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 and joined the MJH Life Sciences team in April 2021. He graduated from The College of New Jersey with a degree in Journalism and Professional Writing. He enjoys listening to records, going to concerts, and playing with his cat Squish. You can reach him at 

ChatGPT answered correctly in more than 80% of complex open-ended 

 but demonstrated a reduced capability to offer a comprehensive response, according to data presented at the 

American Society of Retina Specialists (ASRS) 42nd Annual Meeting

Across the 40 open-ended clinical scenarios, the artificial intelligence (AI) chatbot was incapable of a comprehensive response in approximately 50% of clinical questions and generated nearly 30% hallucinated sources. Hallucinations occur when a large language model (LLM) produces nonsensical or inaccurate responses presented as factual.

“This demonstrates that while ChatGPT is rapidly growing more accurate, it is not yet suitable as an information source for patients,” wrote the investigative team, led by Michael J. Maywood, MD, department of ophthalmology, Corewell Health William Beaumont University Hospital.

AI chatbots continue to evolve as a medical tool, particularly in ophthalmology, making it critical to evaluate its strengths and limitations. In this retrospective, cross-sectional study, Maywood and colleagues assessed the performance of ChatGPT by determining the accuracy of the chatbot’s responses to complex open-ended vitreoretinal clinical scenarios, as well as the sources used in answering the clinical prompts.

Investigators designed 40 open-ended clinical scenarios across 4 primary topics in vitreoretinal disease, with responses graded on correctness and comprehensiveness by 3 blinded retina specialists. The primary outcome of the analysis was the number of clinical scenarios answered correctly and comprehensively by the chatbot.

Secondary outcomes involved theoretical harm to patients from an incorrect response, the distribution of the type of references used by ChatGPT, and the occurrence of hallucinated references.

Upon analysis, in June 2023, ChatGPT answered 83% (n = 33 of 40) of clinical scenarios correctly, while providing a comprehensive answer in only 52.5% (n = 21 of 40) of cases. Subgroup analysis showed an average correct response of 86.7% in neovascular age-related macular degeneration (nAMD), 100% in diabetic retinopathy (DR), 76.7% in retinal vascular disease, and 70% in the surgical domain.

After the assessment of the references, ChatGPT generated 70% real references and 30% hallucinated references. Overall, there were 6 incorrect responses with 1 (16.7%) cases of no harm, 3 (50%) cases of possible harm, and 2 (33.3%) cases of definitive harm.

“It was unable to provide a comprehensive response in ~50% of clinical questions and generated 30% hallucinated sources,” Maywood added.

Maywood MJ. Performance Assessment of an Artificial Intelligence Chatbot in Clinical Vitreoretinal Scenarios. Poster presented at the American Society of Retina Specialists (ASRS) 42nd Annual Meeting. Stockholm, Sweden. July 17-20, 2024.

What are ai hallucinations? IBM. September 1, 2023. Accessed July 25, 2024. https://www.ibm.com/topics/ai-hallucinations.

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Across 40 clinical scenarios, ChatGPT did not provide a comprehensive response in 50% of clinical questions with nearly 30% hallucinated sources.

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Capability of ChatGPT Reduced in Complex Vitreoretinal Scenarios

Chelsie Derman is an assistant editor for 

who covers psychiatry, sleep medicine, and geriatrics. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

was prevalent among adults long after the mass violence incidents occurred in their community.

“The present findings also have important implications for identifying those at most risk for developing PTSD following [mass violence incidents],” wrote investigators, led by Angela D. Moreland, PhD, from the department of psychiatry and behavioral sciences at Medical University of South Carolina.

According to Brady United, every day 327 people are shot in the US, with an average of 117 dying.

 Surviving a mass shooting can be traumatic, but it can also be traumatic for witnesses and people in the community who heard about it secondhand.

Although it is known direct survivors suffer long-lasting psychological consequences, the impact on the broader communities where the mass shooting took place is unknown.

Investigators conducted a cross-sectional survey study from February 2020 to September 2020 with a sample of adults from 6 communities who had most likely experienced a mass violence incidence between 2015 and 2019 at Dayton, Ohio; El Paso, Texas; Parkland, Florida; Pittsburgh, Pennsylvania; San Bernadino, California; and Virginia Beach, Virginia. The team used address-based sampling to identify randomly selected households, mail invitations, and select 1 adult per household to complete a self-administered print or online survey. Investigators analyzed the data from September to November 2023.

The primary outcome was a probable diagnostic-level past-year PTSD, and current (last month) PTSD determined using the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) PTSD criteria.

Among 6867 adults aged ≥ 18 years who accessed the survey website, 5991 (87.2%) agreed to participate and completed the survey, 343 (6.3%) partially completed the survey, and 443 (6.5%) did not meet eligibility criteria or refused to participate. More than half of the respondents were female (53.5%), and the sample had a mean age of 45.56 years.

In the survey 21% of respondents reported high exposure to the mass violence incident, meaning either themselves, a close friend, or a family member was on site during the shooting. Nearly one-quarter (23.7%) of participants met probable DSM-5

diagnosis criteria for past-year PTSD, and 8.9% met the criteria for current PTSD. Among the sample, approximately 1 in 4 individuals met PTSD criteria for past-year and 1 in 10 met the criteria for a current PTSD diagnosis.

Regression analyses demonstrated being female (odds ratio [OR], 2.32; 95% confidence interval [CI], 2.01 – 2.68) and having a history of both physical or sexual assault and other potentially traumatic events (OR, 9.68; 95% CI, 7.48 – 12.52) were associated with the greatest risk of past-year PTSD. People who were younger and had low social support also were more likely to have PTSD.

The team added the results were consistent with previous research on PTSD risk factors. Numerous studies found females were more vulnerable to PTSD, but the reasons for this are not fully known. This may be because females have greater rates of assault, are more vulnerable to stressors, and are often more willing than males to disclose symptoms.

Investigators pointed out several limitations including the self-reported data to determine probable PTSD, the address-based sampling method which could have impacted the response rate and created nonresponse bias, and a small number of participants reported being on the site during the mass shooting.

“It is also important to consider that the rates of community PTSD may be influenced by unique features of each [mass violence incident] and vulnerabilities inherent to the community,” investigators wrote. “Although the majority of PTSD cases occurred in those with high exposure to the [mass violence incident], many respondents with no direct exposure met the criteria for past-year (21.0%) and current (8.9%) PTSD. Community-level factors may be especially important to consider for [mass violence incident] sites with an extensive history of community violence.”

Moreland, A, Rancher, C, Davies, F. Posttraumatic Stress Disorder Among Adults in Communities with Mass Violence Incidents. 

. 2024;7(7):e2423539. doi:10.1001/jamanetworkopen.2024.23539

https://www.bradyunited.org/resources/statistics

A new study found probable PTSD was prevalent among adults in the community after a mass shooting, with greater prevalence among those previously assaulted.

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PTSD

1 in 4 Adults in the Community Meet PTSD Criteria Following Mass Shooting

Abigail Brooks is an assistant editor for 

She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

Findings from a recent study are providing clinicians with an overview of the prevalence of 

metabolic dysfunction-associated steatotic liver disease (MASLD)

-related advanced fibrosis and cirrhosis in the US based on AGILE 3 + and AGILE 4 scores.

The study leveraged National Health and Nutrition Examination Survey (NHANES) 2017-2018 transient elastography data to calculate AGILE 3 + and AGILE 4 scores for advanced fibrosis and cirrhosis, respectively, in participants with MASLD. Based on calculations from the new noninvasive scoring systems, investigators estimated approximately 4.5 million people in the US have advanced fibrosis and 0.6 million have cirrhosis due to MASLD.

“Liver biopsy has been the gold standard to determine the prevalence of MASLD fibrosis and cirrhosis; however, several noninvasive tests and scoring systems have been developed to estimate the prevalence of the two entities,” Naim Alkhouri, MD, chief medical officer, chief of transplant hepatology, and director of the Fatty Liver Program at Arizona Liver Health, and colleagues wrote.

 “Owing to relying on routine blood tests alone, the accuracy of these tests can be easily affected by several factors that are not related to liver disease. More importantly, the positive predictive value of these tests is relatively low, leading to potentially overestimating the true disease prevalence.”

The AGILE scoring system includes AGILE 3 + and AGILE 4, non-proprietary tests that can be calculated using routinely collected clinical, elastography, and laboratory parameters. Specifically, they leverage liver stiffness measurement, AST/ALT ratio, platelets, sex and diabetes status, as well as age for AGILE 3 +. Developed in order to optimize the positive predictive value of noninvasive testing for cirrhosis and advanced fibrosis, the scores seek to provide fewer indeterminate results without the need for liver biopsy.

To estimate the prevalence of MASLD-related advanced fibrosis and cirrhosis using AGILE 3 + and AGILE 4 scores, investigators included NHANES 2017-2018 participants ≥ 18 years of age with vibration-controlled transient elastography (VCTE) results as measured by FibroScan. Pregnant women and patients with excessive alcohol intake, hepatitis B/C, and ALT or AST > 500 IU/L were excluded.

Investigators defined MASLD as a controlled attenuation parameter (CAP) score ≥ 248 dB/m. Advanced fibrosis in patients with MASLD was estimated using AGILE 3 + and was assessed based on the following criteria: < 0.45 as rule out; 0.45–0.68 as indeterminate; and ≥ 0.68 as rule in to identify advanced fibrosis in MASLD patients. Cirrhosis was determined using AGILE 4 scoring based on the following criteria: < 0.25 as rule out; 0.25–0.57 as indeterminate; and ≥ 0.57 as rule in.

In total, 1244 subjects with MASLD were included in the final analysis. Among the cohort, the median age was 52.5 years, 54.9% were male, and 64.2% were White. Type 2 diabetes and obesity were observed among 36.2% and 59.4% of patients, respectively.

Based on AGILE 3+, investigators determined 80.3% of the cohort was at low risk for advanced fibrosis and 11.5% were in the grey zone. The overall prevalence of advanced fibrosis due to MASLD was 8.1%, corresponding to 4.5 million US patients.

Compared to those without advanced fibrosis, the rule-in population tended to be older (64.4 vs 49.6 years; 

 <.001) and have a greater BMI (37.9 vs 32; 

 <.001) with a significantly increased prevalence of type 2 diabetes (86% vs 24.3%; 

 = .001). Those with advanced fibrosis also tended to have slightly greater AST (26.04 vs 21.13 IU/L; 

 = .012) and hemoglobin A1C (6.78 vs 5.92%; 

 <.001), but remarkably lower platelet count (201.69 vs 252.21 per 10^3 cells/uL; 

 <.001). Moreover, those with advanced had significantly greater LSM measurement (16.65 vs 5.25 kPa; 

Based on AGILE 4, investigators determined 96.5% of the cohort was at low risk for cirrhosis and 2.4% were in the grey zone. The overall prevalence of MASLD-related cirrhosis was 1.1%, corresponding to 610,000 US patients.

Compared to those without MASLD-cirrhosis, the rule-in population tended to be older (54.5 vs 52.3 years) and have a greater BMI (44.7 vs 32.4; 

 <.001) with a significantly increased prevalence of type 2 diabetes (85.1% vs 34.9%; 

 <.001). Those with cirrhosis tended to have slightly elevated AST (27.89 vs 21.5 IU/L; 

 = .082) and hemoglobin A1C (6.54 vs 6.09%; 

 = .117) but remarkably lower platelet count (175.8 vs 246.71 per 10^3 cells/uL; 

 <.001). Similar to those with fibrosis, participants with cirrhosis had significantly greater LSM measurement (37.22 vs 5.75 kPa; 

Investigators acknowledged limitations to these findings related to the nature of the AGILE scoring system; uncertainties regarding whether the selected population is representative of the US population as a whole; and potential variations in the cutoff for steatosis.

“It is crucial to balance the accuracy of the diagnostic tools and the feasibility of obtaining the diagnostic information in population-based epidemiological studies like this,” investigators concluded.

 The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD)-related advanced fibrosis and cirrhosis in the United States population utilizing AGILE 3 + and AGILE 4 scores: analysis of the NHANES 2017–2018 cycle. 

https://doi.org/10.1186/s12876-024-03295-8

Sanyal AJ, Foucquier J, Younossi ZM, et al. Enhanced diagnosis of advanced fibrosis and cirrhosis in individuals with NAFLD using FibroScan-based Agile scores. 

https://doi.org/10.1016/j.jhep.2022.10.034

Using NHANES data, researchers calculated AGILE 3 + and AGILE 4 scores to determine the prevalence of advanced fibrosis and cirrhosis in patients with MASLD in the US.

Hepatology

MASH / MASLD

The HCPLive MASH & MASLD page is a comprehensive resource for clinical news and insights on metabolic dysfunction-associated steatotic liver disease and steatohepatitis. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for fatty liver disease, steatohepatitis, and more.

Study Estimates MASLD-Related Fibrosis, Cirrhosis Prevalence Using AGILE Scoring

Future Research Priorities for MDMA-Assisted Therapy, with Gus Alva, MD

, and public health as a whole, wait with anticipation surrounding the US Food and Drug Administration’s decision on 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy in the management of 

A subject mired in controversy as a result of decades-old stigma, MDMA-assisted therapy has, with extensive research efforts and clinical trial data, proven its potential. Beyond MDMA-assisted therapies, clinical programs and trials for other psychedelic agents, including psilocybin, ketamine, and other compounds, have furthered discussions around the roles of these therapeutic options in psychiatric care.

Backed by positive data from the phase 3, randomized, double-blind, placebo-controlled MAPP1 and MAPP2 trials, the application for MDMA-assisted therapy  PTSD seemed poise to usher in a new era in management. 

However, the road to a potential approval has seemingly turned into an even greater uphill battle in the wake of an FDA Psychopharmacologic Advisory Committee on June 4, 2024, which saw the committee vote 2-9 against supporting the effectiveness of MDMA in the treatment of adult patients with PTSD followed by a subsequent 1 to 10 vote against the notion that the benefits of MDMA in combination with the FDA’s proposed risk evaluation and mitigation strategy (REMS) outweigh its risks for the treatment of patients with PTSD.

Despite this, leading researchers, psychiatrists, as well as patients and advocacy organizations, have vocalized their concerns surrounding the unmet need in PTSD management and the need to research further the use of psychedelic therapies for use in psychiatric conditions.

In this 5-part video series, we spotlight the perspective of leading subject matter expert Gus Alva, MD, a psychiatrist and medical director of ATP Clinical Research, on the subject, with segments dedicated to:

Interpreting Trial Data for MDMA-Assisted Therapy

Addressing Stigma Surrounding MDMA and Psychedelic Therapies

Future Research Priorities for MDMA-Assisted Therapy

In this final segment, Alva discusses the critical need for long-term data on MDMA-assisted therapy, emphasizing the importance of understanding potential long-term effects. The conversation highlights concerns about the possibility of negative outcomes over extended periods, which underscores the necessity for ongoing research. Despite these concerns, Alva acknowledges the promising data already available, which extends beyond PTSD to other conditions like alcohol dependence. 

The discussion touches on the potential benefits of MDMA-assisted therapy for various psychiatric and addiction disorders, advocating for a cautious yet open-minded approach. Alva also mentions the importance of adhering to established psychotherapeutic guidelines to ensure safe and effective treatment. The segment concludes by stressing the need for post-marketing studies to monitor long-term outcomes and fulfill regulatory commitments, ultimately aiming to broaden the therapeutic applications of MDMA in a controlled and scientifically sound manner.

Relevant disclosures for Alva include Teva Pharmaceuticals, Otsuka America Pharmaceuticals, AbbVie Inc., Axsome Therapeutics, Janssen Pharmaceuticals, and more.

Mitchell JM, Ot'alora G M, van der Kolk B, et al. MDMA-assisted therapy for moderate to severe PTSD: a randomized, placebo-controlled phase 3 trial. 

. 2023;29(10):2473-2480. doi:10.1038/s41591-023-02565-4

Kunzmann K. FDA Psychopharmacologic Advisory Committee votes against supporting effectiveness of MDMA FOR PTSD. HCP Live. June 4, 2024. Accessed July 26, 2024. https://www.hcplive.com/view/live-updates-fda-psychopharmacologic-advisory-committee-meeting-mdma-ptsd.

Campbell P. First Study of Psilocybin in PTSD shows promise, safety of treatment approach. HCP Live. May 9, 2024. Accessed July 26, 2024. https://www.hcplive.com/view/first-study-of-psilocybin-in-ptsd-shows-promise-safety-of-treatment-approach.

Videos

In this part of our 5-part series, Gus Alva, MD discusses the next steps in research for long-term effects and broader applications of MDMA-assisted therapy.


Insights

Prospect of Psychedelic Therapies in Psychiatry, with Gus Alva, MD

Prospect of Psychedelic Therapies, with Gus Alva, MD

In this segment, Alva emphasizes the importance of a cautious and evidence-based approach to integrating MDMA-assisted therapy into clinical practice for PTSD. Highlighting their active participation in ongoing studies, Alva stresses the necessity of thorough research and data analysis before adopting new treatments. 

The discussion covers the use of off-label treatments like ketamine and esketamine, which, despite lacking FDA approval, have shown promise in treating resistant depression and suicidal ideation. Alva details the neurochemical pathways involved, such as the glutamatergic pathway for ketamine and the impact on monoamines and hormones like oxytocin and cortisol for MDMA. This segment underscores the need to keep an open mind while rigorously evaluating new therapies, emphasizing the potential of MDMA-assisted therapy to address long-standing treatment challenges.

In this part of our 5-part series, Gus Alva, MD explores MDMA’s neurochemical impact and the need for ongoing research.

Future Research Priorities for MDMA-Assisted Therapy in PTSD, with Gus Alva, MD

In this part of our 5-part series, Gus Alva, MD highlights the importance of education and overcoming skepticism about MDMA-assisted therapy.

Addressing Stigma Surrounding MDMA and Psychedelic Therapies, with Gus Alva, MD

In this part of our 5-part series, Gus Alva, MD talks about MDMA's efficacy in controlled settings and addresses misconceptions.

Interpreting Trial Data for MDMA-Assisted Therapy, with Gus Alva, MD

In this part of our 5-part series, Gus Alva, MD discusses the unmet need in PTSD treatment and the potential of MDMA-assisted therapy. 

FDA News

Current Options and Unmet Need in PTSD, with Gus Alva, MD

Tim Smith joined the MJH Life Sciences team as an assistant editor for HCPLive in August 2022. He graduated from UC Berkeley with a degree in political science, working in multimedia journalism as a staff writer prior to joining MJH. In his spare time, he enjoys reading, watching TV, listening to podcasts, and rock climbing. You can contact him at 

Adults with severe alopecia were shown to have statistically significant efficacy across 2 phase 3 clinical studies highlighted in this announcement.

Dermatology

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FDA Approves Deuruxolitinib for Treatment of Severe Alopecia Areata

Lana Pine is the editor of HCPLive Rheumatology. She is an experienced editor and technical writer with a demonstrated history of working in the banking and publishing industries. In her free time, she enjoys cooking, yoga, listening to podcasts, and drawing. She can be reached via email at LPine@mjhlifesciences.com.

Primary and secondary pharmacokinetic parameters through day 75 were similar across treatment arms.

Biosimilars

Golimumab Biosimilar AVT05 Exhibits Pharmacokinetic Similarity 

Ashley Benson, MD, discusses the most recent International Federation of Gynecology and Obstetrics (FIGO) statement on iron deficiency and anemia in women and girls.

Anemia

Peer Exchange

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Confirming Iron Deficiency Diagnosis

Hematologists, a gastroenterologist, and an obstetrician-gynecologist discuss the common causes of iron deficiency seen in clinical practice.

Common Causes of Iron Deficiency

These new data were announced by Aquestive Therapeutics and if approved, Anaphylm Sublingual Film could be the first orally-delivered, non-invasive severe allergy treatment.

Allergy

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New Topline Data Released on Epinephrine Sublingual Film for Severe Allergies

These data highlighted new findings on the experiences of children aged 6 to 11 with uncontrolled type 2 asthma treated with dupilumab.

Asthma

The HCPLive asthma page is a comprehensive resource for clinical news and insights on asthmatic disease. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for allergic and severe asthma, and more.

Dupilumab Reduces Exacerbations Among Children with Severe Asthma Up to 2 Years

A study demonstrated a smartphone app provides comparable benefits to cognitive behavior or mindfulness-based therapy, widening the supply gap for mental health care.

Latest News

Capability of ChatGPT Reduced in Complex Vitreoretinal Scenarios

1 in 4 Adults in the Community Meet PTSD Criteria Following Mass Shooting

Study Estimates MASLD-Related Fibrosis, Cirrhosis Prevalence Using AGILE Scoring

Prospect of Psychedelic Therapies in Psychiatry, with Gus Alva, MD

Future Research Priorities for MDMA-Assisted Therapy in PTSD, with Gus Alva, MD