出版者・発行元：JMIR Publications Inc.  

BACKGROUND<p>Medical interviewing is a critical skill in clinical practice, yet opportunities for practical training are limited in Japanese medical schools, necessitating urgent measures. Given advancements in AI technology, its application in the medical field is expanding. However, reports on its application in medical interviews in medical education are scarce.</p> OBJECTIVE<p>This study aimed to investigate whether medical students' interview skills could be improved by engaging with AI-simulated patients using large language models (LLMs), including the provision of feedback.</p> METHODS<p>A simulation program using LLMs was provided to 35 fourth-year medical students in Japan in 2023. As a control group, 110 fourth-year medical students from 2022 who did not participate in the intervention were selected. The primary outcome was the score on the pre-Clinical Clerkship Objective Structured Clinical Examination (pre-CC OSCE), a national standardized clinical skills examination, in medical interviewing. Secondary outcomes included surveys such as Simulation-Based Training Quality Assurance Tool (SBT-QA10).</p> RESULTS<p>The AI intervention group showed significantly higher scores on medical interviews than the control group (AI group vs. control group: median 28.0 vs. 27.0, p = 0.01). There was a trend of inverse correlation between the SBT-QA10 and pre-CC OSCE scores (regression coefficient -2.0 to -2.1). No significant safety concerns were observed.</p> CONCLUSIONS<p>Education through medical interviews using AI-simulated patients has demonstrated safety and a certain level of educational effectiveness, suggesting promising prospects for multifaceted applications in the field of medical education.</p>

DOI： 10.2196/preprints.58753

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掲載種別：研究論文（学術雑誌）   出版者・発行元：The Japan Society for Hematopoietic Stem Cell Transplantation  

DOI： 10.7889/tct-23-015

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

Abstract

Background

Simulation-based education and peer-assisted learning (PAL) are both known as useful educational methods. Previous research has reported that combining these two methods are effective for training medical residents in short-term evaluation. This study was aimed to evaluate the middle- to long-term effects of simulation-based education combined with PAL on the performance of medical residents during emergency department duties.

Methods

This study was designed as a case-control study and conducted over three years at Okayama University Hospital in Japan. Postgraduate-year-one medical residents were assigned to three groups: a simulation group that received simulation-based education, a lecture group that received traditional lecture-based education, and a control group that received no such prior trainings. Prior training in emergency department duties using PAL was performed as an educational intervention for the simulation and lecture groups during the clinical orientation period. The residents’ medical knowledge was assessed by written examinations before and after the orientation. The performance of residents during their emergency department duties was assessed by self-evaluation questionnaires and objective-assessment checklists, following up with the residents for three months after the orientation period and collecting data on their 1st, 2nd, and 3rd emergency department duties. All the datasets collected were statistically analyzed and compared by their mean values among the three groups.

Results

A total of 75 residents were included in the comparative study: 27 in the simulation group, 24 in the lecture group, and 24 in the control group. The simulation and lecture groups obtained significantly higher written examination scores than the control group. From the self-evaluation questionnaires, the simulation group reported significantly higher satisfaction in their prior training than the lecture group. No significant differences were found in the emergency department performance of the residents among the three groups. However, when evaluating the improvement rate of performance over time, all three groups showed improvement in the subjective evaluation, and only the simulation and lecture groups showed improvement in the objective evaluation.

Conclusion

Simulation-based education combined with PAL is effective in improving the knowledge and satisfaction of medical residents, suggesting the possibility of improving work performance during their emergency department duties.

DOI： 10.1186/s12909-023-04798-w

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その他リンク： https://link.springer.com/article/10.1186/s12909-023-04798-w/fulltext.html

記述言語：日本語   出版者・発行元：(一社)日本造血・免疫細胞療法学会  

Tisagenlecleucel(tisa-cel)輸注後早期(3ヵ月以内)の病勢増悪/再燃を予測する輸注前因子を明らかにするために,当院の42例を後方視的に解析した。Tisa-cel輸注後の観察期間中央値:8.2ヵ月(範囲:0.2-36.5)で,16例(38.1%)が早期に病勢増悪/再燃した。リンパ球採取前の"primary refractory"症例,リンパ球除去化学療法前のLDH高値(>1.5×upper limit of normal)および節外病変≧2は,tisa-cel輸注後早期の病勢増悪/再燃を予測する輸注前因子であった。特に,de novo DLBCLかつ"primary refractory"な臨床経過を有する9/10例(90%)は輸注後4ヵ月以内に病勢増悪したため,この患者群において新たな治療戦略を検討する事の重要性が示唆された。(著者抄録)

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J07578&link_issn=&doc_id=20231024390008&doc_link_id=10.7889%2Ftct-23-014&url=https%3A%2F%2Fdoi.org%2F10.7889%2Ftct-23-014&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The distribution and clinical impact of cell-of-origin (COO) subtypes of diffuse large B-cell lymphoma (DLBCL) outside Western countries remain unknown. Recent literature also suggests that there is an additional COO subtype associated with the germinal center dark zone, that warrants wider validation to generalize clinical relevance. Here, we assembled a cohort of Japanese patients with untreated DLBCL and determined the refined COO subtypes, that include the dark zone signature (DZsig), using the NanoString DLBCL90 assay. To compare the distribution and clinical characteristics of the molecular subtypes, we used a dataset from the cohort of BC Cancer (BCC) (n = 804). Of the 1050 patients where DLBCL90 assay was successfully performed in our cohort, 35%, 45%, and 6% of patients were identified to be germinal center B-cell-like (GCB)-DLBCL, activated B-cell-like (ABC)-DLBCL, and DZsigpos-DLBCL, respectively, with the highest prevalence of ABC-DLBCL differing significantly from that of BCC (P < 0.001). GCB-DLBCL, ABC-DLBCL, and DZsigpos-DLBCL were associated with two-year overall survival rates of 88%, 75%, and 66%, respectively (P < 0.0001), with patients of the DZsigpos-DLBCL having the poorest prognosis. In contrast, GCB-DLBCL without DZsig showed excellent outcomes following rituximab-containing immunochemotherapy. DZsigpos-DLBCL was associated with the significant enrichment of tumors with CD10 expression, concurrent MYC/BCL2 expression, and depletion of microenvironmental components (all P < 0.05). These results provide evidence of the distinct distribution of clinically relevant molecular subtypes in Japanese DLBCL and that refined COO, as measured by the DLBCL90 assay, is a robust prognostic biomarker that is consistent across geographical areas.

DOI： 10.1182/bloodadvances.2023010402

PubMed

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J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本病院総合診療医学会  

J-GLOBAL

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