Research Database. The study obtained data on the age, sex, urbanization, socioeconomic status, area of residence, diagnostic methods, and interventional management of the patients. Incidence, diagnostic modalities, treatment methods, malignancy, and mortality outcomes were analyzed.</p><p><strong>Results: </strong>In total, 206 new achalasia cases were identified. The mean annual incidence in Taiwan was 1.64 (95% confidence interval, 1.22-2.05) per 100 000 persons. The mean age of the patients at diagnosis was 51.8 years. The age-specific incidence of achalasia peaked in patients aged between 70 and 80 years and above 80 years. For achalasia diagnosis, endoscopy, computed tomography (CT), barium studies, and manometry were performed in 123 (59.71%), 97 (47.09%), 49 (23.79%), and 11 patients (5.34 %), respectively. During long-term follow-up, seven patients (3.39%) developed esophageal cancer, and 39 patients (18.93%) died. The median survival was 10.65 years after achalasia diagnosis, with a 10-year survival rate of 76.22%.</p><p><strong>Conclusion: </strong>This is the first population-based epidemiological study on achalasia in Taiwan, revealing the incidence of achalasia before the era of high-resolution manometry. Clinicians should be vigilant about the development of esophageal cancer and mortality during long-term follow-ups. There is also room to enhance the utilization of various diagnostic tools for achalasia.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"383-388"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367162","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}

{"title":"Insulin initiation for patients with poorly controlled type 2 diabetes mellitus.","authors":"Hsin-An Chen, Chia-Hung Lin, Feng-Hsuan Liu","doi":"10.1097/JCMA.0000000000001232","DOIUrl":"10.1097/JCMA.0000000000001232","url":null,"abstract":"<p><strong>Background: </strong>We examined the initiation of insulin therapy in patients with poorly controlled type 2 diabetes mellitus (T2DM), analyzed their glycemic responses, and compared patient profiles based on glycemic outcomes.</p><p><strong>Methods: </strong>Patients with T2DM initiated on insulin therapy were retrospectively analyzed. Data were collected from endocrinology clinic before and 3 and 6 months after insulin initiation. The primary outcome was hemoglobin A1c (HbA1c) level 6 months after commencing insulin treatment. Secondary outcomes included HbA1c levels at 3 months after insulin treatment and fasting blood glucose levels at 3 and 6 months after treatment. We analyzed the effects of insulin initiation and categorized patients based on their 6-month HbA1c levels: below the median of 7.8% (better response) and above 7.8% (worse response). Additionally, we evaluated patients based on HbA1c changes at 6 months, with greater or lesser changes defined by the cohort's median change of -1.4%.</p><p><strong>Results: </strong>Insulin therapy significantly reduced HbA1c (from 9.8% to 8.2%) and fasting blood glucose levels (from 221.4 to 147.2 mg/dL) within 3 months. After 6 months, HbA1c and fasting blood glucose levels decreased by 2.1% (9.8%-7.7%) and 77.2 mg/dL (221.4-144.2 mg/dL), respectively. Patients who responded better to insulin treatment showed lower fasting blood glucose levels by 6 months after insulin initiation and lower HbA1c levels as soon as 3 months after initiation. Patients with higher baseline glycemic profiles experienced significantly greater HbA1c reductions at 6 months post-treatment.</p><p><strong>Conclusion: </strong>Insulin therapy significantly improved glycemic control in patients with T2DM within 3 months after initiation. Patients with higher baseline glycemic profiles experienced greater responses to insulin therapy.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"410-414"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733832","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}

{"title":"Cancer publications using real-world data from the Taiwan National Health Insurance Research Database: Conceptual framework and bibliometric analysis.","authors":"Wing Hin Stanford Siu, Ai Yin Lim, Jia-Rou Liu, Shu-Hao Chang, Wei-Min Chen, Pei-Ru Li, Lai-Chu See","doi":"10.1097/JCMA.0000000000001227","DOIUrl":"10.1097/JCMA.0000000000001227","url":null,"abstract":"<p><strong>Background: </strong>Bibliometric analysis often overlooks study-based components such as study aims, design, and statistical methods. In this study, we propose a conceptual framework incorporating these study-based components with disease-based components for the bibliometric analysis of cancer articles using real-world data. This framework is a significant step forward in cancer research. We then investigated the distribution and temporal trends of these components for cancer articles using the Taiwan National Health Insurance Research Database (NHIRD) published from 2006 to 2022.</p><p><strong>Methods: </strong>Study- and disease-based components were extracted and cross-validated. The distribution and temporal trends of these components were then presented.</p><p><strong>Results: </strong>We analyzed 1232 articles and found a noticeable increase in the annual publication count from 2011 onward. This upward trend signified the growing momentum in cancer research. Cancer risk factors were the most studied (52%), followed by cancer outcomes (36%) and incidence/prevalence (3%). Among the publications on risk factors and outcomes, most were cohort studies (85%), followed by case-control studies (10.7%). In both study designs, the use of the propensity score method increased steadily from 2.4% in 2011 to 40% in 2022. The most frequently studied cancer site was \"all cancers or multiple cancers\" (25.6%), followed by breast (9.6%), hepatobiliary (9.2%), and colorectal cancers (8.8%). Among the top 10 cited articles, the first and fourth focused on whether suppressing hepatitis B viral load with nucleoside analogs could reduce hepatocellular carcinoma recurrence and incidence in chronic hepatitis B patients. The remaining eight examined the association between medications and cancer risk.</p><p><strong>Conclusion: </strong>Beyond citation metrics, our research underscores the importance of considering study-based and disease-based components in bibliometric analysis. These components form the foundation of the real-world data cancer research framework and have practical implications for diseases beyond cancers, providing a broader perspective for researchers and practitioners.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"398-409"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652912","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}

{"title":"Causal relationships between air pollutants and upper respiratory tract infections: A two-sample, Mendelian randomization study.","authors":"Fuhai Chen, Jin Zhang, Jing Xie, Xiao Fu","doi":"10.1097/JCMA.0000000000001242","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001242","url":null,"abstract":"<p><strong>Background: </strong>The issue of air pollution is a concern that affects the health of individuals globally. Air pollutants (APs) have been linked to upper respiratory tract infections (URTIs); however, the exact association between them remains unclear.</p><p><strong>Methods: </strong>Two-sample Mendelian randomization (MR) was performed to examine the causal relationship between APs and URTIs. Data regarding APs and URTIs were obtained from genome-wide association studies. Single nucleotide polymorphisms associated with each exposure were defined as instrumental variables. Inverse variance weighting is the primary method for analyzing causal effects. Quality control was performed using MR-Egger, weighted mode, simple mode, and weighted median. Heterogeneity was assessed using Cochran's Q. The MR-Egger test was used to evaluate pleiotropy. Sensitivity analysis was performed using the \"leave-one-out\" method.</p><p><strong>Results: </strong>MR analysis revealed that airborne particulate matter with a diameter ≤ 10 micrometers (PM10) had a notable impact on acute pharyngitis, whereas nitrogen dioxide had a significant impact on chronic rhinitis, chronic nasopharyngitis, and chronic pharyngitis. Pleiotropy and heterogeneity were not observed.</p><p><strong>Conclusion: </strong>Higher PM10 levels were associated with a greater likelihood of developing acute pharyngitis. Increased nitrogen dioxide concentrations were associated with an increased risk for chronic rhinitis, nasopharyngitis, and pharyngitis. As such, controlling APs is crucial for preventing and treating URTIs.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048875","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}

{"title":"Air pollution causes abnormal alanine aminotransferase levels in patients with chronic hepatitis B.","authors":"Tyng-Yuan Jang, Yu-Ting Zeng, Po-Cheng Liang, Chih-Da Wu, Yu-Ju Wei, Pei-Chien Tsai, Po-Yao Hsu, Yi-Shan Tsai, Ming-Yen Hsieh, Yi-Hung Lin, Meng-Hsuan Hsieh, Chih-Wen Wang, Jeng-Fu Yang, Ming-Lun Yeh, Chung-Feng Huang, Wan-Long Chuang, Jee-Fu Huang, Batbold Batsaikhan, Chia-Yen Dai, Pau-Chung Chen, Ming-Lung Yu","doi":"10.1097/JCMA.0000000000001216","DOIUrl":"10.1097/JCMA.0000000000001216","url":null,"abstract":"<p><strong>Background: </strong>To investigate the association between air pollution and abnormal alanine aminotransferase levels in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs (NAs).</p><p><strong>Methods: </strong>This cross-sectional study enrolled 1275 patients with chronic hepatitis B treated with nucleotide/NAs from 2019 to 2022 in Kaohsiung and analyzed the incidence and risk factors for abnormal alanine aminotransferase levels. Daily air pollutant concentrations were estimated for the year before enrollment.</p><p><strong>Results: </strong>Abnormal alanine aminotransferase levels were observed in 1127 patients (88.4%) before treatment with nucleotide/NAs. Logistic regression analysis revealed that the strongest factor associated with abnormal alanine aminotransferase levels was the level of hepatitis B virus DNA (odds ratio/CI: 1.40/1.25-1.57; p < 0.001), followed by concentration of particulate matter ≤2.5 µm in diameter (1.05/1.02-1.08; p < 0.001) and liver cirrhosis (0.27/0.17-0.42; p < 0.001). Among patients without cirrhosis, logistic regression analysis revealed that the strongest factors associated with abnormal alanine aminotransferase levels were the level of hepatitis B virus DNA (odds ratio/CI: 1.52/1.28-1.82; p < 0.001) and concentration of particulate matter ≤2.5 µm in diameter (1.06/1.101-1.11; p = 0.01). Among patients with cirrhosis, logistic regression analysis revealed that the strongest factor associated with abnormal alanine aminotransferase levels was hepatitis B virus DNA level (odds ratio/CI: 1.28/1.12-1.48; p = 0.001).</p><p><strong>Conclusion: </strong>Higher concentrations of particulate matter ≤2.5 µm in diameter caused elevated baseline alanine aminotransferase levels in patients with chronic hepatitis B receiving nucleotide/NA therapy. The impact of particulate matter ≤2.5 µm in diameter on abnormal alanine aminotransferase levels was particularly pronounced in patients without cirrhosis.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"361-366"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412123","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}

{"title":"TwPAD registry: A prospective, multicenter registry of chronic peripheral arterial disease involving lower limbs in Taiwan.","authors":"Yueh-Hung Lin, Chung-Ho Hsu, Jen-Kuang Lee, Po-Chao Hsu, Chiu-Yang Lee, Chun-Chi Chen, Po-Wei Chen, Hsu-Ping Wu, Min-I Su, Chun-Wei Lee, Hung-I Yeh","doi":"10.1097/JCMA.0000000000001224","DOIUrl":"10.1097/JCMA.0000000000001224","url":null,"abstract":"<p><strong>Background: </strong>Peripheral arterial disease (PAD) is a consequence of systemic atherosclerosis, resulting in arterial narrowing and diminished blood flow, leading to complications like claudication, rest pain, ulcers, gangrene, and functional limitations. Despite its impact on cardiovascular mortality, physical function, and quality of life, PAD has received less attention than other atherosclerotic disorders. This study addresses the paucity of comprehensive clinical data on PAD in Taiwan, aiming to analyze its incidence, risk factors, pharmacological and interventional treatments, and outcomes.</p><p><strong>Methods: </strong>This prospective, multicenter, observational registry includes PAD patients from 10 medical centers or teaching hospitals across Taiwan. Data collected encompass demographic characteristics, medical history, laboratory results, and treatment history. Patients are followed up annually to monitor all-cause mortality, major clinical events (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke), and total cardiovascular events (including hard events, unplanned revascularizations, hospitalizations for endovascular therapy, stroke, transient ischemic attacks, and heart failure).</p><p><strong>Results: </strong>From September 2020 to December 2022, 1005 patients were enrolled. The mean age of the cohort was 70.3 years, with men constituting the majority (59.3%). The prevalence rates of key medical conditions were 68.2% for diabetes, 76.3% for hypertension, 72.6% for hypercholesterolemia, 40.6% for smoking, and 26.2% for end-stage renal disease. Central Taiwan patients were younger and had a higher body mass index (BMI) and prevalence of obesity, but lower rates of comorbidities such as hypertension, diabetes, and smoking history. In contrast, eastern Taiwan patients who were older had a lower BMI and prevalence of obesity, but exhibited higher levels of comorbidity.</p><p><strong>Conclusion: </strong>The TwPAD registry provides comprehensive insights into patient characteristics, treatments, and outcomes. Regional variations in age, BMI, and comorbidity levels were noted between central and eastern Taiwan. Importantly, the registry identified gaps in adherence to guideline-directed medical therapy, particularly in statin use. Continued data collection will support improvements in PAD management nationwide.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"389-397"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702507","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}

{"title":"While GPT-3.5 is unable to pass the Physician Licensing Exam in Taiwan, GPT-4 successfully meets the criteria.","authors":"Tsung-An Chen, Kuan-Chen Lin, Ming-Hwai Lin, Hsiao-Ting Chang, Yu-Chun Chen, Tzeng-Ji Chen","doi":"10.1097/JCMA.0000000000001225","DOIUrl":"10.1097/JCMA.0000000000001225","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the performance of ChatGPT-3.5 and ChatGPT-4 in answering medical questions from Taiwan's Physician Licensing Exam, ranging from basic medical knowledge to specialized clinical topics. It aims to understand these artificial intelligence (AI) models' capabilities in a non-English context, specifically traditional Chinese.</p><p><strong>Methods: </strong>The study incorporated questions from the Taiwan Physician Licensing Exam in 2022, excluding image-based queries. Each question was manually input into ChatGPT, and responses were compared with official answers from Taiwan's Ministry of Examination. Differences across specialties and question types were assessed using the Kruskal-Wallis and Fisher's exact tests.</p><p><strong>Results: </strong>ChatGPT-3.5 achieved an average accuracy of 67.7% in basic medical sciences and 53.2% in clinical medicine. Meanwhile, ChatGPT-4 significantly outperformed ChatGPT-3.5, with average accuracies of 91.9% and 90.7%, respectively. ChatGPT-3.5 scored above 60.0% in seven out of 10 basic medical science subjects and three of 14 clinical subjects, while ChatGPT-4 scored above 60.0% in every subject. The type of question did not significantly affect accuracy rates.</p><p><strong>Conclusion: </strong>ChatGPT-3.5 showed proficiency in basic medical sciences but was less reliable in clinical medicine, whereas ChatGPT-4 demonstrated strong capabilities in both areas. However, their proficiency varied across different specialties. The type of question had minimal impact on performance. This study highlights the potential of AI models in medical education and non-English languages examination and the need for cautious and informed implementation in educational settings due to variability across specialties.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"352-360"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627332","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}

{"title":"Harness the power of artificial intelligence to generate graphical abstracts.","authors":"Feng-Yuan Yang, Tzeng-Ji Chen","doi":"10.1097/JCMA.0000000000001222","DOIUrl":"10.1097/JCMA.0000000000001222","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"341-342"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545255","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}