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Artificial intelligence (AI) is the study of computer systems capable of performing tasks that traditionally require human intelligence, and machine learning (ML) is one mechanism through which an AI system can be developed by creating algorithms that modify themselves in response to patterns and make inferences when applied to new data [1-4]. Rapidly interpreting clinical data to classify patients and predict outcomes is paramount to emergency department (ED) operations, with direct impacts on cost, efficiency, and quality of care. The future of medicine is poised to harness the potential of AI to aid medical providers, and the ED stands to benefit greatly by reducing inefficiencies, streamlining processes, and improving patient care.Source of Support This research did not receive any specific grant from funding agencies in the public, commercials, or not-for-profit sectors.

Adverse reactions to intravenous (IV) iodinated contrast media are classified by the American College of Radiology (ACR) Manual on Contrast Media as either allergic-like (ALR) or physiologic (PR). Premedication may be beneficial for patients who have prior documented mild or moderate ALR. We sought to perform a retrospective analysis of patients who received computed tomography (CT) imaging in our emergency department (ED) to establish whether listing of an iodinated contrast media allergy results in a delay in care, increases the use of non-contrast studies, and to quantify the incidence of listing iodinated contrast allergies which do not necessitate premedication. We performed a retrospective analysis of CT scans performed in our academic medical center ED during a 6-month period. There were 12,737 unique patients of whom 454 patients had a listed iodinated contrast allergy. Of these, 106 received IV contrast and were categorized as to whether premedication was necessary. Descriptive statistics were used to evaluate patient demographics, clinical characteristics, and operational outcomes. A multivariate linear regression model was used to predict time from order to start (OTS time) of CT imaging while controlling for co-variates. Non-allergic patients underwent contrast-enhanced CT imaging at a significantly higher rate than allergic patients (45.9% vs. 23.3%, p < 0.01). The OTS time for allergic patients who underwent contrast-enhanced CT imaging was 360 min and significantly longer than the OTS time for non-allergic patients who underwent contrast-enhanced CT imaging (118 min, p < 0.001). Of the 106 allergic patients who underwent contrast-enhanced CT imaging, 27 (25.5%) did not meet ACR criteria for necessitating premedication. The average OTS time for these 27 patients was 296 min, significantly longer than the OTS for non-allergic patients (118 min, p < 0.01) and did not differ from the OTS time for the 79 patients who did meet premedication criteria (382 min, p = 0.23). A multivariate linear regression showed that OTS time was significantly longer if a contrast allergy was present (p < 0.001). A chart-documented iodinated contrast allergy resulted in a significant increase in time to obtain a contrast-enhanced CT study. This delay persisted among patients who did not meet ACR criteria for premedication. Appropriately deferring premedication could potentially reduce the ED length-of-stay by over 4 h for these patients.

As innovations in the biotechnology sector continue to proliferate, the traditional education of medical students, residents and fellows will need to change to incorporate innovation as a core tenet of training.

A 32-year-old woman presented with fatigue, myalgias, and palpitations. The cardiac rhythm was irregularly irregular, and an electrocardiogram showed findings suggestive of grouped beating. A diagnosis was made.

The advent of large language models (LLMs) represents an enormous opportunity to revolutionize medical education. Via “synthetic education,” LLMs can be harnessed to generate novel content for medical education purposes, offering potentially unlimited resources for physicians in training. Utilizing OpenAI’s GPT-4, we generated clinical vignettes and accompanying explanations for 20 skin and soft tissue diseases tested on the United States Medical Licensing Examination. Physician experts gave the vignettes high average scores on a Likert scale in scientific accuracy (4.45/5), comprehensiveness (4.3/5), and overall quality (4.28/5) and low scores for potential clinical harm (1.6/5) and demographic bias (1.52/5). A strong correlation ( r  = 0.83) was observed between comprehensiveness and overall quality. Vignettes did not incorporate significant demographic diversity. This study underscores the potential of LLMs in enhancing the scalability, accessibility, and customizability of dermatology education materials. Efforts to increase vignettes’ demographic diversity should be incorporated to increase applicability to diverse populations.

As innovations in the biotechnology sector continue to proliferate, the traditional education of medical students, residents and fellows will need to change to incorporate innovation as a core tenet of training.