Early-onset gastric cancer demonstrates advanced stage of disease, and a high incidence of poorly-differentiated and signet-cell type carcinoma. Overall survival is poor with no added benefit to surgical intervention in advanced disease.
MSA in patients with large hiatal hernias demonstrates decreased postoperative PPI requirement and mean GERD-HRQL scores compared to patients with smaller hernias. The incidence of symptom resolution or improvement and the percentage of patients requiring intervention for dysphagia are similar. Short-term outcomes of MSA are encouraging in patients with gastroesophageal reflux disease and large hiatal hernias.
Purpose
ChatGPT is a large language model trained on a large dataset covering a broad range of topics, including the medical literature. We aim to examine its accuracy and reproducibility in answering patient questions regarding bariatric surgery.
Materials and methods
Questions were gathered from nationally regarded professional societies and health institutions as well as Facebook support groups. Board-certified bariatric surgeons graded the accuracy and reproducibility of responses. The grading scale included the following: (1) comprehensive, (2) correct but inadequate, (3) some correct and some incorrect, and (4) completely incorrect. Reproducibility was determined by asking the model each question twice and examining difference in grading category between the two responses.
Results
In total, 151 questions related to bariatric surgery were included. The model provided “comprehensive” responses to 131/151 (86.8%) of questions. When examined by category, the model provided “comprehensive” responses to 93.8% of questions related to “efficacy, eligibility and procedure options”; 93.3% related to “preoperative preparation”; 85.3% related to “recovery, risks, and complications”; 88.2% related to “lifestyle changes”; and 66.7% related to “other”. The model provided reproducible answers to 137 (90.7%) of questions.
Conclusion
The large language model ChatGPT often provided accurate and reproducible responses to common questions related to bariatric surgery. ChatGPT may serve as a helpful adjunct information resource for patients regarding bariatric surgery in addition to standard of care provided by licensed healthcare professionals. We encourage future studies to examine how to leverage this disruptive technology to improve patient outcomes and quality of life.
Graphical Abstract
Based on our data, LSG with concomitant HHR improved GERD symptoms or the need for daily antisecretory therapy only in a third of symptomatic patients. Furthermore, 15.6 % of asymptomatic patients developed de novo GERD symptoms despite a HHR. In patients with a documented hiatal hernia, HHR does not lead to GERD resolution or prevention after LSG, indicating the need for appropriate patient counseling and further study.
OD of the hiatus with crural closure resulted in less recurrence of reflux symptoms and hiatal hernia, despite an increased proportion of patients with larger hiatal hernia and more complex anatomic disease at the time of operation.
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