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width="1.25rem" xmlns="http://www.w3.org/2000/svg"><polyline points="6 9 6 2 18 2 18 9"></polyline><path d="M6 18H4a2 2 0 0 1-2-2v-5a2 2 0 0 1 2-2h16a2 2 0 0 1 2 2v5a2 2 0 0 1-2 2h-2"></path><rect x="6" y="14" width="12" height="8"></rect></svg></a></button></div></div><div><div class="flex flex-wrap"><p class=" text-primary font-semibold">News</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1"></div><p class=" text-primary font-semibold">Article</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1 "></div><time class="text-gray-500 " dateTime="2024-09-09T11:39:10.404">September 9, 2024</time></div><h1 class="text-[26px] font-medium leading-8">ChatGPT Outperforms Trainee Doctors in Assessing Pediatric Respiratory Illness</h1><div class="py-3 text-gray-600 md:flex flex-col md:justify-between"><div class="flex flex-col xs:flex-row"><p class="mr-1 self-start">Author(s):</p><div class="flex flex-col xs:flex-row mb-3 md:mb-0"><div class="flex flex-wrap"><span class="text-md mr-2"><a class="text-author text-gray-500 hover:text-primary underline hover:no-underline decoration-gray-400" href="/authors/hayden-e-klein">Hayden E. Klein</a></span></div></div></div><div class="max-w-full"><div class="flex flex-wrap sm:flex-nowrap items-center w-fit my-2"></div><div class="w-full flex flex-col sm:flex-row justify-between mt-2"><div class="block md:hidden "><div class="mt-2 flex items-center max-w-fit"><button title="ChatGPT Outperforms Trainee Doctors in Assessing Pediatric Respiratory Illness" aria-label="facebook" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#3b5998"></circle><path d="M34.1,47V33.3h4.6l0.7-5.3h-5.3v-3.4c0-1.5,0.4-2.6,2.6-2.6l2.8,0v-4.8c-0.5-0.1-2.2-0.2-4.1-0.2 c-4.1,0-6.9,2.5-6.9,7V28H24v5.3h4.6V47H34.1z" fill="white"></path></svg></button><button aria-label="twitter" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg fill="#DC7633" xmlns="http://www.w3.org/2000/svg" width="32" zoomAndPan="magnify" viewBox="0 0 375 374.9999" height="32" preserveAspectRatio="xMidYMid meet" version="1.0"><defs><path d="M 7.09375 7.09375 L 367.84375 7.09375 L 367.84375 367.84375 L 7.09375 367.84375 Z M 7.09375 7.09375 " fill="#000000"></path></defs><g><path d="M 187.46875 7.09375 C 87.851562 7.09375 7.09375 87.851562 7.09375 187.46875 C 7.09375 287.085938 87.851562 367.84375 187.46875 367.84375 C 287.085938 367.84375 367.84375 287.085938 367.84375 187.46875 C 367.84375 87.851562 287.085938 7.09375 187.46875 7.09375 " fill-opacity="1" fill-rule="nonzero" fill="#000000"></path></g><g transform="translate(85, 75)"> <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24" version="1.1" height="215" width="215"><path d="M18.244 2.25h3.308l-7.227 8.26 8.502 11.24H16.17l-5.214-6.817L4.99 21.75H1.68l7.73-8.835L1.254 2.25H8.08l4.713 6.231zm-1.161 17.52h1.833L7.084 4.126H5.117z" fill="#ffffff"></path></svg> </g></svg></button><button aria-label="linkedin" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#007fb1"></circle><path d="M20.4,44h5.4V26.6h-5.4V44z M23.1,18c-1.7,0-3.1,1.4-3.1,3.1c0,1.7,1.4,3.1,3.1,3.1 c1.7,0,3.1-1.4,3.1-3.1C26.2,19.4,24.8,18,23.1,18z M39.5,26.2c-2.6,0-4.4,1.4-5.1,2.8h-0.1v-2.4h-5.2V44h5.4v-8.6 c0-2.3,0.4-4.5,3.2-4.5c2.8,0,2.8,2.6,2.8,4.6V44H46v-9.5C46,29.8,45,26.2,39.5,26.2z" fill="white"></path></svg></button><button title="ChatGPT Outperforms Trainee Doctors in Assessing Pediatric Respiratory Illness" aria-label="pinterest" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#cb2128"></circle><path d="M32,16c-8.8,0-16,7.2-16,16c0,6.6,3.9,12.2,9.6,14.7c0-1.1,0-2.5,0.3-3.7 c0.3-1.3,2.1-8.7,2.1-8.7s-0.5-1-0.5-2.5c0-2.4,1.4-4.1,3.1-4.1c1.5,0,2.2,1.1,2.2,2.4c0,1.5-0.9,3.7-1.4,5.7 c-0.4,1.7,0.9,3.1,2.5,3.1c3,0,5.1-3.9,5.1-8.5c0-3.5-2.4-6.1-6.7-6.1c-4.9,0-7.9,3.6-7.9,7.7c0,1.4,0.4,2.4,1.1,3.1 c0.3,0.3,0.3,0.5,0.2,0.9c-0.1,0.3-0.3,1-0.3,1.3c-0.1,0.4-0.4,0.6-0.8,0.4c-2.2-0.9-3.3-3.4-3.3-6.1c0-4.5,3.8-10,11.4-10 c6.1,0,10.1,4.4,10.1,9.2c0,6.3-3.5,11-8.6,11c-1.7,0-3.4-0.9-3.9-2c0,0-0.9,3.7-1.1,4.4c-0.3,1.2-1,2.5-1.6,3.4 c1.4,0.4,3,0.7,4.5,0.7c8.8,0,16-7.2,16-16C48,23.2,40.8,16,32,16z" fill="white"></path></svg></button><button aria-label="email" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#7f7f7f"></circle><path d="M17,22v20h30V22H17z M41.1,25L32,32.1L22.9,25H41.1z M20,39V26.6l12,9.3l12-9.3V39H20z" fill="white"></path></svg></button><a class="print-wrap flex justify-center items-center cursor-pointer"><svg id="print" xmlns="http://www.w3.org/2000/svg" width="24" height="24" fill="currentColor" class="print bi bi-printer" viewBox="0 0 16 16"> <path d="M2.5 8a.5.5 0 1 0 0-1 .5.5 0 0 0 0 1z"></path> <path d="M5 1a2 2 0 0 0-2 2v2H2a2 2 0 0 0-2 2v3a2 2 0 0 0 2 2h1v1a2 2 0 0 0 2 2h6a2 2 0 0 0 2-2v-1h1a2 2 0 0 0 2-2V7a2 2 0 0 0-2-2h-1V3a2 2 0 0 0-2-2H5zM4 3a1 1 0 0 1 1-1h6a1 1 0 0 1 1 1v2H4V3zm1 5a2 2 0 0 0-2 2v1H2a1 1 0 0 1-1-1V7a1 1 0 0 1 1-1h12a1 1 0 0 1 1 1v3a1 1 0 0 1-1 1h-1v-1a2 2 0 0 0-2-2H5zm7 2v3a1 1 0 0 1-1 1H5a1 1 0 0 1-1-1v-3a1 1 0 0 1 1-1h6a1 1 0 0 1 1 1z"></path></svg></a></div><style> .print-wrap { width: 32px; height: 32px; background: #7F7F7F; border-radius: 100%; } .print { background: #7F7F7F; color: white; padding: 2px; border-radius: 100%; } </style></div></div></div></div><div class=" lg:w-full flex flex-col lg:flex-row lg:items-center lg:justify-end"><div class="related-landing sm:w-auto md:max-w-fit lg:w-[auto] md:text-center my-2 md:my-0 undefined"><a class="" href="/conference/ers"><div class="mt-6"><span class="text-primary text-sm">Conference</span><span class="mx-1 text-sm">|</span><span class="text-sm text-blue-700 underline">ERS: European Respiratory Society</span></div></a></div></div><p class="py-2 mb-2 text-sm italic text-gray-600">New findings highlight the potential role of artificial intelligence in supporting health care professionals, but thorough testing is needed before its integration into everyday clinical practice.</p><div class="py-2"><div class="blockText_blockContent__TbCXh"><p class="pb-2"><a rel="nofollow noreferrer noopener" target="_blank" href="https://k4.ersnet.org/prod/v2/Front/Program/Session?e=549&session=17916">New research</a> presented at the <a target="_blank" href="https://www.ajmc.com/conference/ers">European Respiratory Society (ERS) Congress</a> in Vienna, Austria, reveals that ChatGPT could assess complex cases of respiratory disease in children better than trainee doctors.<sup class="text-inherit">1</sup></p><p class="pb-2"></p><p class="pb-2">To come to this finding, 6 experts in pediatric respiratory medicine provided 6 clinical scenarios of cases such as cystic fibrosis, asthma, sleep-disordered breathing, breathlessness, and chest infections, that frequently occur in children. These scenarios were posed to 10 trainee doctors with less than 4 months of pediatric clinical experience, and they were given 1 hour to solve each case using internet resources, but not chatbots. These cases did not have an immediately clear diagnosis, and existing guidelines or evidence did not provide a definitive answer.</p><div class=""><div style="width:40%;float:right;max-width:525px;margin:0 0 1.5rem 1.5rem;clear:both;cursor:" class=" figure"><div class="flex-none relative text-center"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%274500%27%20height=%272532%27/%3e"/></span><img alt="ChatGPT | Image credit: Timon – stock.adobe.com" title="ChatGPT | Image credit: Timon – stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="ChatGPT | Image credit: Timon – stock.adobe.com" title="ChatGPT | Image credit: Timon – stock.adobe.com" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fec006cd9abfc9f21b53d00d89b8c7cd352db360a-4500x2532.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 1x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Fec006cd9abfc9f21b53d00d89b8c7cd352db360a-4500x2532.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div id="image-caption" class="text-gray-500 italic"><div class="blockText_blockContent__TbCXh"><p class="pb-2">ChatGPT scored the highest overall, with 7 of 9 points, performing better than trainee doctors | Image credit: Timon – stock.adobe.com</p></div></div><div class="top-[-100%] block w-[1px] transition-opacity duration-500 ease-in-out opacity-0 overflow-hidden"><img class="m-auto absolute inset-0 max-w-[0%] max-h-[0%] border-[3px] border-solid border-white shadow-[0px_0px_8px_rgba(0,0,0,0.3)] box-border transition ease-in-out duration-500" src="https://cdn.sanity.io/images/0vv8moc6/ajmc/ec006cd9abfc9f21b53d00d89b8c7cd352db360a-4500x2532.jpg?fit=crop&auto=format"/></div></div><style> #image-caption p{ font-size: 12px; max-width: 525px; margin: 0 auto; text-align: center; } </style></div><p class="pb-2"></p><p class="pb-2">The 6 scenarios were also presented to 3 large language models (LLMs): ChatGPT version 3.5, Google’s Bard, and Microsoft Bing’s chatbot. The 6 experts then gave all responses a score out of 9 based on their correctness, comprehensiveness, usefulness, plausibility, and coherence, and answered whether they thought each response was generated by a human or chatbot.</p><p class="pb-2"></p><p class="pb-2">Manjith Narayanan, MD, PhD, a consultant in pediatric pulmonology at the Royal Hospital for Children and Young People, presented the study’s findings at the ERS Congress 2024. He noted his motivation for the study was to determine how well LLMs can help clinicians in the real world.<sup class="text-inherit">2</sup></p><p class="pb-2"></p><p class="pb-2">The results were intriguing. Trainee doctors scored a median (IQR) of 4 (3-6) points, the same as Bing (3-5), while Bard scored higher at 6 (5-7) and scored better than trainee doctors in coherence specifically (<em>P</em> < .05).</p><p class="pb-2"></p><p class="pb-2">ChatGPT scored the highest overall with 7 of 9 points (6-8.25) and outperformed trainee doctors in all criteria (<em>P</em> < .001). Experts also believed ChatGPT had more human-like responses than responses from the other chatbots, as they correctly identified Bard and Bing responses as being nonhuman.</p><p class="pb-2"></p><p class="pb-2">Notably, none of the chatbots showed signs of hallucination, a phenomenon where LLMs generate seemingly accurate but false information. However, there were occasional irrelevant responses from the chatbots and the trainee doctors, and experts should be aware of the potential of hallucinations.</p><p class="pb-2"></p><p class="pb-2">According to Narayanan, this is the first study to test LLMs against trainee doctors in scenarios reflecting real-life clinical practice, and these results imply artificial intelligence (AI) could play a crucial role in alleviating pressure put on health care systems, although more research is needed.</p><p class="pb-2"></p><p class="pb-2">“We have not directly tested how LLMs would work in patient facing roles,” Narayanan noted. “However, it could be used by triage nurses, trainee doctors, and primary care physicians, who are often the first to review a patient.”</p><p class="pb-2"></p><p class="pb-2">Future studies will focus on comparing chatbot performance with that of more experienced doctors and exploring the capabilities of newer LLMs. The research team is also considering investigating how chatbots can assist with more complex cases and further testing for accuracy and safety in real-world clinical environments.</p><p class="pb-2"></p><p class="pb-2">Hilary Pinnock, MD, chair of the ERS Education Council and professor of primary care respiratory medicine at The University of Edinburgh, called the study “fascinating” while also expressing caution.</p><p class="pb-2"></p><p class="pb-2">“It is encouraging, but maybe also a bit scary, to see how a widely available AI tool like ChatGPT can provide solutions to complex cases of respiratory illness in children,” she said. “It certainly points the way to a brave new world of AI-supported care.”</p><p class="pb-2"></p><p class="pb-2">However, as the researchers highlighted, it is crucial to ensure these chatbots and other generative AI tools do not cause errors before they can be implemented in everyday clinical practice. These mistakes can include fabricated or hallucinated information, and can be due to the AI being trained on data that inadequately represent the diverse populations it is meant to serve.</p><p class="pb-2"></p><p class="pb-2">“As the researchers have demonstrated, AI holds out the promise of a new way of working, but we need extensive testing of clinical accuracy and safety, pragmatic assessment of organizational efficiency, and exploration of the societal implications before we embed this technology in routine care,” she added.</p><p class="pb-2"></p><p class="pb-2">As AI continues to advance, this study signals a potential shift in the future of health care, where LLMs could become integrated into the clinical workflow, aiding professionals in delivering faster and more accurate diagnoses. However, the journey toward full adoption will require careful evaluation of clinical accuracy, organizational efficiency, and ethical considerations.</p><p class="pb-2"></p><p class="pb-2"><strong>References</strong></p><p class="pb-2">1. Juan J, Duverger K, Armstrong D, et al. Clinical scenarios in paediatric pulmonology: can large language models fare better than trainee doctors? Presented at: ERS Congress; September 7-11, 2024; Vienna, Austria. https://k4.ersnet.org/prod/v2/Front/Program/Session?e=549&session=17916</p><p class="pb-2">2. ChatGPT outperformed trainee doctors in assessing complex respiratory illness in children. News release. ERS. September 9, 2024. Accessed September 9, 2024. https://www.ersnet.org/news-releases/chatgpt-outperformed-trainee-doctors-in-assessing-complex-respiratory-illness-in-children/</p></div></div><div class="flex items-center lg:w-3/4 mb-4 pb-12"></div><div class="jsx-19ede9f0a5a45918 py-4 relative bg-primary md:px-8 -ml-6 xs:ml-0 w-screen xs:w-auto"><div class="jsx-19ede9f0a5a45918 px-4 sm:px-0"><div class="flex justify-between items-center py-1 space-x-4 border-0 select-none sm:border-b border-secondary"><div class="text-3xl text-white text-lg sm:text-3xl">Related Videos</div></div></div><div style="scroll-snap-type:none" class="jsx-19ede9f0a5a45918 flex items-start overflow-x-auto space-x-4 py-4 relative mx-auto w-full pl-4"><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/rems-program-supports-use-of-mavacamten-in-obstructive-hypertrophic-cardiomyopathy"><div class="w-full shadow-md shadow-gray-800 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loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/the-day-to-day-effect-of-a-schizophrenia-diagnosis-on-patient-quality-of-life"><div class="w-full shadow-md shadow-gray-800 overflow-hidden relative bg-white aspect-video"><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:absolute;top:0;left:0;bottom:0;right:0"><img alt="Screenshot of an interview with Megan Ehret, PharmD" title="Screenshot of an interview with Megan Ehret, PharmD" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="fill" 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src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Ffc9e82e513d673008765ce4ebc4b04c3d7ffd4fe-1280x720.png%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=30" decoding="async" data-nimg="fill" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div class="w-full flex-wrap text-center text-sm mt-4 font-light no-underline text-white"></div></a></div></div><div class="relative block sm:hidden"><div class="mt-4 overflow-hidden"><div class="flex justify-between"><div class="flex items-center clear-both pt-4 pb-2 text-3xl lg:text-2xl xl:text-3xl min-w-fit ">Related Content </div><div class="hidden lg:flex w-full flex-col justify-end items-end"><div class="hidden w-full lg:flex flex-wrap pb-2 gap-x-2 gap-y-1 justify-end items-end"></div></div></div><div class="w-full mb-2 border border-secondary"></div><div class="lg:hidden flex flex-wrap items-center"></div><div class="flex flex-wrap w-full"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/semaglutide-eligibility-expands-to-over-half-of-us-adults?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/76c68f1b272ff40db499b3c5e4d48a6bb9da308d-5000x4000.jpg?fit=crop&auto=format" alt="Semaglutide injectors. | Image Credit :Andreas Prott- stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 21st 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/semaglutide-eligibility-expands-to-over-half-of-us-adults?utm_source=www.ajmc.com&utm_medium=relatedContent">Semaglutide Eligibility Expands to Over Half of US Adults</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/cameron-santoro">Cameron Santoro</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/semaglutide-eligibility-expands-to-over-half-of-us-adults?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Over half of the US adult population may benefit from semaglutide, a drug primarily used for weight loss and diabetes, although concerns about access and cost persist, especially considering its potential for wider health applications.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/the-importance-of-examining-and-preventing-atrial-fibrillation?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/9de113904a026205cbaf84d08420c4065d52fd67-1000x563.jpg?fit=crop&auto=format" alt="Image of Managed Care Cast logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">August 29th 2023</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/the-importance-of-examining-and-preventing-atrial-fibrillation?utm_source=www.ajmc.com&utm_medium=relatedContent">The Importance of Examining and Preventing Atrial Fibrillation</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/maggie-l-shaw">Maggie L. Shaw</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/the-importance-of-examining-and-preventing-atrial-fibrillation?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/community-investment-engagement-are-essential-to-fully-address-cardiovascular-health-disparities?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/e6a6b3083d61a8df9607a840c3e41ba56b38b0c4-2880x1618.png?fit=crop&auto=format" alt="Khadijah Breathett, MD" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 19th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/community-investment-engagement-are-essential-to-fully-address-cardiovascular-health-disparities?utm_source=www.ajmc.com&utm_medium=relatedContent">Community Investment, Engagement Are Essential to Fully Address Cardiovascular Health Disparities</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/kyle-munz">Kyle Munz</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/community-investment-engagement-are-essential-to-fully-address-cardiovascular-health-disparities?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Community-based researchers can teach clinicians a lot about how to best approach underserved populations disproportionately impacted by cardiovascular health complications. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/promoting-equity-in-public-health-policy-investment-and-community-engagement-solutions?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/a1728e6a06fccde8af20d2308f860344f9776b8f-800x400.jpg?fit=crop&auto=format" alt="Managed Care Cast." width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">June 28th 2022</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/promoting-equity-in-public-health-policy-investment-and-community-engagement-solutions?utm_source=www.ajmc.com&utm_medium=relatedContent">Promoting Equity in Public Health: Policy, Investment, and Community Engagement Solutions</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/matthew-gavidia">Matthew Gavidia</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/promoting-equity-in-public-health-policy-investment-and-community-engagement-solutions?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/latest-from-the-finearts-hf-trial-no-sex-specific-differences-reported-in-finenerone-outcomes-for-heart-failure?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4760e0a286de287b8e7d1ba3868814a0d6b395d9-2880x1618.png?fit=crop&auto=format" alt="Latest From FINEARTS-HF: No Sex-Specific Differences in Finerenone Outcomes for Heart Failure" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 18th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/latest-from-the-finearts-hf-trial-no-sex-specific-differences-reported-in-finenerone-outcomes-for-heart-failure?utm_source=www.ajmc.com&utm_medium=relatedContent">Latest From FINEARTS-HF: No Sex-Specific Differences in Finerenone Outcomes for Heart Failure</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/kyle-munz">Kyle Munz</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/latest-from-the-finearts-hf-trial-no-sex-specific-differences-reported-in-finenerone-outcomes-for-heart-failure?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The FINEARTS-HF trial offered novel clinical insights as one of the few cardiovascular trials to feature such a great proportion of female participants. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/cardiomyopathy-risk-plummets-when-sacubitril-valsartan-taken-with-chemo?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/8132c39d1104aa281fcfc366c4a00b16f1e55b7a-3600x2391.webp?fit=crop&auto=format" alt="Entresto packaging | Image credit: Novartis" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 18th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/cardiomyopathy-risk-plummets-when-sacubitril-valsartan-taken-with-chemo?utm_source=www.ajmc.com&utm_medium=relatedContent">Cardiomyopathy Risk Plummets When Sacubitril/Valsartan Taken With Chemo</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/mary-caffrey">Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/cardiomyopathy-risk-plummets-when-sacubitril-valsartan-taken-with-chemo?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The SARAH trial was limited to high-risk patients, which the lead investigator said prevented unnecessary exposure to adverse events in patients less at risk of cardiomyopathy.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="relative hidden sm:block"><div class="mt-4 overflow-hidden"><div class="flex justify-between"><div class="flex items-center clear-both pt-4 pb-2 text-3xl lg:text-2xl xl:text-3xl min-w-fit ">Related Content </div><div class="hidden lg:flex w-full flex-col justify-end items-end"><div class="hidden w-full lg:flex flex-wrap pb-2 gap-x-2 gap-y-1 justify-end items-end"></div></div></div><div class="w-full mb-2 border border-secondary"></div><div class="lg:hidden flex flex-wrap items-center"></div><div class="flex flex-wrap w-full"><div class="jsx-ad50481d5ee26850 w-full h-full"><div><div><div class="text-[8px] text-center text-gray-500 hidden">Advertisement</div><div id="div-gpt-ad-infeed-1"></div></div></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/semaglutide-eligibility-expands-to-over-half-of-us-adults?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/76c68f1b272ff40db499b3c5e4d48a6bb9da308d-5000x4000.jpg?fit=crop&auto=format" alt="Semaglutide injectors. | Image Credit :Andreas Prott- stock.adobe.com" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 21st 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/semaglutide-eligibility-expands-to-over-half-of-us-adults?utm_source=www.ajmc.com&utm_medium=relatedContent">Semaglutide Eligibility Expands to Over Half of US Adults</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/cameron-santoro">Cameron Santoro</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/semaglutide-eligibility-expands-to-over-half-of-us-adults?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Over half of the US adult population may benefit from semaglutide, a drug primarily used for weight loss and diabetes, although concerns about access and cost persist, especially considering its potential for wider health applications.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/the-importance-of-examining-and-preventing-atrial-fibrillation?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/9de113904a026205cbaf84d08420c4065d52fd67-1000x563.jpg?fit=crop&auto=format" alt="Image of Managed Care Cast logo" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">August 29th 2023</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/the-importance-of-examining-and-preventing-atrial-fibrillation?utm_source=www.ajmc.com&utm_medium=relatedContent">The Importance of Examining and Preventing Atrial Fibrillation</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/maggie-l-shaw">Maggie L. Shaw</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/the-importance-of-examining-and-preventing-atrial-fibrillation?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex md:hidden justify-center items-center"></div><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/community-investment-engagement-are-essential-to-fully-address-cardiovascular-health-disparities?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/e6a6b3083d61a8df9607a840c3e41ba56b38b0c4-2880x1618.png?fit=crop&auto=format" alt="Khadijah Breathett, MD" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 19th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/community-investment-engagement-are-essential-to-fully-address-cardiovascular-health-disparities?utm_source=www.ajmc.com&utm_medium=relatedContent">Community Investment, Engagement Are Essential to Fully Address Cardiovascular Health Disparities</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/kyle-munz">Kyle Munz</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/community-investment-engagement-are-essential-to-fully-address-cardiovascular-health-disparities?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">Community-based researchers can teach clinicians a lot about how to best approach underserved populations disproportionately impacted by cardiovascular health complications. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/promoting-equity-in-public-health-policy-investment-and-community-engagement-solutions?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/a1728e6a06fccde8af20d2308f860344f9776b8f-800x400.jpg?fit=crop&auto=format" alt="Managed Care Cast." width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">June 28th 2022</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/promoting-equity-in-public-health-policy-investment-and-community-engagement-solutions?utm_source=www.ajmc.com&utm_medium=relatedContent">Promoting Equity in Public Health: Policy, Investment, and Community Engagement Solutions</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/matthew-gavidia">Matthew Gavidia</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/promoting-equity-in-public-health-policy-investment-and-community-engagement-solutions?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/latest-from-the-finearts-hf-trial-no-sex-specific-differences-reported-in-finenerone-outcomes-for-heart-failure?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/4760e0a286de287b8e7d1ba3868814a0d6b395d9-2880x1618.png?fit=crop&auto=format" alt="Latest From FINEARTS-HF: No Sex-Specific Differences in Finerenone Outcomes for Heart Failure" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 18th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/latest-from-the-finearts-hf-trial-no-sex-specific-differences-reported-in-finenerone-outcomes-for-heart-failure?utm_source=www.ajmc.com&utm_medium=relatedContent">Latest From FINEARTS-HF: No Sex-Specific Differences in Finerenone Outcomes for Heart Failure</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/kyle-munz">Kyle Munz</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/latest-from-the-finearts-hf-trial-no-sex-specific-differences-reported-in-finenerone-outcomes-for-heart-failure?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The FINEARTS-HF trial offered novel clinical insights as one of the few cardiovascular trials to feature such a great proportion of female participants. </div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div><div class="jsx-ad50481d5ee26850 w-full h-full"><div class="jsx-ad50481d5ee26850 flex flex-col sm:flex-row justify-between my-4 "><a class="jsx-ad50481d5ee26850" href="/view/cardiomyopathy-risk-plummets-when-sacubitril-valsartan-taken-with-chemo?utm_source=www.ajmc.com&utm_medium=relatedContent"><img src="https://cdn.sanity.io/images/0vv8moc6/ajmc/8132c39d1104aa281fcfc366c4a00b16f1e55b7a-3600x2391.webp?fit=crop&auto=format" alt="Entresto packaging | Image credit: Novartis" width="288" class="jsx-ad50481d5ee26850 max-h-[200px] xs:w-[288px] "/></a><div class="jsx-ad50481d5ee26850 article-detail flex flex-col gap-[0.2rem] w-full sm:w-[46%] md:w-[65%]"><span class="jsx-ad50481d5ee26850 article-publish-date block italic text-sm text-gray-500 mt-[1rem] sm:mt-0">November 18th 2024</span><p class="jsx-ad50481d5ee26850 article-title font-bold text-[1rem]"><a class="jsx-ad50481d5ee26850" href="/view/cardiomyopathy-risk-plummets-when-sacubitril-valsartan-taken-with-chemo?utm_source=www.ajmc.com&utm_medium=relatedContent">Cardiomyopathy Risk Plummets When Sacubitril/Valsartan Taken With Chemo</a></p><div class="jsx-ad50481d5ee26850 authors flex-row wrap gap-[0.2rem]"><a class="jsx-ad50481d5ee26850 text-[#00ADEF] underline text-sm italic" href="/authors/mary-caffrey">Mary Caffrey</a></div><div class="jsx-ad50481d5ee26850 article-summary"><a class="jsx-ad50481d5ee26850" href="/view/cardiomyopathy-risk-plummets-when-sacubitril-valsartan-taken-with-chemo?utm_source=www.ajmc.com&utm_medium=relatedContent"><div class="jsx-ad50481d5ee26850 text-sm text-gray-500 py-1">The SARAH trial was limited to high-risk patients, which the lead investigator said prevented unnecessary exposure to adverse events in patients less at risk of cardiomyopathy.</div></a></div></div></div><div style="border-bottom:1px solid #CCCCCC" class="jsx-ad50481d5ee26850"></div></div></div></div></div><div class="pb-24"></div></div><script type="application/ld+json">{"@context":"https://schema.org","@type":"NewsArticle","headline":"ChatGPT Outperforms Trainee Doctors in Assessing Pediatric Respiratory Illness","datePublished":"2024-09-09T11:39:10.404Z","dateModified":"2024-09-09T12:46:01Z","inLanguage":"en-US","image":"https://cdn.sanity.io/images/0vv8moc6/ajmc/ec006cd9abfc9f21b53d00d89b8c7cd352db360a-4500x2532.jpg?fit=crop&auto=format","mainEntityOfPage":{"@type":"WebPage","@id":"https://www.ajmc.com/view/chatgpt-outperforms-trainee-doctors-in-assessing-pediatric-respiratory-illness"},"publisher":{"@type":"Organization","name":"AJMC","logo":{"@type":"ImageObject","url":"https://www.ajmc.com/ajmc_logo_inverted.png"}},"keywords":"respiratory health care,ERS Congress,chatgpt,google bard,microsoft bing,ai health care","articleBody":"New research presented at the European Respiratory Society (ERS) Congress in Vienna, Austria, reveals that ChatGPT could assess complex cases of respiratory disease in children better than trainee doctors.1\n\n\n\nTo come to this finding, 6 experts in pediatric respiratory medicine provided 6 clinical scenarios of cases such as cystic fibrosis, asthma, sleep-disordered breathing, breathlessness, and chest infections, that frequently occur in children. These scenarios were posed to 10 trainee doctors with less than 4 months of pediatric clinical experience, and they were given 1 hour to solve each case using internet resources, but not chatbots. These cases did not have an immediately clear diagnosis, and existing guidelines or evidence did not provide a definitive answer.\n\n\n\n\n\nThe 6 scenarios were also presented to 3 large language models (LLMs): ChatGPT version 3.5, Google’s Bard, and Microsoft Bing’s chatbot. The 6 experts then gave all responses a score out of 9 based on their correctness, comprehensiveness, usefulness, plausibility, and coherence, and answered whether they thought each response was generated by a human or chatbot.\n\n\n\nManjith Narayanan, MD, PhD, a consultant in pediatric pulmonology at the Royal Hospital for Children and Young People, presented the study’s findings at the ERS Congress 2024. He noted his motivation for the study was to determine how well LLMs can help clinicians in the real world.2\n\n\n\nThe results were intriguing. Trainee doctors scored a median (IQR) of 4 (3-6) points, the same as Bing (3-5), while Bard scored higher at 6 (5-7) and scored better than trainee doctors in coherence specifically (P < .05).\n\n\n\nChatGPT scored the highest overall with 7 of 9 points (6-8.25) and outperformed trainee doctors in all criteria (P < .001). Experts also believed ChatGPT had more human-like responses than responses from the other chatbots, as they correctly identified Bard and Bing responses as being nonhuman.\n\n\n\nNotably, none of the chatbots showed signs of hallucination, a phenomenon where LLMs generate seemingly accurate but false information. However, there were occasional irrelevant responses from the chatbots and the trainee doctors, and experts should be aware of the potential of hallucinations.\n\n\n\nAccording to Narayanan, this is the first study to test LLMs against trainee doctors in scenarios reflecting real-life clinical practice, and these results imply artificial intelligence (AI) could play a crucial role in alleviating pressure put on health care systems, although more research is needed.\n\n\n\n“We have not directly tested how LLMs would work in patient facing roles,” Narayanan noted. “However, it could be used by triage nurses, trainee doctors, and primary care physicians, who are often the first to review a patient.”\n\n\n\nFuture studies will focus on comparing chatbot performance with that of more experienced doctors and exploring the capabilities of newer LLMs. The research team is also considering investigating how chatbots can assist with more complex cases and further testing for accuracy and safety in real-world clinical environments.\n\n\n\nHilary Pinnock, MD, chair of the ERS Education Council and professor of primary care respiratory medicine at The University of Edinburgh, called the study “fascinating” while also expressing caution.\n\n\n\n“It is encouraging, but maybe also a bit scary, to see how a widely available AI tool like ChatGPT can provide solutions to complex cases of respiratory illness in children,” she said. “It certainly points the way to a brave new world of AI-supported care.”\n\n\n\nHowever, as the researchers highlighted, it is crucial to ensure these chatbots and other generative AI tools do not cause errors before they can be implemented in everyday clinical practice. These mistakes can include fabricated or hallucinated information, and can be due to the AI being trained on data that inadequately represent the diverse populations it is meant to serve.\n\n\n\n“As the researchers have demonstrated, AI holds out the promise of a new way of working, but we need extensive testing of clinical accuracy and safety, pragmatic assessment of organizational efficiency, and exploration of the societal implications before we embed this technology in routine care,” she added.\n\n\n\nAs AI continues to advance, this study signals a potential shift in the future of health care, where LLMs could become integrated into the clinical workflow, aiding professionals in delivering faster and more accurate diagnoses. However, the journey toward full adoption will require careful evaluation of clinical accuracy, organizational efficiency, and ethical considerations.\n\n\n\nReferences\n\n1. Juan J, Duverger K, Armstrong D, et al. Clinical scenarios in paediatric pulmonology: can large language models fare better than trainee doctors? Presented at: ERS Congress; September 7-11, 2024; Vienna, Austria. https://k4.ersnet.org/prod/v2/Front/Program/Session?e=549&session=17916\n\n2. ChatGPT outperformed trainee doctors in assessing complex respiratory illness in children. News release. ERS. September 9, 2024. Accessed September 9, 2024. https://www.ersnet.org/news-releases/chatgpt-outperformed-trainee-doctors-in-assessing-complex-respiratory-illness-in-children/","description":"New findings highlight the potential role of artificial intelligence in supporting health care professionals, but thorough testing is needed before its integration into everyday clinical practice.","author":[{"@type":"Person","name":"Hayden E. Klein"}]}</script></div></div><div class="flex-none w-[300px] z-[9999] relative hidden md:block"><div style="top:5rem" class="sticky custom-spacing"><div class="collapse-container " style="overflow:hidden;max-height:900px;transition:max-height .4s ease-in-out"></div></div></div></div><div id="div-gpt-ad-pixel" style="width:1px;height:1px" class=""></div><noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-NK5KQXS" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript><div id="footerOuterWrap" class=" mx-auto flex"><div class="bg-[#00598D] xl:w-[70%] w-[70%] py-12 pl-auto"><div class="xxl:w-[75%] w-[90%] ml-auto"><div><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span 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Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award—having received the honor for her extraordinary contributions to the field of preventive cardiology."}],"_type":"block","style":"normal","_key":"05ad6f56657f","markDefs":[{"blank":true,"_type":"link","href":"https://www.ajmc.com/conference/aspc-american-society-for-preventive-cardiology","_key":"4dcd358ee4b4","nofollow":false}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"add12fd8ce300"}],"_type":"block","style":"normal","_key":"84cc17abc6ef"},{"children":[{"_type":"span","marks":[],"text":"She stopped by to talk with ","_key":"33b7ea4ad4fb0"},{"_type":"span","marks":["em"],"text":"The American Journal of Managed Care","_key":"793a88f262d2"},{"marks":["superscript"],"text":"®","_key":"c39e4f32a7e6","_type":"span"},{"text":" while in Arlington, Texas, and our conversation covered everything from ","_key":"7fc1fc37a896","_type":"span","marks":[]},{"marks":["113a8d4907b6"],"text":"just what atrial fibrillation (AFib) is","_key":"08d50812142c","_type":"span"},{"text":" to risk factors and prevention strategies to connections between AFib and noncardiovascular health conditions to long-term data on stroke.","_key":"b75b6594c611","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"4e2453118957","markDefs":[{"nofollow":false,"blank":true,"_type":"link","href":"https://www.ajmc.com/compendium/heart-failure","_key":"113a8d4907b6"}]},{"style":"normal","_key":"b737717abafe","markDefs":[],"children":[{"_key":"700babdeeae20","_type":"span","marks":[],"text":""}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"Benjamin is associate provost for faculty development at Boston University Medical Campus; cardiologist at Boston Medical Center, a large urban safety net hospital; professor of medicine, Department of Medicine, at Boston University Chobanian and Avedisian School of Medicine; and professor of epidemiology, Boston University School of Public Health.","_key":"f93441383e6e0"}],"_type":"block","style":"normal","_key":"638d4818c723","markDefs":[]},{"markDefs":[],"children":[{"_key":"cd97204ca121","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"0563fe2e4ea9"},{"_type":"iframe","_key":"96d8685c6fe3","url":"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/1603670073%3Fsecret_token%3Ds-AmPI7XRrykh\u0026color=%23ff5500\u0026auto_play=false\u0026hide_related=false\u0026show_comments=true\u0026show_user=true\u0026show_reposts=false\u0026show_teaser=true\u0026visual=true"},{"_key":"2b433f01736a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Listen above or on one of these podcast services:","_key":"5625ac01ab88"}],"_type":"block","style":"normal"},{"children":[{"marks":["94eed32a44a2"],"text":"iTunes","_key":"d958276dcba4","_type":"span"},{"_type":"span","marks":[],"text":"\n","_key":"78acb4d972f5"},{"marks":["0c46e1a6482e"],"text":"TuneIn","_key":"5b3cc80b54e2","_type":"span"},{"marks":[],"text":"\n","_key":"3443be063560","_type":"span"},{"marks":["d7aacb13974e"],"text":"Stitcher","_key":"21ad339a5e71","_type":"span"},{"_type":"span","marks":[],"text":"\n","_key":"ba73f973bc91"},{"text":"Spotify","_key":"abb03e0565b9","_type":"span","marks":["cd75c74cb5c0"]}],"_type":"block","style":"normal","_key":"98de600b48c1","markDefs":[{"nofollow":true,"blank":true,"_type":"link","href":"https://podcasts.apple.com/us/podcast/managed-care-cast/id1177540313","_key":"94eed32a44a2"},{"nofollow":true,"blank":true,"_type":"link","href":"https://tunein.com/podcasts/Health--Wellness-Podcasts/Managed-Care-Cast-p937637/","_key":"0c46e1a6482e"},{"blank":true,"_type":"link","href":"https://www.stitcher.com/podcast/managed-care-cast","_key":"d7aacb13974e","nofollow":true},{"_key":"cd75c74cb5c0","nofollow":true,"blank":true,"_type":"link","href":"https://open.spotify.com/show/7JQZGTuflqnkt8wjfX238y"}]}],"url":"the-importance-of-examining-and-preventing-atrial-fibrillation","targeting":{"content_placement":["podcasts","podcasts/managed-care-cast","compendium/heart-failure","news","topic/center-on-health-equity-and-access","stakeholders/providers","topic/healthcare-delivery","interviews","partners","conference"],"document_url":["the-importance-of-examining-and-preventing-atrial-fibrillation"],"document_group":null,"rootDocumentGroup":[],"issue_url":"","publication_url":""},"relatedArticles":[{"title":"FDA Accepts Resubmitted NDA for Ataluren in Nonsense Duchenne Muscular Dystrophy","url":{"current":"fda-accepts-resubmitted-nda-for-ataluren-in-nonsense-duchenne-muscular-dystrophy","_type":"slug"},"thumbnail":{"_type":"mainImage","alt":"FDA website | Image Credit: © Postmodern Studio - 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Persistent disparities in heart failure have reinforced the need to take a closer look at why some populations bear the brunt of disease burden more than others. Health inequities was a large topic explored throughout the 100th ","_key":"f18309f320a6"},{"text":"American Heart Association","_key":"aeb7c10d0e19","_type":"span","marks":["32408c1f26c6"]},{"text":" (AHA) conference. Khadijah Breathett, MD, MS, FACC, associate professor of medicine, Indiana University, spoke to the impact of social determinants of health and, notably, how community-based research can inform efforts to tackle inequities in ","_key":"80ccdd99b234","_type":"span","marks":[]},{"_key":"39488c252d94","_type":"span","marks":["b3c398b1635b"],"text":"cardiovascular disease"},{"_type":"span","marks":[],"text":".","_key":"8424697a6d1c"}],"_type":"block","style":"normal","_key":"3f280750f3b8","markDefs":[{"_type":"link","href":"https://www.ajmc.com/conference/aha","_key":"32408c1f26c6","nofollow":false,"blank":true},{"blank":true,"_type":"link","href":"https://www.ajmc.com/compendium/heart-failure","_key":"277c2dae978f","nofollow":false},{"_type":"link","href":"https://www.ajmc.com/compendium/cardiovascular","_key":"b3c398b1635b","nofollow":false,"blank":true}]},{"_type":"block","style":"normal","_key":"5b0f4c84092e","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"83745168a1db0"}]},{"children":[{"_type":"span","marks":["em"],"text":"This transcript has been lightly edited for clarity and length.","_key":"e3aae91ee57c0"}],"_type":"block","style":"normal","_key":"4042781b7746","markDefs":[]},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"1c62a792ddaa0","_type":"span"}],"_type":"block","style":"normal","_key":"29041cd08c90"},{"_type":"block","style":"normal","_key":"821523526d0d","markDefs":[],"children":[{"_type":"span","marks":["strong","underline"],"text":"Transcript","_key":"d1437c8569810"}]},{"_key":"4b81131c4e1a","markDefs":[],"children":[{"marks":[],"text":"","_key":"bdc7c872f47c0","_type":"span"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"marks":["strong"],"text":"What findings from community-based research have been the most surprising, specifically regarding factors that drive disparities in cardiovascular health?","_key":"fd57146317730","_type":"span"}],"_type":"block","style":"normal","_key":"96f9f7480464"},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"646f003f1a7b0","_type":"span"}],"_type":"block","style":"normal","_key":"e417d912885a"},{"markDefs":[],"children":[{"marks":[],"text":"I think there are multiple issues that have come to the horizon. One: we definitely need to include the community. In my own work, I've focused on developing a patient and stakeholder community advisory board that's national that we use to develop ideas, to understand what the problems are, to develop the strategies, using actually implementation science frameworks, to then attempt to deploy in studies to fix some of these major disparities that are facing our nation, particularly in the way that we deliver cardiovascular care.","_key":"b45fa4389fd30","_type":"span"}],"_type":"block","style":"normal","_key":"4b8960bfa0d1"},{"_key":"6ff65949ab96","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"93233c8ae9680"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_key":"14aa778aa0150","_type":"span","marks":[],"text":"I think there's a greater focus on that now, on community-based research, community-based participatory research as well. I think one of the major benefits that have happened over the past couple years is that some of the large funding organizations also recognize that this is important, and have made this a major requirement to compete for some of these large awards."}],"_type":"block","style":"normal","_key":"27278cc791c5"},{"style":"normal","_key":"12129dcedb91","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"bf078adc498e0"}],"_type":"block"},{"style":"normal","_key":"c0777f824464","markDefs":[],"children":[{"_key":"eb7ef1c359ac0","_type":"span","marks":[],"text":"We have to include the community as we're moving forward to address these problems of disparities in cardiovascular disease. It's devastating underrepresented populations, and it's only projected to worsen over the next several decades."}],"_type":"block"},{"style":"normal","_key":"3ee20bb44013","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"2bf946af1018"}],"_type":"block"},{"children":[{"_type":"span","marks":["strong"],"text":"Can you speak to the value of community engagement? What strategies have you found are the most effective for building trust and optimizing engagement within communities impacted by cardiovascular health disparities?","_key":"b9b01b8739d60"}],"_type":"block","style":"normal","_key":"d8cbf8228c96","markDefs":[]},{"children":[{"_key":"9e6890c5d5840","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"c131b477784f","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"We know you have to belong to the community and invest in the community to develop those appropriate relationships and identify \"what does the community need?\" so that we can again work collaboratively together to meet those needs. And so for me, personally, it's really important just in terms of who I am to belong to my faith community, to my church, and so that's a natural community I already belong to. And I use those different communities to also work on the some of the research that I do. As I've lived in many different places over the past couple decades, I've developed relationships with individuals that also care about these things, with community members and also those may have an academic position as well to figure out, how can we do things differently, how can we think outside of the box of what is considered the status quo, to do things differently. ","_key":"284c523b98fc0"}],"_type":"block","style":"normal","_key":"a4ef3961385e","markDefs":[]},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"ec6fbb4daa0b","_type":"span"}],"_type":"block","style":"normal","_key":"c23ed1a6a7fc"},{"_type":"block","style":"normal","_key":"4c958ae61d98","markDefs":[],"children":[{"_type":"span","marks":[],"text":"I had a study called the CEASe study that was actually funded through the HRSA [Health Resources and Services Administration] to identify how to improve cardiovascular care delivery in an inpatient setting. And we looked at population data nationwide, statewide, to understand what are the differences in care, particularly in regards to something called the segregation index, to understand the likelihood that a patient will receive care from a cardiologist, or whether they'll receive care from a group of people that vary based upon the race of the actual patient, and how does that impact their care. We've had a lot of complex findings. Some are still under review with respective journals, so I can't completely share all of what we found, but there were some interesting, significant findings that need to be addressed further. ","_key":"a9dacfd6ca57"}]},{"children":[{"text":"And so we presented this data to our national patient stakeholder advisory board, and then discussed what were the next steps. 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The trial demonstrated that finerenone effectively reduced heart failure events and mortality in both sexes without significant sex-specific differences in outcomes or adverse events. While obesity's impact on HFpEF and finerenone's effectiveness showed no sex-based differences, the drug's nonsteroidal nature suggests kidney safety benefits for all patients. 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New data from the FINEARTS-HF trial, which evaluated the safety and efficacy of finerenone (Kerendia), offers some relief in this respect due to its large inclusion of female patients. Finerenone is a nonsteroidal mineralocorticoid receptor antagonist (MRA) that has gained traction as a "},{"marks":["ac599e0f156b"],"text":"new therapeutic","_key":"361b9d186ec11","_type":"span"},{"_type":"span","marks":[],"text":" for patients with cardiorenalmetabolic diseases.","_key":"361b9d186ec12"}]},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"0eaefa1a143a0","_type":"span"}],"_type":"block","style":"normal","_key":"ebd4acb48ef2"},{"_type":"block","style":"normal","_key":"a47e97298532","markDefs":[{"_type":"link","href":"https://www.ajmc.com/conference/aha","_key":"8e0b7900f78f"}],"children":[{"_type":"span","marks":[],"text":"Misato Chimura, MD, PhD, University of Glasgow, presented on some of the latest, sex-specific findings from FINEARTS-HF at the 2024 ","_key":"ffcd41401e540"},{"_type":"span","marks":["8e0b7900f78f"],"text":"American Heart Association","_key":"ffcd41401e541"},{"_type":"span","marks":[],"text":" (AHA) conference. Overall, the study participation consisted of 46% females (n = 2732 vs 3269 males), which Chimura proudly stated, “makes it one of the few cardiovascular trials with a substantial representation of women.”","_key":"ffcd41401e542"}]},{"_type":"block","style":"normal","_key":"b22c0e518063","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"0822dd04487f0"}]},{"_type":"block","style":"normal","_key":"2e26571b8cf6","markDefs":[],"children":[{"_type":"span","marks":["em"],"text":"This transcript has been lightly edited for clarity and length.","_key":"8b4c82f653e20"}]},{"_key":"d3a7ee1e8919","markDefs":[],"children":[{"marks":[],"text":"","_key":"b262f28708230","_type":"span"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"181aa2f7414e","markDefs":[],"children":[{"_type":"span","marks":["strong","underline"],"text":"Transcript","_key":"97e2cf8371220"}]},{"_key":"16c2353be502","markDefs":[],"children":[{"marks":[],"text":"","_key":"bd5e8e2660220","_type":"span"}],"_type":"block","style":"normal"},{"_key":"675e2aa676eb","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"What kind of questions did you examine in your sex-specific analysis? What results surprised you?","_key":"1205b4cd46600"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"","_key":"464e262506f70"}],"_type":"block","style":"normal","_key":"0995d80dbece","markDefs":[]},{"_key":"c21c5c01395e","markDefs":[],"children":[{"_type":"span","marks":[],"text":"I think that’s a very important question. In this study, we examined the efficacy and safety of finerenone in both women and men. Compared to placebo, finerenone similarly reduced the risk of the primary end point in both women and men, and consistent effects were observed for total heart failure events, first heart failure event, cardiovascular disease, and all-cause mortality. And the test for grade 6 treatment interaction was not significant for each outcome.","_key":"11daf12d1af10"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_key":"e052f3fc36920","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"2fb4394aebca"},{"markDefs":[],"children":[{"text":"For adverse events, finerenone increased the risk of hyperkalemia and hypertension and reduced the risk of hypokalemia compared with placebo, with similar effect in both women and men. And potential antiandrogen adverse events were rare between women and men and their treatment groups, and with no difference between placebo and treatment group.","_key":"76aa3fdc261a0","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"eb572d5ab41b"},{"style":"normal","_key":"84a973f65ad0","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"17d2c539bc9d0"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Did your findings shed any light on the relationship between obesity and HFpEF? If so, what differences did you see between men and women?","_key":"c5e6911f00990"}],"_type":"block","style":"normal","_key":"da020e665dd3"},{"markDefs":[],"children":[{"_key":"2dffc269ea1a0","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"92e84f5405a5"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"We do not have a clear answer now, but in my impression, MRA is more effective in patients with obesity, but there is no difference between the sexes in the effect of finenerone in patients with obesity. Because obesity is associated with the excessive aldosterone secretion from adipocytes, independent of the classical renin-angiotensin-aldosterone system. So therefore MRA is more effective in the patient with obesity.","_key":"d4adf71200010"}],"_type":"block","style":"normal","_key":"dfbbf0f38864"},{"_key":"050f955f1ff1","markDefs":[],"children":[{"_type":"span","marks":[],"text":"But we believe that there are no reported differences in the metabolism of MRA between women and men. So currently, the substudy analysis of obesity is conducted, and once this data is available, we can get more information about this.","_key":"6f5442f3ca93"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"75efc5a8cb780"}],"_type":"block","style":"normal","_key":"dbdaf2cd3543"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Finerenone is a nonsteroidal MRA, which should be safer for the kidneys than a steroidal MRA. Is this aspect of finerenone especially important to men or women?","_key":"015564e58eaf0"}],"_type":"block","style":"normal","_key":"48f575a97718"},{"children":[{"text":"","_key":"c49eb2db38af0","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"e458be332e25","markDefs":[]},{"_key":"87e1ce99d2cc","markDefs":[],"children":[{"marks":[],"text":"Well, the answer would be no, because, you know, the differences in anatomy, such as BSA [body surface area] and organ sites, as well as the differences in the pharmacokinetics and the pharmacodynamics are observed between women and men. But as I said, we believe that there are no notable differences in metabolism or MRA. 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The study revealed a 77% reduction in cardiomyopathy risk among patients taking the drug compared to placebo. Conducted at Erasto Cancer Hospital, the trial involved 114 adults, primarily women with breast cancer. Results indicated significant improvements in global longitudinal strain and left ventricle ejection fraction. Despite promising outcomes, the study's limitations include its small size, single location, and lack of diversity, necessitating further research.","factCheckAuthorMapping":null,"documentGroupMapping":null,"url":"cardiomyopathy-risk-plummets-when-sacubitril-valsartan-taken-with-chemo","_rev":"1U42a9jxrELBwJpoJ7DSG2","contentCategory":{"_type":"contentCategory","name":"Articles","_id":"3f4b3ced-7c9d-4fc4-967f-fe993087cce2","_updatedAt":"2023-09-29T14:32:27Z","_createdAt":"2020-04-03T20:03:53Z","_rev":"Q2ZL7ihdIB33NiMMcGccmh"},"title":"Cardiomyopathy Risk Plummets When Sacubitril/Valsartan Taken With Chemo","_updatedAt":"2024-11-20T01:15:24Z","gptTakeaways":"• Sacubitril/valsartan reduced cardiomyopathy risk by 77% in cancer patients on anthracycline chemotherapy, as shown in the SARAH trial.\n\n• The trial involved 114 adults, primarily women with breast cancer, and showed significant improvements in GLS and LVEF.\n\n• Limitations include small sample size, single location, and lack of diversity, highlighting the need for further research.\n\n• The study's focus on high-risk patients and good safety profile were noted strengths, with no serious adverse events reported.","ExcludeFromPubMedXML":false,"_type":"article","factCheckAuthors":null,"is_visible":true,"published":"2024-11-18T14:15:00.000Z","body":[{"_type":"block","style":"normal","_key":"6d74bcc24ec2","markDefs":[{"nofollow":false,"blank":true,"_type":"link","href":"https://www.ajmc.com/conference/aha","_key":"5c01c08b6a71"}],"children":[{"text":"A well-known heart failure (HF) drug showed promise for blocking cardiotoxic effects in patients taking anthracycline chemotherapy for cancer, according to results presented today at the ","_key":"782eebf89dc40","_type":"span","marks":[]},{"_type":"span","marks":["5c01c08b6a71"],"text":"2024 American Heart Association (AHA) Scientific Sessions","_key":"cf79f17c02ae"},{"text":" in Chicago, Illinois.","_key":"2c11c47d9498","_type":"span","marks":[]}]},{"asset":{"_ref":"image-df44de01651e6aa7937daf747ba61f34fdb74f7f-800x800-jpg","_type":"reference"},"disableTextWrap":false,"disableLightBox":true,"_key":"bac23da65593","_type":"figure","alt":"Marcely G. Bonatto, MD, PhD | Image credit: University of São Paulo","widthP":25,"imgcaption":[{"_key":"36b515bc990a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Marcely G. Bonatto, MD, PhD | Image credit: University of São Paulo","_key":"e9c003d38593"}],"_type":"block","style":"normal"}],"alignment":"left"},{"markDefs":[],"children":[{"_key":"ae99f27e42630","_type":"span","marks":[],"text":"Patients in a small study who took sacubitril/valsartan, sold as Entresto (Novartis), saw their risk of cardiomyopathy drop 77% compared with those taking placebo. The results led to lead author Marcely G. Bonatto, MD, PhD, of the University of São Paulo in Curitiba, Brazil, calling for steps to identify high-risk patients who might benefit from this approach."}],"_type":"block","style":"normal","_key":"8951cd1f3f5e"},{"style":"normal","_key":"4629c7a914f9","markDefs":[],"children":[{"marks":[],"text":"The trial, called SARAH, addressed a longstanding challenge in the care of patients with cancer. Regimens that treat many types of cancer—including breast, stomach, bladder, ovarian, and leukemia—rely anthracyclines such as doxorubicin that are derived from enzyme-killing bacteria that are highly toxic. ","_key":"b2fb48a7080d0","_type":"span"}],"_type":"block"},{"style":"normal","_key":"1585a60943b7","markDefs":[],"children":[{"text":"The mechanisms of anthracyclines that target DNA in cancer can also cause heart damage, primarily due to the effect on topoisomerase 2β, which has become a focus of research. When this protein, also known as top2β, interacts with anthracyclines, it can lead to the DNA damage that causes cardiomyopathy.","_key":"f99ff4439e040","_type":"span","marks":[]}],"_type":"block"},{"style":"normal","_key":"86d125ed784d","markDefs":[{"_key":"50f765a7fd2e","nofollow":true,"blank":true,"_type":"link","href":"https://www.cancer.gov/news-events/cancer-currents-blog/2018/increased-heart-failure-risk#:~:text=Although%20the%20risk%20of%20developing,Scientific%20Session%20on%20March%2010."},{"href":"https://www.yalemedicine.org/news/early-onset-cancer-in-younger-people-on-the-rise#:~:text=More%20of%20those%20new%20cases,according%20to%20the%20ACS%20report.","_key":"89bf98720bb7","nofollow":true,"blank":true,"_type":"link"}],"children":[{"text":"Concern about the ","_key":"35902fbf0f6a","_type":"span","marks":[]},{"_type":"span","marks":["50f765a7fd2e"],"text":"long-term effects of anthracyclines","_key":"ca87edff1ae0"},{"_type":"span","marks":[],"text":" on cancer survivors has increased in the past decade, since new classes of therapies have reduced cancer mortality. Newer drugs may be used later in the course of the disease or alongside chemotherapy in a multidrug regimen. At the same time, cancer is ","_key":"a017e3b17bee"},{"marks":["89bf98720bb7"],"text":"being diagnosed in younger adults","_key":"1aa7d2fa6e9a","_type":"span"},{"text":" due to rising obesity rates; these patients often have cancers where anthracyclines remain a mainstay of treatment.","_key":"15ae7f432915","_type":"span","marks":[]}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"SARAH Trial Design","_key":"333416eeeeb40"}],"_type":"block","style":"h3","_key":"a46587799af2"},{"style":"normal","_key":"4ca9e21cfd45","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Investigators in SARAH identified patients at high risk of heart failure by measuring troponin levels during anthracycline treatment. Those at the 99th percentile were eligible for the study.","_key":"333416eeeeb41"}],"_type":"block"},{"_type":"block","style":"normal","_key":"5daf5cbb39e4","markDefs":[],"children":[{"text":"Patients were randomized to receive either sacubitril/valsartan or placebo for 6 months; after starting with a dose of 24 mg or 26 mg twice a day, the doses were titrated up at the 2- and 4-week marks to reach optimal dosing of 97 mg to 103 mg twice a day. Patients were treated with the heart failure drug for 24 weeks. The study group was evaluated for biomarkers, echocardiographic (ECHO) assessments, and cardiac magnetic resonance (CMR).","_key":"0b16286e77290","_type":"span","marks":[]}]},{"style":"normal","_key":"e3bfd6dd0561","markDefs":[],"children":[{"_key":"27dcfc1a6ee20","_type":"span","marks":[],"text":"Investigators reported that they calculated a sample size of 100 patients using estimated event rates of 35% in the placebo group and 12% in the study drug group, with 80% power and a type I error rate of .05. The primary end point was defined as the incidence of patients showing a greater than 15% reduction in global longitudinal stain (GLS) on the left ventricle after 6 months. Secondary end points included changes in biomarkers, GLS, and left ventricle ejection fraction (LVEF) after 6 months."}],"_type":"block"},{"style":"h3","_key":"2ca14f7c840d","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"SARAH Trial Results","_key":"cfcf37e2f4140"}],"_type":"block"},{"markDefs":[],"children":[{"_key":"cfcf37e2f4141","_type":"span","marks":[],"text":"The study was conducted at Erasto Cancer Hospital in Brazil from March 2022 to August 2024. The trial assigned 114 adults with cancer in a randomized fashion (1:1). The participants were undergoing chemotherapy at Erasto Gaertner, a cancer hospital in Curitiba, Brazil. The group was 90% women, with 80.7% being treated for breast cancer, and the mean age was 51.7 years. Of this group, 92% were White, 7% were Black or mixed-race, and 1% were Asian."}],"_type":"block","style":"normal","_key":"79c12e3af381"},{"_key":"ee1daea7a983","listItem":"bullet","markDefs":[],"children":[{"text":"Almost two-thirds (64%) had at least 1 comorbidity.","_key":"b519e139d0d50","_type":"span","marks":[]}],"level":1,"_type":"block","style":"normal"},{"listItem":"bullet","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Baseline GLS –20.1% (–15.5% to –29%) and baseline LVEF was 64% (53.1% to 79.2%).","_key":"6826ba7af9cc0"}],"level":1,"_type":"block","style":"normal","_key":"5695ac354144"},{"listItem":"bullet","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The primary end point was met in 7.1% of patients receiving sacubitril/valsartan, compared with 25% receiving placebo (HR, 0.23; 95% CI, 0.07-0.75, ","_key":"6f0d23665f090"},{"_type":"span","marks":["em"],"text":"P","_key":"6f0d23665f091"},{"text":" \u003c .015)","_key":"6f0d23665f092","_type":"span","marks":[]}],"level":1,"_type":"block","style":"normal","_key":"10bbdb1daba3"},{"level":1,"_type":"block","style":"normal","_key":"9d7b68c03c77","listItem":"bullet","markDefs":[],"children":[{"_key":"53a8084cf23c0","_type":"span","marks":[],"text":"The sacubitril/valsartan group improved GLS by 2.5%, compared with the placebo group, which saw a 7.6% decline ("},{"marks":["em"],"text":"P","_key":"53a8084cf23c1","_type":"span"},{"_type":"span","marks":[],"text":" = .015).","_key":"53a8084cf23c2"}]},{"style":"normal","_key":"c39891efbdea","listItem":"bullet","markDefs":[],"children":[{"text":"At 6 months, LVEF as measured by CMR increased by 0.19% in the sacubitril/valsartan group and decreased by 3.47% in the placebo group (","_key":"be0f79c2d6f50","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"P","_key":"be0f79c2d6f51"},{"_key":"be0f79c2d6f52","_type":"span","marks":[],"text":" = .011)."}],"level":1,"_type":"block"},{"listItem":"bullet","markDefs":[],"children":[{"marks":[],"text":"There were no differences seen biomarkers, ECHO, or other CMR measures.","_key":"4f1699d9e7000","_type":"span"}],"level":1,"_type":"block","style":"normal","_key":"a966493fefe5"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"SARAH, Bonatto said at a press conference ahead of Monday’s presentation, “is the first study to test sacubitril/valsartan as a protective cardio strategy against anthracycline-induced cardiotoxicity, especially in high-risk patients.”","_key":"cd97723e32c10"}],"_type":"block","style":"normal","_key":"0c801b9391c9"},{"style":"normal","_key":"bea14a99b585","markDefs":[],"children":[{"_type":"span","marks":[],"text":"“It's important to note that our strategy selected patients with cellular injury and therefore at high risk of developing cardiotoxicity,” she said. Pinpointing the patients that may benefit from sacubitril/valsartan “helps to avoid unnecessary exposure to adverse events and costs for lower-risk patients.”","_key":"8f333069e74a0"}],"_type":"block"},{"style":"h3","_key":"8ac4736fddb5","markDefs":[],"children":[{"marks":["strong"],"text":"Long-Term Follow-Up Needed","_key":"1ab038952752","_type":"span"}],"_type":"block"},{"alignment":"left","widthP":25,"_type":"figure","disableLightBox":true,"alt":"Tochi M. Okwuosa, DO | Image credit: Rush University","_key":"1d9d79509852","imgcaption":[{"_type":"block","style":"normal","_key":"9e40d22f3f18","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Tochi M. Okwuosa, DO | Image credit: Rush University","_key":"424b621f09d5"}]}],"disableTextWrap":false,"asset":{"_ref":"image-0c48275827a2708bdc5163b169dee5383a848e83-800x605-jpg","_type":"reference"}},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Tochi M. Okwuosa, DO, of Rush University in Chicago offered comment on the study, first explaining the separate mechanisms of sacubitril and valsartan. She noted that SARAH evaluated patients by CMR and ECHO, which most studies have not done.","_key":"8967389d890c0"}],"_type":"block","style":"normal","_key":"e97575da288a"},{"style":"normal","_key":"92044c2aefa7","markDefs":[],"children":[{"_type":"span","marks":[],"text":"More research is needed, she said.","_key":"b098bcf55c830"}],"_type":"block"},{"markDefs":[],"children":[{"marks":[],"text":"“We need longer term follow-up in the cardio-oncology population,” Okwuosa said. “The serum trial was just for 6 months. We need comparison between sacubitril/valsartan and valsartan alone. We need hard outcomes like heart failure hospitalizations, cardiovascular and overall mortality. We need real world studies. And then, cost and wide availability is also an issue,” she said.","_key":"c3b91bc0507e0","_type":"span"}],"_type":"block","style":"normal","_key":"24d52147d5dc"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Strengths of the study include its focus on high-risk patients and the good safety profile, Bonatto said. There were no serious adverse events, she said, and fewer patients in the sacubitril/valsartan group completed the study with cardiac dysfunction. In response to the suggestion about using valsartan alone, Bonatto said in animal studies, sacubitril/valsartan is superior to valsartan alone in preventing damage.","_key":"1c23ad0bfeb40"}],"_type":"block","style":"normal","_key":"f679965a92cd"},{"_type":"block","style":"normal","_key":"e5f130645d0b","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Limitations cited include the study’s small size, single location, and lack of diversity in the patient population.","_key":"0a95886804a00"}]},{"_key":"94ecc24cafb8","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The AHA sessions conclude today.","_key":"5f8ee639dea90"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"3fe0d1d65468","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Reference","_key":"5b93731563960"}]},{"children":[{"text":"Bonatto M, Ferreira S, Avila M, et al. Effects of sacubitril-valsartan on prevention of cardiotoxicity in high-risk patients undergoing anthracycline chemotherapy: a double-blind randomized placebo-controlled clinical trial – the SARAH trial. Presented at: American Heart Association Scientific Sessions; November 16-18, 2024; Chicago, IL. 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