Annals of family medicine
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Annals of family medicine · Mar 2024
Quality, Accuracy, and Bias in ChatGPT-Based Summarization of Medical Abstracts.
Worldwide clinical knowledge is expanding rapidly, but physicians have sparse time to review scientific literature. Large language models (eg, Chat Generative Pretrained Transformer [ChatGPT]), might help summarize and prioritize research articles to review. However, large language models sometimes "hallucinate" incorrect information. ⋯ Summaries generated by ChatGPT were 70% shorter than mean abstract length and were characterized by high quality, high accuracy, and low bias. Conversely, ChatGPT had modest ability to classify the relevance of articles to medical specialties. We suggest that ChatGPT can help family physicians accelerate review of the scientific literature and have developed software (pyJournalWatch) to support this application. Life-critical medical decisions should remain based on full, critical, and thoughtful evaluation of the full text of research articles in context with clinical guidelines.
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Annals of family medicine · Mar 2024
Challenges Addressing Lung Cancer Screening for Patients With Multimorbidity in Primary Care: A Qualitative Study.
Many individuals who are eligible for lung cancer screening have comorbid conditions complicating their shared decision-making conversations with physicians. The goal of our study was to better understand how primary care physicians (PCPs) factor comorbidities into their evaluation of the risks and benefits of lung cancer screening and into their shared decision-making conversations with patients. ⋯ Shared decision-making conversations about lung cancer screening differed substantially from the standard for patients with complex comorbidities. Future research should include efforts to characterize the risks and benefits of LCS in patients with comorbidities to inform guidelines and clinical application.
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Annals of family medicine · Mar 2024
Small Independent Primary Care Practices Serving Socially Vulnerable Urban Populations.
This mixed methods study sought to describe the extent to which family physicians in urban communities serve socially vulnerable patients and to better understand their practices, their challenges, and the structural supports that could facilitate their patient care. ⋯ Small independent practices serving vulnerable patients in urban communities are surviving because deeply committed physicians are making personal sacrifices. Health equity-focused policies could decrease the burden on these physicians and bolster independent practices so that socially vulnerable patients continue to have options when seeking primary care.
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Annals of family medicine · Mar 2024
Paternal Perspectives on Latino and Black Sons' Readiness for Sex and Condom Guidance: A Mixed Methods Study.
Although a large proportion of males in the United States become sexually active during high school, condom use is decreasing and contributing to negative sexual health outcomes. Fathers are influential in promoting adolescent male sexual health; however, factors that shape fathers' decisions about when to discuss condom use with their sons remain understudied. We examined paternal perceptions of adolescent males' readiness for sex relative to fathers providing guidance for condom use in Latino and Black families. ⋯ Fathers' perception of their sons' readiness for sex is a predictor of providing condom guidance. We provide practical suggestions for engaging fathers in primary care to promote correct and consistent condom use by adolescent males.
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Annals of family medicine · Mar 2024
Mission Impossible? Managing the American Academy of Pediatrics' Obesity Guideline.
A primary care pediatrician casts a skeptical eye at the American Academy of Pediatrics Obesity Guideline. Using back-of-the-envelope calculations, she explains that meeting the guidelines would swamp her office, hospital, and the country's clinicians in a manner that is unrealistic. Warning against the alienation that boots-on-the-ground clinicians experience when guidelines are too theoretical to be practical, she suggests alternative avenues for addressing this public health issue.