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      A commentary on: ‘Matters arising: authors of research papers must cautiously use ChatGPT for scientific writing’

      research-article
      , MD a , , PhD b , , PhD a , c ,
      International Journal of Surgery (London, England)
      Lippincott Williams & Wilkins

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          Abstract

          Dear Editor, ChatGPT has attracted global attention as an AI tool that generates human-like text, providing users with conversational answers. Recent studies emphasize ChatGPT’s potential in medical applications, such as offering expert advice and assisting in academic writing 1 . Shafiee et al. 2 . delineated the phenomenon of ChatGPT fabricating study sources. Upon meticulous scrutiny of their thought-provoking study, we endeavor to contribute our insights to enhance the scholarly dialogue surrounding this subject. We concur with the authors’ viewpoint that ChatGPT exhibits the phenomenon of fabricating facts, a concern that has become frequent and apparent in practical applications. However, Shafiee and colleagues omitted the information that ChatGPT 3.5 and 4.0 versions were trained with the same fixed knowledge base, last updated in September 2021. Meanwhile, coronavirus disease 2019 (COVID-19) was initially reported in Wuhan, China, in December 2019 and rapidly spread worldwide 3 . Therefore, ChatGPT may not provide accurate information when answering due to the limited training corpus regarding the latest studies on COVID-19. Meanwhile, as Large Language Models (LLMs), ChatGPT also experiences the common problem of the ‘hallucination’ phenomenon, which poses risks of fabricating study sources that do not exist 4 . This also constitutes a critical barrier to the current unfeasibility of ChatGPT in clinical practice. However, ChatGPT can provide accurate answers when searching within the knowledge base’s coverage. For comparison, we tasked ChatGPT with composing an introduction and references related to the 2003 outbreak of a global health event, severe acute respiratory syndrome (SARS) 5 . After increasing the question difficulty, ChatGPT consistently produced correct references. We also tested its ability to respond to a similar question with the authors, ‘Write an introduction about brain neurotrophic factor and SARS with 50 words, including some references.’ ChatGPT provided two valid references. When asked to include 10 references, it demonstrated a 100% valid recognition rate. Figure 1 illustrates the precise nature of these conversations. Figure 1 ChatGPT’s responses to questions related to SARS. In summary, there are two main reasons why ChatGPT cannot currently serve as a tool for paper retrieval. First, the knowledge base is fixed and cannot be updated in real time. Integration with the database would enhance retrieval accuracy and breadth. Secondly, until the hallucination problem is resolved, the distortion of paper information occurs when the inquired content surpasses the cognitive capacity of ChatGPT. Shafiee and colleagues provide an insightful perspective on the use of ChatGPT for scientific writing. Our insights hold the potential to catalyze progress in this field, enhance the discourse process, and offer an alternative perspective for future exploration. Ethical approval Not applicable. Consent Not applicable. Sources of funding This work was supported by the National Natural Science Foundation of China (82171475). Author contribution All authors read and approved the final version of the manuscript. Conflicts of interest disclosure There are no conflicts of interest. Research registration unique identifying number (UIN) Not applicable. Guarantor All the authors of this paper accept full responsibility for the work and/or the conduct of the study, have access to the data, and control the decision to publish. Data availability statement No primary data were generated and reported in this manuscript. Therefore, data have not become available to any academic repository. Provenance and peer review Not applicable.

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          COVID-19 diagnosis —A review of current methods

          A fast and accurate self-testing tool for COVID-19 diagnosis has become a prerequisite to comprehend the exact number of cases worldwide and to take medical and governmental actions accordingly. SARS-CoV-2 (formerly, 2019-nCoV) infection was first reported in Wuhan (China) in December 2019, and then it has rapidly spread around the world, causing ~14 million active cases with ~582,000 deaths as of July 2020. The diagnosis tools available so far have been based on a) viral gene detection, b) human antibody detection, and c) viral antigen detection, among which the viral gene detection by RT-PCR has been found as the most reliable technique. In this report, the current SARS-CoV-2 detection kits, exclusively the ones that were issued an “Emergency Use Authorization” from the U.S. Food and Drug Administration, were discussed. The key structural components of the virus were presented to provide the audience with an understanding of the scientific principles behind the testing tools. The methods that are still in the early research state were also reviewed in a subsection based on the reports available so far.
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            SARS — beginning to understand a new virus

            Key Points A new infectious disease, called severe acute respiratory syndrome (SARS), appeared in southern China in 2002. During the period from November 2002 to the summer of 2003, the World Health Organization recorded 8098 probable SARS cases and 774 deaths in 29 countries. A previously unknown coronavirus was isolated from FRhK-4 and Vero E6 cells inoculated with clinical specimens from patients. A virus with close homology to SARS-CoV was isolated from palm civets and racoon dogs, which are used as food in southern China In less than a month from the first indication that a coronavirus might be implicated in the disease, the nucleotide sequence of the virus was available, and diagnostic tests were set up. The phylogenetic analysis of the SARS-CoV genome revealed that the virus is distinct from the three known groups of coronaviruses and represents an early split-off from group 2. The development of antiviral drugs or vaccines is being investigated. Viral enzymes essential for virus replication, such as the RNA-dependent RNA polymerase (RdRp), the 3C-like cystein protease (3Clpro) and the helicases are the most attractive targets for antiviral molecules. Of the possible vaccine targets, the spike (S) protein represents the most promising one. So far, β-interferon is the only licensed drug available, which has been reported to interfere with virus replication in vitro. Should SARS return during the next winter, we will still need to rely mostly on quarantine measures to contain it.
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              Performance of ChatGPT and GPT-4 on Neurosurgery Written Board Examinations

              Interest surrounding generative large language models (LLMs) has rapidly grown. Although ChatGPT (GPT-3.5), a general LLM, has shown near-passing performance on medical student board examinations, the performance of ChatGPT or its successor GPT-4 on specialized examinations and the factors affecting accuracy remain unclear. This study aims to assess the performance of ChatGPT and GPT-4 on a 500-question mock neurosurgical written board examination. The Self-Assessment Neurosurgery Examinations (SANS) American Board of Neurological Surgery Self-Assessment Examination 1 was used to evaluate ChatGPT and GPT-4. Questions were in single best answer, multiple-choice format. χ 2 , Fisher exact, and univariable logistic regression tests were used to assess performance differences in relation to question characteristics. ChatGPT (GPT-3.5) and GPT-4 achieved scores of 73.4% (95% CI: 69.3%-77.2%) and 83.4% (95% CI: 79.8%-86.5%), respectively, relative to the user average of 72.8% (95% CI: 68.6%-76.6%). Both LLMs exceeded last year's passing threshold of 69%. Although scores between ChatGPT and question bank users were equivalent ( P = .963), GPT-4 outperformed both (both P .005). Multimodal input was not available at the time of this study; hence, on questions with image content, ChatGPT and GPT-4 answered 49.5% and 56.8% of questions correctly based on contextual context clues alone. LLMs achieved passing scores on a mock 500-question neurosurgical written board examination, with GPT-4 significantly outperforming ChatGPT.
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                Author and article information

                Contributors
                Journal
                Int J Surg
                Int J Surg
                JS9
                International Journal of Surgery (London, England)
                Lippincott Williams & Wilkins (Hagerstown, MD )
                1743-9191
                1743-9159
                March 2024
                11 January 2024
                : 110
                : 3
                : 1877-1878
                Affiliations
                [a ]Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
                [b ]School of Computer Science and Technology, Harbin Institute of Technology
                [c ]Chinese University of Hong Kong (Shenzhen) School of Medicine, Shenzhen, Guangdong, People’s Republic of China
                Author notes
                [* ]Corresponding author. Address: 2001 Longxiang Avenue, Longgang District, Shenzhen, 518172, Guangdong, the People’s Republic of China. Tel.: +86-18612671601. E-mail: wangrz@ 123456126.com (R. Wang).
                Article
                IJS-D-23-02991 00084
                10.1097/JS9.0000000000001037
                10942224
                38484262
                88319950-0264-406f-a9b2-b9193e45cded
                Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/

                History
                : 19 December 2023
                : 20 December 2023
                Categories
                Correspondence
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                Surgery
                Surgery

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