Daily Cosmetic Research Analysis

BACKGROUND: Scars and keloids impose significant physical and psychological burdens on patients, often leading to functional limitations, cosmetic concerns, and mental health issues such as anxiety or depression. Patients increasingly turn to online platforms for information; however, existing web-based resources on scars and keloids are frequently unreliable, fragmented, or difficult to understand. Large language models such as GPT-4 show promise for delivering medical information, but their accuracy, readability, and potential to generate hallucinated content require validation for patient education applications. OBJECTIVE: This study aimed to systematically evaluate GPT-4's performance in providing patient education on scars and keloids, focusing on its accuracy, reliability, readability, and reference quality. METHODS: This study involved collecting 354 questions from Reddit communities (r/Keloids, r/SCAR, and r/PlasticSurgery), covering topics including treatment options, pre- and postoperative care, and psychological impacts. Each question was input into GPT-4 in independent sessions to mimic real-world patient interactions. Responses were evaluated using multiple tools: the Patient Education Materials Assessment Tool-Artificial Intelligence for understandability and actionability, DISCERN-AI for treatment information quality, the Global Quality Scale for overall information quality, and standard readability metrics (Flesch Reading Ease score, and Gunning Fog Index). Three plastic surgeons used the Natural Language Assessment Tool for Artificial Intelligence to rate the accuracy, safety, and clinical appropriateness, while the Reference Evaluation for Artificial Intelligence tool validated references for reference hallucination, relevance, and source quality. We conducted the same analysis to assess the quality of GPT-4-generated content in response to questions from 3 medical websites. RESULTS: GPT-4 demonstrated high accuracy and reliability. The Patient Education Materials Assessment Tool-Artificial Intelligence showed 75.5% understandability, DISCERN-AI rated responses as "good" (26.3/35), and the Global Quality Scale score was 4.28 of 5. Surgeons' evaluations averaged 3.94 to 4.43 out of 5 across dimensions (accuracy 3.9, SD 0.7; safety 4.3, SD 0.8; clinical appropriateness 4.4, SD 0.5; actionability 4.1, SD 0.8; and effectiveness 4.1, SD 0.8). Readability analyses indicated moderate complexity (Flesch Reading Ease Score: 50.13; Gunning Fog Index: 12.68), corresponding to a 12th-grade reading level. Reference Evaluation for Artificial Intelligence identified 11.8% (383/3250) hallucinated references, while 88.2% (2867/3250) of references were real, with 95.1% (2724/2867) from authoritative sources (eg, government guidelines and the literature). The overall results about questions from medical websites were consistent with the answers to Reddit questions. CONCLUSIONS: GPT-4 has serious potential as a patient education tool for scars and keloids, offering reliable and accurate information. However, improvements in readability (to align with sixth to eighth grade standards) and reduction of reference hallucinations are essential to enhance accessibility and trustworthiness. Future large language model optimizations should prioritize simplifying medical language and strengthening reference validation mechanisms to maximize clinical utility.

PURPOSE: To prospectively compare dose to swallowing-related organs-at-risk (OARs) and swallowing outcomes between proton (intensity-modulated proton therapy, IMPT) and photon (volumetric modulated arc therapy, VMAT) radiotherapy (RT), and to characterize dose-response relationships associated with dysphagia in nasopharyngeal carcinoma (NPC). METHODS: In total, 104 patients with NPC received definitive chemoradiotherapy (IMPT, n = 58; VMAT, n = 46). Mean OAR doses were compared. Swallowing-related quality of life (QoL) was assessed using the MD Anderson Dysphagia Inventory (MDADI) at baseline (T1), end of RT (T2), and one-year post-RT (T3). Logistic regression evaluated predictors of ≥ 10-point MDADI decline or > 10% weight loss; linear mixed-effects and multivariable linear models assessed OAR dose-response relationships. RESULTS: IMPT delivered lower mean doses to the oral cavity, middle pharyngeal constrictor muscle (M-PCM), and inferior pharyngeal constrictor muscle (all P < 0.01), with similar sparing of salivary glands and the superior pharyngeal constrictor muscle (S-PCM). IMPT resulted in less weight loss at T2 (3.4% vs 5.5%; P = 0.019) and lower odds of > 10% loss (OR 0.10; 95% CI, 0.01-0.80). MDADI Composite and domain scores did not differ by RT modality. Higher baseline MDADI predicted better T2 and T3 scores, and older age reduced the risk of ≥ 10-point decline at T2. Higher S-PCM dose was consistently associated with worse MDADI at T2 and T3, while M-PCM dose was associated with acute declines at T2. CONCLUSIONS: IMPT improves sparing of several swallowing-related OARs and reduces early weight loss, but swallowing-related QoL is associated with dose at pharyngeal constrictor muscles, particularly the S-PCM.

PURPOSE: As demand for nonsurgical aesthetic procedures increases, interest is also growing for desirable skin quality-radiant, healthy, and glowing skin-by patients seeking treatment to improve appearance. Although aesthetic medicine physicians are well positioned to advise on the role of basic skin care products in maintenance of results and healing, clear guidelines and protocols are currently lacking regarding the standard use of these products before and after aesthetic procedures. METHODS: An international panel of dermatologists (n = 6) and plastic surgeons (n = 2) convened virtually in March 2022 to discuss the role of skin care before and after nonsurgical aesthetic procedures (including injectables, energy-based devices, chemical peels, and microdermabrasion). As an outcome of that meeting, expert recommendations were developed for periprocedural skin care with the goal of improving recovery time or treatment outcomes for each procedure based on clinical evidence from a systematic literature review of relevant articles published through June 2022 combined with the authors' experience. RESULTS: Overall, 104 publications were identified and reviewed; publications could be counted more than once if they covered more than one topic (energy-based procedures, n = 70; injectable procedures including microneedling, n = 25; chemical peels, n = 21; microdermabrasion, n = 10). Common periprocedural skin care included daily routines utilizing cleansers, moisturizers, toners, hydroquinone, antioxidant serums, and sunscreens (as needed) across procedure types. Evidence supports pre/post-procedure routines (cleansers, moisturizers, toners, hydroquinone, antioxidants, sunscreens) across injectables (n = 25 studies), energy devices (n = 70), peels (n = 21), microdermabrasion (n = 10); high-evidence data limited, petrolatum/antioxidants show particular benefit post-laser. CONCLUSION: Panel consensus endorses tailored regimens to optimize recovery/outcomes. However, very few studies were designed to evaluate a specific routine vs no skin care treatment. Further studies are needed to provide clinical evidence supporting the effectiveness of periprocedural skin care in reducing healing time and improving aesthetic outcomes. Herein, we provide evidence- and expert-based recommendations for incorporating daily skincare, including cleansers, moisturizers, antioxidant serums, depigmenting agents, and sunscreens, into periprocedural care for minimally invasive aesthetic treatments. These regimens should be adapted to procedure type and individual post-procedural responses and symptoms to optimize outcomes and address specific patient needs.