DeepSeek is a recently launched large language model (LLM), whereas GPT-4o is an advanced ChatGPT version whose electrocardiography (ECG) interpretation capabilities have been previously studied. However, DeepSeek's performance in this domain remains unexplored. This study aims to evaluate DeepSeek's accuracy in ECG interpretation and compare it with GPT-4o, emergency medicine specialists, and cardiologists. A secondary aim is to assess any performance changes in GPT-4o over one year. Between February 9 and March 1, 2025, 40 ECG images (20 daily routine, 20 more challenging) from the book 150 ECG Cases were evaluated by both GPT-4o and DeepSeek, each model tested 13 times. The accuracy of their responses was compared with previously collected answers from 12 cardiologists and 12 emergency medicine specialists. GPT-4o's 2025 performance was compared to its 2024 results on identical ECGs. GPT-4o outperformed DeepSeek with higher median correct answers on daily routine (14 vs. 12), more challenging (13 vs. 10), and total ECGs (27 vs. 22) with statistically significant differences (p=0.048, p<0.001, p<0.001). A moderate agreement was observed between the responses provided by GPT-4o (p<0.001, Fleiss Kappa=0.473), while a substantial agreement was observed in the responses provided by DeepSeek (p<0.001, Fleiss Kappa=0.712). No significant year-over-year improvement was observed in GPT-4o's performance. This first evaluation of DeepSeek in ECG interpretation reveals its performance is lower than that of GPT-4o and human experts. While GPT-4o demonstrates greater accuracy, both models fall short of expert-level performance, underscoring the need for caution and further validation before clinical integration.

Aim: We aimed to display factors associated with error rates in identifying skin lesions with subjective methods and determine potential effectiveness of objective and metric measurements on judicial processes which may result in unwanted social and legal outcomes and raise the awareness of physicians. Material and Method: We made an incision on a piece of sponge with a lencet in order to model a skin lesion. The length and depth of the lesion was measured by compass device. Then, a face to face interview was planned with the physicians working in the hospital and they were asked to estimate the length and depth of the lesion. Estimations of the physicians were recorded. Results: Total of 146 physicians were involved into the study. Of these, 41.8% (n=61) were female and 58.2% (n=85) were male. Mean age of the physicians was 33.46±7.94 (24-61) years. Of the physicians, 7.5% (n=11) were a member of basic medical sciences, 26% (n=38) were a member of surgical medical sciences and 21.9% (n=32) were practitioner physician. When titles of the physicians were investigated, it was found that 21.9% (n=32) were practitioners, 34.9% (n=51) were residents, 34.9% (n=51) were specialists, 8.2% (n=12) were lecturers. The rate of the participants who estimated the incision more than 8 cm was higher than those who estimated less than 8 cm. Standart deviation of the depth estimation was 1.35 cm. Thirty-nine (26.7%) participants made an exact estimation of the depth of the incision. Conclusion: The measurement accuracy without a device is not associated with experience and errors of both inexperienced physicians and experienced physicians of any grade do similar mistakes during judicial report preparation process. These high error levels reveal that use of devices may avoid errors of physicians at any grade and protect physicians from possible judicial challenges.

Aims: To our knowledge, the performances of Emergency Medicine (EM) journals have not been investigated in terms of contribution to scientific literature. This study, Aimed to reveal the characteristics of EM journals and compare them in terms of their qualitative and quantitative features. Material and Methods: Conducteda hand-searching on the websites of 8 EM journals. Also categorized the articles published in these journals into subgroups in terms of relevance to trauma and disaster medicine, cardiovascular and cardiology emergencies, pulmonary emergencies, toxicology, COVID-19, surgical emergencies, internal medicine/gastroenterological emergencies, medical treatment and marker studies, resuscitation and airway management, infectious diseases, sedation and analgesia, imaging, neurological emergencies, forensic medicine, epidemiological and statistical studies, hospital and emergency department management, intensive care and mechanical ventilation, prehospital care, experimental studies, elective surgery and surgical complications. The journals were also compared according to their contribution to COVID-19 literature. Results: Among 8 journals, only Ulus Travma Acil Cerrahi Derg is indexed in SCI-E. The top 3 journals according to the number of published articles and citations were as follows: Ulus Travma (1792 articles, 7834 citations), EAJEM (784 articles, 822 citations) and TJEM (646 articles, 3146 citations). Mean citation per article was the highest in TJEM (n=4.87) followed by Ulus Travma Acil Cerrahi Derg (n=4.37) and EAJEM (n=1,05). Ulus Travma Acil Cerrahi Derg has the highest H index (n=25). Conclusion: Academic development of EM is strongly linked to the performance of EM journals. The quality, amount and number of grant-supported research should increase in EM.

Background and Objectives: Various hematological and biochemical parameters, including derived indices such as the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR), have been investigated for prognostic assessment in cardiac arrest. The lactate-to-albumin ratio (LAR) may also predict mortality in critically ill patients. The primary objective of this study was to determine the prognostic value of hematological and biochemical parameters in predicting in-hospital mortality among patients who achieved ROSC following cardiac arrest. Materials and Methods: This retrospective cohort study was conducted in patients who experienced cardiac arrest. Laboratory parameters obtained at emergency department admission, including PLR, NLR, LAR, albumin and lactate, were recorded together with clinical outcomes, including return of spontaneous circulation (ROSC) and in-hospital mortality. The study examined the effectiveness of hematological and biochemical parameters in clinical ROSC prediction in patients experiencing both in-hospital and out-of-hospital cardiac arrest. The relationship between these parameters and in-hospital mortality in patients who achieved ROSC was also investigated. Results: During the study period, 505 patients were included, of whom 225 achieved ROSC and 168 died during hospitalization. LAR values were significantly higher in patients with in-hospital mortality (p < 0.001). For predicting in-hospital mortality after ROSC, LAR showed an AUC of 0.737 (95% CI: 0.661–0.812) and significantly outperformed lactate, PLR, and NLR (all p < 0.001). Adding LAR to the clinical model increased the AUC from 0.731 to 0.789 (ΔAUC = 0.058, p = 0.022). In multivariable analysis, higher LAR was independently associated with increased in-hospital mortality (aOR 1.61, 95% CI 1.21–2.16; p = 0.001). Conclusions: In patients who achieved ROSC after cardiac arrest, high initially recorded LAR levels were independently associated with in-hospital mortality. Although lower LAR values were associated with achievement of ROSC, the discriminative performance of LAR for predicting ROSC was insufficient to support its use as a standalone clinical predictor. However, the lack of standardized sampling times relative to cardiac arrest and ROSC limits the interpretation of LAR as a post-ROSC prognostic marker.

Background and Objectives: Temporalis muscle thickness (TMT) has emerged as an imaging-based morphometric surrogate associated with reduced muscle mass and frailty; however, its prognostic value in emergency department cardiac arrest (EDCA) remains unclear. This study aimed to evaluate the association between TMT and emergency department mortality in patients with EDCA who had cranial CT imaging available during the same emergency department encounter and to investigate its association with in-hospital mortality. Materials and Methods: This study included 129 adult patients who experienced cardiac arrest in the emergency department between 1 June 2022 and 31 May 2025, and had eligible cranial CT imaging available during the same emergency department encounter. TMT was measured on non-contrast brain computed tomography images. The association between TMT and mortality outcomes, including emergency department and in-hospital mortality, was statistically analyzed. Results: TMT was significantly lower in patients who died in the emergency department compared with survivors (median 3.29 mm [Q1–Q3: 2.63–3.95] vs. 4.69 mm [Q1–Q3: 3.70–5.65], p < 0.001). Similarly, patients who died in an in-hospital setting had lower TMT values than survivors (median 4.06 mm [Q1–Q3: 3.26–5.34] vs. 5.00 mm [Q1–Q3: 4.21–5.85], p = 0.040). ROC analysis demonstrated the moderate discriminative ability of TMT for predicting emergency department mortality (AUC = 0.763, 95% CI 0.671–0.856). Logistic regression analysis identified that, after adjustment for age, sex, and CPR duration, TMT remained associated with emergency department mortality (adjusted OR 0.34, 95% CI 0.133–0.886; p = 0.027). Conclusions: Among patients with EDCA who had eligible cranial CT imaging during the same emergency department encounter, lower temporalis muscle thickness was associated with increased emergency department mortality, whereas its association with in-hospital mortality was weaker. Given the retrospective design and limited number of outcome events, these findings should be considered exploratory and require validation in larger independent cohorts.