Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: A large language model (LLM) is a machine learning model inferred from text data that captures subtle patterns of language use in context. Modern LLMs are based on neural network architectures that incorporate transformer methods. They allow the model to relate words together through attention to multiple words in a text sequence. LLMs have been shown to be highly effective for a range of tasks in natural language processing (NLP), including classification and information extraction tasks and generative applications. Objective: The aim of this adapted Delphi study was to collect researchers’ opinions on how LLMs might influence health care and on the strengths, weaknesses, opportunities, and threats of LLM use in health care. Methods: We invited researchers in the fields of health informatics, nursing informatics, and medical NLP to share their opinions on LLM use in health care. We started the first round with open questions based on our strengths, weaknesses, opportunities, and threats framework. In the second and third round, the participants scored these items. Results: The first, second, and third rounds had 28, 23, and 21 participants, respectively. Almost all participants (26/28, 93% in round 1 and 20/21, 95% in round 3) were affiliated with academic institutions. Agreement was reached on 103 items related to use cases, benefits, risks, reliability, adoption aspects, and the future of LLMs in health care. Participants offered several use cases, including supporting clinical tasks, documentation tasks, and medical research and education, and agreed that LLM-based systems will act as health assistants for patient education. The agreed-upon benefits included increased efficiency in data handling and extraction, improved automation of processes, improved quality of health care services and overall health outcomes, provision of personalized care, accelerated diagnosis and treatment processes, and improved interaction between patients and health care professionals. In total, 5 risks to health care in general were identified: cybersecurity breaches, the potential for patient misinformation, ethical concerns, the likelihood of biased decision-making, and the risk associated with inaccurate communication. Overconfidence in LLM-based systems was recognized as a risk to the medical profession. The 6 agreed-upon privacy risks included the use of unregulated cloud services that compromise data security, exposure of sensitive patient data, breaches of confidentiality, fraudulent use of information, vulnerabilities in data storage and communication, and inappropriate access or use of patient data. Conclusions: Future research related to LLMs should not only focus on testing their possibilities for NLP-related tasks but also consider the workflows the models could contribute to and the requirements regarding quality, integration, and regulations needed for successful implementation in practice.

Mobile and tablet apps, ubiquitous and pervasive computing, wearable computing and domotics for health.

Mobile and tablet apps, ubiquitous and pervasive computing, wearable computing and domotics for health.

Background: Contents published on social media have an impact on individuals and on their decision making. Knowing the sentiment toward diabetes is fundamental to understanding the impact that such information could have on people affected with this health condition and their family members. The objective of this study is to analyze the sentiment expressed in messages on diabetes posted on Twitter. Method: Tweets including one of the terms “diabetes,” “t1d,” and/or “t2d” were extracted for one week using the Twitter standard API. Only the text message and the number of followers of the users were extracted. The sentiment analysis was performed by using SentiStrength. Results: A total of 67 421 tweets were automatically extracted, of those 3.7% specifically referred to T1D; and 6.8% specifically mentioned T2D. One or more emojis were included in 7.0% of the posts. Tweets specifically mentioning T2D and that did not include emojis were significantly more negative than the tweets that included emojis (–2.22 vs −1.48, P < .001). Tweets on T1D and that included emojis were both significantly more positive and also less negative than tweets without emojis (1.71 vs 1.49 and −1.31 vs −1.50, respectively; P < .005). The number of followers had a negative association with positive sentiment strength ( r = –.023, P < .001) and a positive association with negative sentiment ( r = .016, P < .001). Conclusion: The use of sentiment analysis techniques on social media could increase our knowledge of how social media impact people with diabetes and their families and could help to improve public health strategies.

Large Language Models (LLMs) such as General Pretrained Transformer (GPT) and Bidirectional Encoder Representations from Transformers (BERT), which use transformer model architectures, have significantly advanced artificial intelligence and natural language processing. Recognized for their ability to capture associative relationships between words based on shared context, these models are poised to transform healthcare by improving diagnostic accuracy, tailoring treatment plans, and predicting patient outcomes. However, there are multiple risks and potentially unintended consequences associated with their use in healthcare applications. This study, conducted with 28 participants using a qualitative approach, explores the benefits, shortcomings, and risks of using transformer models in healthcare. It analyses responses to seven open-ended questions using a simplified thematic analysis. Our research reveals seven benefits, including improved operational efficiency, optimized processes and refined clinical documentation. Despite these benefits, there are significant concerns about the introduction of bias, auditability issues and privacy risks. Challenges include the need for specialized expertise, the emergence of ethical dilemmas and the potential reduction in the human element of patient care. For the medical profession, risks include the impact on employment, changes in the patient-doctor dynamic, and the need for extensive training in both system operation and data interpretation.