Background & Aims: Patients with cirrhosis and hepatocellular carcinoma (HCC) require extensive and personalized care to improve outcomes. ChatGPT (Generative Pre-trained Transformer), a large language model, holds the potential to provide professional yet patient-friendly support. We aimed to examine the accuracy and reproducibility of ChatGPT in answering questions regarding knowledge, management, and emotional support for cirrhosis and HCC.Methods: ChatGPT's responses to 164 questions were independently graded by two transplant hepatologists and resolved by a third reviewer. The performance of ChatGPT was also assessed using two published questionnaires and 26 questions formulated from the quality measures of cirrhosis management. Finally, its emotional support capacity was tested. Results:We showed that ChatGPT regurgitated extensive knowledge of cirrhosis (79.1% correct) and HCC (74.0% correct), but only small proportions (47.3% in cirrhosis, 41.1% in HCC) were labeled as comprehensive. The performance was better in basic knowledge, lifestyle, and treatment than in the domains of diagnosis and preventive medicine. For the quality measures, the model answered 76.9% of questions correctly but failed to specify decision-making cut-offs and treatment durations. ChatGPT lacked knowledge of regional guidelines variations, such as HCC screening criteria. However, it provided practical and multifaceted advice to patients and caregivers regarding the next steps and adjusting to a new diagnosis. Conclusions:We analyzed the areas of robustness and limitations of ChatGPT's responses on the management of cirrhosis and HCC and relevant emotional support. ChatGPT may have a role as an adjunct informational tool for patients and physicians to improve outcomes.

Background: Patients with cirrhosis and hepatocellular carcinoma (HCC) require extensive care. Personalized education can improve their outcomes. ChatGPT (Generative Pre-trained Transformer), a natural language processing model, has shown potential to provide professional yet patient-freindly responses. Aim: To examine the accuracy and reproducibility of ChatGPT in responding to questions regarding knowledge, management, and emotional support for cirrhosis and HCC. Method: ChatGPT's responses to 164 frequently asked questions were independently graded by two transplant hepatologists, with a third reviewer resolving any discrepancies. We also compared the performance of ChatGPT on two previously validated and published questionnaires to the physicians or trainees who were tested in the included publications. Furthermore, we formulated the 26 quality measures of cirrhosis management into questions and tested ChatGPT's knowledge in cirrhosis care. Finally, the capacity to provide emotional support to patients or caregivers was tested. Results: ChatGPT regurgitated extensive knowledge about both cirrhosis and HCC, but for questions with correct responses, only a small proportion was labelled as comprehensive. The performance was better in basic knowledge, lifestyle, and treatment than in the domains of diagnosis and preventive medicine. For the quality measures, the model answered 76.9% of questions correctly but failed to specify the cut-off values for making medical decisions and treatment durations. When compared to physicians/trainees, ChatGPT fell short in knowledge of guidelines varying across geographic regions, such as HCC screening criteria. The model also provided practical and multifaceted advice to patients and caregivers regarding the next steps and adjusting to a new diagnosis. Conclusion: In summary, we analyzed the areas of robustness and limitations of ChatGPT's responses on the management of cirrhosis and HCC and relevant emotional support. ChatGPT may have a role as an adjunct informational tool for patients and physicians to improve outcomes.

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

Theta oscillations (~ 4–12 Hz) are dynamically modulated by speed and direction in freely moving animals. However, due to the paucity of electrophysiological recordings of freely moving humans, this mechanism remains poorly understood. Here, we combined mobile-EEG with fully immersive virtual-reality to investigate theta dynamics in 22 healthy adults (aged 18–29 years old) freely navigating a T-maze to find rewards. Our results revealed three dynamic periods of theta modulation: (1) theta power increases coincided with the participants’ decision-making period; (2) theta power increased for fast and leftward trials as subjects approached the goal location; and (3) feedback onset evoked two phase-locked theta bursts over the right temporal and frontal-midline channels. These results suggest that recording scalp EEG in freely moving humans navigating a simple virtual T-maze can be utilized as a powerful translational model by which to map theta dynamics during “real-life” goal-directed behavior in both health and disease.

Background and Objectives: Artificial intelligence is increasingly being employed in healthcare, raising concerns about the exacerbation of disparities. This study evaluates ChatGPT and GPT-4's ability to comprehend and respond to cirrhosis-related questions in English, Korean, Mandarin, and Spanish, addressing language barriers that may impact patient care. Methods: A set of 36 cirrhosis-related questions were translated into Korean, Mandarin, and Spanish and prompted to both ChatGPT and GPT-4 models. Non-English responses were graded by native-speaking hepatologists on accuracy and similarity to English responses. Chi-square tests were used to compare the proportions of grading between ChatGPT and GPT-4. Results: GPT-4 showed a marked improvement in the proportion of comprehensive and correct answers compared to ChatGPT across all four languages (p<0.05). GPT-4 demonstrated enhanced accuracy and avoided erroneous responses evident in ChatGPT's output. Significant improvement was observed in Mandarin and Korean subgroups, with a smaller quality gap between English and non-English responses in GPT-4 compared to ChatGPT. Conclusions: GPT-4 exhibited significantly higher accuracy in English and non-English cirrhosis-related questions, highlighting its potential for more accurate and reliable language model applications in diverse linguistic contexts. These advancements have important implications for patients with language discordance, contributing to equalizing health literacy on a global scale.