Introduction Informed consent is essential to surgical care yet often burdens clinicians. Recent studies suggest that large language models can streamline this process. This study evaluates ChatGPT-generated consents for common general surgery procedures and compares between surgeon and resident perceptions of their clinical utility. Materials and methods In this cross-sectional, survey-based feasibility study, board-certified surgeons and general surgery residents at a community-based training program reviewed ChatGPT-generated consents for four common procedures. Each document included indications, risks, benefits, and alternatives. Participants completed structured surveys assessing perceived accuracy, completeness, and appropriateness. Interrater reliability was assessed using Cohen's kappa. Agreement proportions were compared using one-way ANOVA. Free-text responses were thematically analyzed. Results Twenty-one reviewers (11 surgeons, 10 residents) evaluated ChatGPT-generated consents. Mean agreement across consent components ranged from 94.5% to 96.4%, with no significant differences by procedure (P = 0.79). Interrater reliability was low and nonsignificant (P > 0.5), indicating limited agreement beyond chance. When responses were pooled by question type, agreement differed significantly (P < 0.01): all reviewers unanimously agreed on the appropriateness of listed benefits (100%), while agreement on risks (93.2%) and overall comprehensiveness (94.3%) was slightly lower. Qualitative responses highlighted the need for physician oversight, concerns about missing clinical nuance, and the importance of preserving patient rapport. Conclusions Surgeons and residents rated ChatGPT-generated consents as accurate and appropriate for routine general surgery procedures. With clinician oversight, integrating large language models into the consent process appears feasible and may reduce documentation burden without compromising accuracy.
Hemoptysis is a frequent and potentially life-threatening pulmonary presentation that requires rapid stabilization and timely definitive management. Tranexamic acid (TXA), a synthetic antifibrinolytic agent, has gained increasing interest as an adjunctive medical therapy for hemoptysis, supported by recent randomized trials, observational studies, and systematic reviews evaluating inhalational and endobronchial routes. While bronchoscopy, bronchial artery embolization (BAE), and surgery remain central to the management of severe or life-threatening hemoptysis, TXA may reduce bleeding burden, shorten hospitalization, and serve as a temporizing or bridging therapy while definitive interventions are arranged. This narrative review summarizes TXA pharmacology, available routes of administration, dosing strategies, clinical evidence, safety considerations, and practical integration into contemporary hemoptysis management pathways. The literature selection approach is briefly described in the manuscript body to improve transparency regarding how representative studies were identified and prioritized.
OBJECTIVES:Ecological Momentary Assessment (EMA) is a promising methodology for examining the contextual impact of psychosocial functioning on chronic disease management in individuals with type 1 diabetes (T1D). Little is known regarding psychometric properties of EMA of psychosocial functioning in adults with complications related to T1D. The aim of this study is to explore the feasibility, reliability, and validity of EMA psychosocial measures examining depression, anxiety, diabetes-related distress, and fear of hypoglycemia in a sample of adult individuals with complications related to T1D. METHODS:Fifty-one participants with T1D completed a 14-day EMA of symptoms of depression, anxiety, diabetes-related distress, and fear of hypoglycemia. Multilevel linear models were used to evaluate the association of EMA psychosocial questions with standard psychosocial measures. RESULTS:Feasibility was demonstrated via high response rates across the 14-day EMA response period (3 times daily). All 4 EMA measures (depression, anxiety, diabetes-related distress, and fear of hypoglycemia) showed meaningful (i.e. ≥25%) within-person variability (from 28.7% in diabetes-related distress to 46.5% in fear of hypoglycemia). All measures exceeded between-person reliability of 0.8 within 1 to 3 days. None of the measures demonstrated significant diurnal patterns. Convergent validity was established via significant correlations between all aggregate EMA measures with corresponding "gold standard" surveys. CONCLUSIONS:Overall, findings support the psychometric properties (feasibility, reliability, and validity) of EMA of psychosocial measures in an adult cohort with complications related to T1D. This is the first study to date to examine psychometric properties of EMA of psychosocial measures examining depression, anxiety, diabetes-related distress, and fear of hypoglycemia simultaneously in an adult population with complications related to T1D.
