Artificial intelligence (AI) has shown promise in generating multiple-choice questions (MCQs) for medical education, yet the psychometric quality of such items remains underexplored. This study aimed to compare the psychometric properties of MCQs created by ChatGPT-4o and those written by emergency medicine clinicians. Eighteen emergency medicine residents completed a 100-item examination comprising 50 AI-generated and 50 clinician-authored questions across core emergency medicine topics. Each item was analyzed for difficulty (P_index), discrimination (D_index), and point-biserial correlation (PBCC). Items were also categorized based on standardized index classifications. ChatGPT-4o-generated questions exhibited a higher mean difficulty index (P_index: 0.76 ± 0.23) compared to those created by clinicians (0.65 ± 0.24; p = 0.02), indicating that the AI-generated items were generally easier. Participants achieved significantly higher scores on AI-generated items (76.8 ± 8.18) than on clinician-authored questions (67.3 ± 9.65; p = 0.003). The mean discrimination index did not differ significantly between AI-generated (0.172 ± 0.23) and clinician-generated items (0.196 ± 0.26; p = 0.634). Likewise, the mean point-biserial correlation coefficient (PBCC) was nearly identical between the two groups (AI: 0.23 ± 0.28; clinicians: 0.23 ± 0.25; p = 0.99), suggesting similar internal consistency. Categorical analysis revealed that 56% of AI-generated items were classified as “easy,” compared to 36% of clinician-designed items. Furthermore, based on PBCC values, 36% of AI-generated items and 24% of clinician items were identified as “problematic” (p = 0.015), indicating a higher rate of psychometric concerns among AI-generated questions. The findings suggest that AI-generated questions, while generally easier and associated with higher participant scores, may pose psychometric limitations, as evidenced by a greater proportion of items classified as problematic. Although the overall internal consistency and discrimination indices were comparable to clinician-authored items, careful quality control and validation are essential when integrating AI-generated content into assessment frameworks.

Background: YouTube has become one of the most widely used platforms for medical education and patient information. However, the accuracy and reliability of such unregulated content remain highly variable and sometimes misleading. This study aimed to evaluate the quality, reliability, and educational value of YouTube videos related to poisonings, insect bites, and envenomations using validated scoring systems. Methods: A cross-sectional analysis of YouTube videos was conducted using the search terms “approach to insect bites and stings,” “approach to poisonings,” “approach to scorpion envenomation,” “approach to snake envenomation,” and “approach to mushroom poisoning.” Searches were performed in incognito mode on August 1, 2025. Only English-language videos shorter than one hour were included. Video quality and reliability were evaluated using the Global Quality Score (GQS), modified DISCERN (mDISCERN), and Journal of the American Medical Association (JAMA) benchmarks, while viewer engagement was measured using the Video Power Index (VPI). Results: A total of 279 videos were analyzed. The mean ± SD scores were as follows: GQS, 3.53 ± 1.09; mDISCERN, 3.53 ± 1.08; and JAMA, 2.63 ± 0.96. Based on the GQS, 59.5% of the videos were high quality, 20.8% moderate quality, and 19.7% low quality; thus, approximately 40% of the evaluated videos (low- and moderate-quality categories combined) did not meet optimal quality standards. Videos on snake envenomation and general poisoning had significantly higher quality and reliability scores (p < 0.001). Educational, physician-sourced, and physician-presented videos achieved higher GQS, JAMA, and mDISCERN values (p < 0.001 for all). However, no significant differences were found in the VPI, indicating that popularity metrics did not correlate with content quality. Conclusions: YouTube provides wide access to poisoning-related educational materials, but content quality varies considerably, and a substantial proportion of videos fall below acceptable quality thresholds. Videos produced or presented by physicians are more reliable, whereas popularity is not a valid indicator of scientific accuracy. Active involvement of healthcare professionals and academic institutions, together with platform-level quality verification and visibility strategies, is essential to improve the credibility and impact of online health information.

Background: Gastrointestinal (GI) bleeding is a common and potentially life-threatening condition frequently encountered in emergency departments (EDs). The optimal strategy for red blood cell suspension (RBCS) transfusion, including timing and location, remains unclear. This study aimed to evaluate the impact of transfusion location (ED vs. inpatient units) on mortality and hospital stay in GI bleeding patients. Methods: A cross-sectional descriptive study was conducted in the ED of a tertiary care hospital. Patients admitted with GI bleeding between June 1, 2021, and June 1, 2023, who received RBCS transfusion were included. Data on demographics, laboratory parameters, transfusion details, and clinical outcomes were collected from the hospital information system. Logistic regression was used to identify mortality predictors. Results: A total of 244 patients were included. Patients transfused in the ED had a significantly shorter hospital stay compared to those transfused in inpatient units. However, mortality did not differ between groups. Logistic regression identified age, albumin, hemoglobin, creatinine, and hospital stay as independent mortality predictors, while transfusion location was not significant. Conclusions: Early RBCS transfusion in the ED may reduce hospital stay but does not significantly impact mortality. Identifying mortality-associated factors is crucial for optimizing patient management. Further prospective studies are needed to clarify the role of transfusion location in GI bleeding outcomes.

Background: Gastrointestinal (GI) bleeding is a common and potentially life-threatening condition frequently encountered in emergency departments (EDs). The optimal strategy for red blood cell suspension (RBCS) transfusion, including timing and location, remains unclear. This study aimed to evaluate the impact of transfusion location (ED vs. inpatient units) on mortality and hospital stay in patients with GI bleeding. Methods: A cross-sectional descriptive study was conducted in the ED of a tertiary care hospital. Patients admitted with GI bleeding between 1 June 2021, and 1 June 2023, who received RBCS transfusion were included. Data on demographics, laboratory parameters, transfusion details, and clinical outcomes were collected from the hospital information system. Logistic regression was used to identify mortality predictors. Results: A total of 244 patients were included. Patients transfused in the ED had a significantly shorter hospital stay compared to those transfused in inpatient units. However, mortality did not differ between the groups. Logistic regression identified age, albumin, hemoglobin, creatinine, and hospital stay as independent mortality predictors, while transfusion location was not significant. Conclusions: Early RBCS transfusion in the ED may reduce hospital stay but does not significantly impact mortality. Identifying mortality-associated factors is crucial for optimizing patient management. Further prospective studies are needed to clarify the role of transfusion location in GI bleeding outcomes.

INTRODUCTION: Despite the declining clinical importance of Coronavirus Disease 2019 (COVID-19), the virus is still causes mortality in the critically ill patients. This study aims to determine the impact COVID-19 on mortality, evaluate the performance of Acute Physiology and Chronic Health Evaluation-2 Scores (APACHE II), Sequential Organ Failure Assessment Scores (SOFA) and Pneumonia Severity Index (PSI) for mortality prediction in the COVID-19 suspected patients. MATERIALS AND METHODS: This study is a retrospective cross-sectional analysis of patients who were admitted to the pandemic intensive care unit with possible COVID-19. 28-day mortality difference between positive and negative groups was defined as the primary outcome. RESULTS: Of the 397 patients, 111 (28 %) patients had positive polymerase chain reaction (PCR). 75 (67.6 %) patients deceased in the PCR positive group while 163 (57.0 %) patients deceased in the negative group (p > 0,05). The median values of APACHE II, SOFA and PSI scores were significantly higher in the deceased group, for all patients. Cutoff points were determined for APACHE II score at 19 (AUC 0,96, PLR 14, 16, NLR 0,12), SOFA score at 9 (AUC 0,96, PLR 20,23, NLR 0,11) and PSI score at 81 points (AUC 0,91, PLR 7,01, NLR 0,23). The AUCs of PSI was significantly lower from AUC of APACHE II and SOFA score (DeLong Test, p < 0,001). CONCLUSION: There was no statistically significant difference on mortality between positive and negative group.

This letter provides a critical appraisal of the article titled “Assessing the Prognostic Value of the Hemoglobin-to-Red Cell Distribution Width Ratio in Emergency Department Patients with Acute Coronary Syndrome” by Kudu and Danış. The study explores the prognostic utility of the hemoglobin-to-RDW ratio (HRR) in acute coronary syndrome (ACS) patients admitted to the emergency department. While the investigation highlights a clinically accessible biomarker, key methodological limitations are identified. These include the retrospective, single-center design; absence of multivariate statistical adjustment for confounders; and lack of subgroup analyses based on ACS types. Additionally, the clinical applicability of HRR is questioned due to its low specificity and limited integration into established risk models. This letter underscores the need for more comprehensive, prospective studies to clarify HRR’s independent prognostic value and its role in acute cardiovascular care.