Tom Heston MD

AI Models Show Human-Like Personality Patterns in Groundbreaking Psychology Study

noreply@blogger.com (Tom Heston MD) — Sat, 26 Jul 2025 13:21:00 +0000

A groundbreaking study has demonstrated that artificial intelligence systems exhibit consistent personality patterns similar to humans when assessed through standardized psychological tests. Researchers administered personality assessments to four major AI models, discovering that each displayed unique behavioral tendencies. Claude 3 Opus emerged as highly introverted and analytical, while ChatGPT-3.5 showed more extroverted characteristics. The research utilized both Myers-Briggs-style typological assessments and Big Five personality measurements across multiple testing sessions. These findings have significant implications for the deployment of AI in healthcare settings, particularly mental health applications where personality compatibility between AI and patients could affect treatment outcomes. The study suggests that AI personality profiling should become a standard component of responsible AI deployment protocols, especially in patient-facing roles where interpersonal dynamics are crucial for therapeutic success.

Beyond P-Values: How the Relative Risk Index Enhances Statistical Reliability in Orthopaedic Research

noreply@blogger.com (Tom Heston MD) — Sat, 12 Apr 2025 00:16:00 +0000

Orthopaedic researchers increasingly recognize the limitations of traditional statistical measures. In a recent letter to the Journal of the American Academy of Orthopaedic Surgeons, Dr. Thomas Heston introduces the Relative Risk Index (RRI) as a valuable complement to the established Fragility Index (FI). The core difference lies in their focus: while FI measures susceptibility to P-value changes based on minimal outcome alterations, RRI evaluates the magnitude of change needed to reach therapeutic equivalence across all data. This distinction proves significant in tranexamic acid research, where FI suggests fragility but RRI indicates robustness. The RRI's value stems from its independence from arbitrary P-value thresholds and its alignment with clinical decision-making processes. As orthopaedic surgery continues advancing evidence-based practice, adopting complementary statistical approaches like RRI could enhance research reliability and ultimately improve surgical outcomes through more nuanced evaluation of intervention efficacy.
Citation: Heston TF. Letter to the Editor: The Relative Risk Index: A Complementary Metric for Assessing Statistical Fragility in Orthopaedic Surgery Research. J Am Acad Orthop Surg. 2025 Apr 1;33(7)
doi: 10.5435/JAAOS-D-24-00473

The Role of Prompt Engineering in Transforming Primary Care

noreply@blogger.com (Tom Heston MD) — Thu, 12 Dec 2024 02:37:00 +0000

Prompt engineering is emerging as a critical skill in healthcare, particularly in primary care settings. By designing and optimizing input prompts, healthcare providers can guide AI systems to generate more accurate and valuable outputs. This article highlights the importance of prompt engineering in medical education and its various applications, including enhancing patient–provider communication, streamlining clinical documentation, supporting medical education, and facilitating personalized care. By adopting best practices such as incorporating domain-specific knowledge, engaging in iterative refinement and validation, and addressing ethical considerations, healthcare providers can ensure the effective and responsible use of generative AI. Embracing prompt engineering will be crucial for transforming primary care delivery and improving patient outcomes.

Citation: Patil R, Heston TF, Bhuse V. Prompt Engineering in Healthcare. Electronics. 2024;13(15):2961. doi:10.3390/electronics13152961

Beyond p-values: Assessing Statistical Fragility with Robustness and Percent Fragility Indices

noreply@blogger.com (Tom Heston MD) — Mon, 17 Jun 2024 19:11:00 +0000

While p-values have been the traditional measure of statistical significance in scientific research, they often fail to capture the complexity of statistical evidence. Fragility metrics such as the robustness index and percent fragility index offer a more nuanced approach to evaluating the strength of research findings. By quantifying the impact of small changes in data on statistical significance, these indices provide a valuable complement to p-values. Incorporating fragility metrics into research practices can be seen as a step toward a more responsible form of data-driven decision-making that recognizes the conditional nature of statistical evidence.

Citation: Heston TF. Redefining significance: robustness and percent fragility indices in biomedical research. Stats. 2024;7(2):537-48. https://doi.org/10.3390/stats7020033

Balancing the Benefits and Risks of Nuclear Medicine: A Safety Imperative

noreply@blogger.com (Tom Heston MD) — Wed, 22 May 2024 17:07:00 +0000

Nuclear medicine offers remarkable diagnostic and therapeutic capabilities, revolutionizing patient care. However, the use of radioactive materials presents inherent risks that demand unwavering attention to safety protocols. Regulatory authorities, such as the Nuclear Regulatory Commission, establish comprehensive standards for radiopharmaceutical handling, administration, and disposal. Compliance with these regulations requires specialized training for authorized users, meticulous documentation, and regular safety audits. As nuclear medicine continues to evolve, the integration of advanced technologies and the expansion of theranostic agents further emphasize the need for enhanced safety measures. By fostering a culture of education, accountability, and adherence to best practices, the nuclear medicine community can responsibly harness the power of radioactivity to improve patient outcomes while prioritizing safety.

Citation: Heston TF, Tafti D. Nuclear Medicine Safety. [Updated 2024 Mar 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK603730/

The Synergy of AI and Blockchain: Driving the Next Generation of Telemedicine

noreply@blogger.com (Tom Heston MD) — Thu, 25 Apr 2024 15:48:00 +0000

The convergence of artificial intelligence (AI) in the form of large language models (LLMs) and blockchain technology is poised to drive the next generation of telemedicine. LLMs can rapidly analyze patient records, providing contextualized recommendations and enhancing diagnostic processes. Blockchain technology enables secure, decentralized storage and sharing of medical data, ensuring patient privacy and cross-organizational interoperability. The synergy between these technologies can lead to improved care personalization, automated triage, and secure remote patient monitoring. However, the responsible adoption of AI and blockchain in telemedicine requires addressing challenges such as bias, unclear responsibility, and integration with existing systems while prioritizing patient interests and ethical considerations.

Citation: Heston TF. Perspective Chapter: Integrating Large Language Models and Blockchain in Telemedicine. IntechOpen; 2024. DOI: 10.5772/intechopen.1005063

Study Highlights Limitations of ChatGPT-4 in Cardiac Risk Assessment

noreply@blogger.com (Tom Heston MD) — Wed, 17 Apr 2024 17:42:00 +0000

Heston and Lewis conducted a study to evaluate the performance of ChatGPT-4 in risk-stratifying patients with atraumatic chest pain. The researchers compared ChatGPT-4's risk scores with established tools like TIMI and HEART scores using simulated patient data. Although the mean scores correlated well, ChatGPT-4 provided different risk scores for identical patient data when presented on separate occasions. This inconsistency suggests that further refinement and customization are necessary before integrating ChatGPT-4 into clinical practice for cardiac risk assessment.

Citation: Heston TF, Lewis LM (2024) ChatGPT provides inconsistent risk-stratification of patients with atraumatic chest pain. PLOS ONE 19(4): e0301854. https://doi.org/10.1371/journal.pone.0301854

Improving Medical Research Communication: The Need for Structured Reporting

noreply@blogger.com (Tom Heston MD) — Tue, 02 Apr 2024 15:24:00 +0000

In this research article, I suggest adopting structured reporting formats similar to those used in clinical trial abstracts and manuscripts to address the challenges in medical research reporting by online news outlets. Implementing standardized inclusion criteria, such as background information, study methods, main results with statistical analyses, discussion of implications and limitations, and disclosure of conflicts of interest, could enhance the quality and transparency of medical research communication. Collaboration among journalists, news organizations, and medical researchers is crucial to establish and promote best practices, fostering informed public discourse on health topics and ultimately contributing to better health outcomes.

Citation: Heston TF. Critical Gaps in Medical Research Reporting by Online News Media. Cureus. 2024 Apr 2;16(4):e57457. doi: 10.7759/cureus.57457.

Harnessing the Power of Blockchain and AI for Climate Action

noreply@blogger.com (Tom Heston MD) — Thu, 21 Mar 2024 15:48:00 +0000

The fight against climate change requires innovative solutions, and the integration of blockchain technology and large language models (LLMs) holds immense potential. Blockchain ensures the transparency and security of climate data, while LLMs analyze vast datasets to generate actionable insights. This powerful combination enhances data management, improves climate models, and enables evidence-based policymaking. By addressing current challenges and opening up new avenues for collaborative climate action, the synergy between blockchain and AI signifies a transformative shift in the global response to climate change.

Heston TF. A blockchain AI solution to climate change. International Journal of Science and Research Archive. 2024;11(02):450–4. DOI: https://doi.org/10.30574/ijsra.2024.11.2.0471

The Pitfalls of Statistical Fragility in Survey Research

noreply@blogger.com (Tom Heston MD) — Tue, 05 Mar 2024 20:16:00 +0000

Survey research plays a crucial role in understanding complex issues, such as bias and work climate in medicine. However, the validity of the results heavily depends on the robustness of the statistical methods employed. A recent study by Carnes and colleagues serves as a reminder of the pitfalls of statistical fragility. Low response rates, small effect sizes, and multiple significance tests can lead to misleading conclusions. Researchers should strive for higher response rates and larger effect sizes to ensure the reliability of their findings and to drive meaningful change in their fields.

Heston TF. Statistical Fragility in Surveys. Acad Med 2024 Mar 1;99(3):240. doi: 10.1097/ACM.0000000000005584. Epub 2023 Dec 7.

Finding Hope and Connection During Hardship

noreply@blogger.com (Tom Heston MD) — Fri, 16 Feb 2024 16:50:00 +0000

This musical essay recounts my experience with homelessness and the emotional toll of isolation and uncertainty. Yet even in the darkest moments, acts of compassion from strangers ignite sparks of resilience. The message conveyed is one of shared humanity - we all have value and can make a difference through small gestures of warmth and kindness.

Citation: Heston, TF. Two Left Shoes. Zenodo 2024. https://purl.archive.org/theston/two-left-shoes

Foundations of Ethical Academic Research

noreply@blogger.com (Tom Heston MD) — Fri, 19 Jan 2024 21:01:00 +0000

This article examines core principles underlying rigorous, ethical research across disciplines. It emphasizes judicious topic selection to address knowledge gaps, exhaustive literature analysis to contextualize studies, aligning methodologies to research questions, transparent analysis and reporting, proactive ethical considerations, and effective communication for impact. Sustaining integrity as research evolves requires individual and institutional commitment to moral purpose.

Citation: Heston TF. Foundations of scholarly writing. In: An overview on business, management and economics research. BP International; 2024. p. 113-51. doi: https://zenodo.org/doi/10.5281/zenodo.10535789

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Assessing Need for Workup of Coronary Artery Disease in Symptomatic Versus Asymptomatic Diabetics

noreply@blogger.com (Tom Heston MD) — Wed, 10 Jan 2024 18:43:00 +0000

Should diabetic patients with chest pain be worked up more aggressively for coronary artery disease than diabetics without symptoms? A retrospective study of over 1000 patients undergoing nuclear stress testing found that although anginal symptoms do predict myocardial ischemia in non-diabetics, they do not reliably indicate the presence of ischemia or ventricular dysfunction in diabetics. Therefore, the decision to initiate an ischemic evaluation in patients with diabetes cannot depend primarily on the presence or absence of symptomatic chest pain.

Citation: Heston, Thomas F. (2005). Anginal symptoms are not predictive of myocardial perfusion in diabetics. Journal of Nuclear Cardiology, 12(4), S108. https://doi.org/10.1016/j.nuclcard.2005.06.028

Leveraging Financial Math to Capture Volatility in Medicine

noreply@blogger.com (Tom Heston MD) — Wed, 03 Jan 2024 19:11:00 +0000

A model used in finance to characterize unpredictable stock price changes could provide a useful framework for tackling variability in healthcare. By quantifying fluctuating volatility, the Heston Model may offer improved disease forecasting and individualized medication dosing. Before clinical adoption, rigorous empirical testing is essential. However, the mathematical versatility merits open-minded assessment, as validated applications could yield clinical dividends.

Citation: Heston TF. Quantifying uncertainty: potential medical applications of the heston model of financial stochastic volatility. Contemporary Perspective on Science, Technology and Research. 2024 Jan 1;3:92-103.

Chatbots built on ChatGPT delay mental health crisis referrals

noreply@blogger.com (Tom Heston MD) — Mon, 18 Dec 2023 16:59:00 +0000

A new study found significant safety issues with publicly available conversational agents built on ChatGPT that are designed to provide mental health counseling. When given simulations of escalating depression and suicide risk, the chatbots frequently postponed referring users to human support until severe levels. Most failed to provide crisis resources and over 80% resumed conversations after insisting the user seek help. The findings indicate deficiencies in identifying hazardous states, jeopardizing user safety. More rigorous testing and prioritizing ethical considerations are needed before clinical implementation.

Citation: Heston TF. Safety of large language models in addressing depression. Cureus. 2023;15(12):e50729. https://doi.org/10.7759/cureus.50729

Standardizing PET/CT Analysis in Oncology

noreply@blogger.com (Tom Heston MD) — Wed, 13 Dec 2023 17:53:00 +0000

This article proposes a systematic methodology for interpreting and reporting PET/CT scans for oncology patients. By standardizing quality control, analysis, impression reporting, and recommendations for further imaging, the authors aim to reduce errors and provide clear, actionable information to referring physicians to guide patient care. Key elements include protocol validation, assessing fusion and artifacts, detailing tracer uptake parameters, categorizing findings by location and appearance, correlating PET and CT, comparing to prior imaging, summarizing impression and differential, and advising precise further imaging.

Citation: Heston TF, Wahl R, Jacene H. A systematic approach to PET/CT interpretation and reporting in oncology. Journal of Nuclear Medicine 2009;50(Supplement 2):1089.

https://jnm.snmjournals.org/content/50/supplement_2/1089

Tracing a Personal Journey Linking Music, Art, Physics and Clinical Medicine

noreply@blogger.com (Tom Heston MD) — Fri, 01 Dec 2023 18:22:00 +0000

Here I trace my personal journey linking music, art, physics and clinical medicine in a new article, exploring holistic connections, finding symmetries between sound waves, visual art, and quantum phenomena. This has led me to integrate artistic, scientific and humanistic viewpoints, seeing medicine as continuing his musical creativity.

Citation: Heston, Thomas F. (2023). The Beholder - A Symphony of Life in Medicine. International Journal of Scientific Research. 2023;12(12):1-2. https://doi.org/10.5281/zenodo.10246612

Coronary calcium and normal myocardial perfusion

noreply@blogger.com (Tom Heston MD) — Thu, 30 Nov 2023 16:55:00 +0000

Among patients with normal myocardial perfusion on cardiac testing, higher coronary calcium scores are associated with increased patient age and hyperlipidemia. Even with normal perfusion, around 10% of patients had concerningly high calcium scores above 400. Assessing coronary calcium may provide additional risk information.

Citation: Heston T, Merrill J, Bengel F, Wahl R. Coronary calcium scores in patients with normal myocardial perfusion. Journal of Nuclear Medicine. 2009;50(Suppl 2):1160.

DOI: 10.5281/zenodo.10230802

URL: https://jnm.snmjournals.org/content/50/supplement_2/1160

The Ethical Significance of Statistics in Medical Research

noreply@blogger.com (Tom Heston MD) — Wed, 29 Nov 2023 00:14:00 +0000

A new review article examines the pivotal role statistics plays in upholding research integrity and patient safety. It scrutinizes common statistical errors in medical studies, like p-hacking and neglecting limitations. Using historical examples, it demonstrates how such errors have resulted in flawed conclusions causing public harm, including with hormone therapy research. Recommendations encompass more statistical rigor by ethical review boards assessing proposals, requiring open access data to enable peer review and mandating an ethical discussion. Overall, properly applying statistical principles is an ethical obligation, ensuring findings are valid, generalizable and reproducible.

Citation: Heston TF. Statistical Ethics in Medical Research: A Narrative Review. Jour Clin Med Res. 2023;4(3):1-10. http://dx.doi.org/10.46889/JCMR.2023.4308

Beware Statistically Significant Findings in Isolation

noreply@blogger.com (Tom Heston MD) — Mon, 27 Nov 2023 18:36:00 +0000

Statistical tests answer a narrow, mathematical question - is there likely a real difference between group means? But science aims to produce clinically useful knowledge to benefit individual patients. This nuclear medicine study serves as a sobering reminder that statistical significance does not reliably predict clinical usefulness.

While group averages may differ in a statistically compelling fashion, typical cutoffs misclassify a full third of healthy individuals. So a statistically significant finding applied blindly in clinical practice, without further consideration of its clinical implications, is prone to harm individuals.

The mathematical abstractions of statistics have undeniable value. But statistical significance is easily misinterpreted as clinical importance when groups are viewed as interchangeable with individuals. As this study shows, what seems persuasive in aggregate often breaks down at the individual level. Statistical findings should be interpreted judiciously, with due consideration of clinical context and implications.

Citation: Heston TF, Wahl RL. How often are statistically significant results clinically relevant? Not often. J Nucl Med. 2009;50(Suppl 2):1370. https://zenodo.org/doi/10.5281/zenodo.10198933

The Efficacy of Smoking Cessation Strategies: A Meta-Analysis

noreply@blogger.com (Tom Heston MD) — Mon, 13 Nov 2023 20:30:00 +0000

A meta-analysis published in 1993 reviewed research on the effectiveness of various smoking cessation interventions. The analysis found that interventions delivered in clinical settings were more effective than those implemented in community settings. Among the most effective strategies were brief counseling from a healthcare provider, nicotine replacement therapy, workplace smoking bans, and increased tobacco excise taxes. While the meta-analysis sheds light on the short-term efficacy of different approaches, more research is still needed to understand their long-term outcomes. Overall, the findings underscore the importance of incorporating smoking cessation initiatives into comprehensive tobacco control programs.

Citation: Heston TF. Smoking cessation strategies: a meta-analysis. Southern Medical Journal. 1993;86(Suppl):S36. doi:10.5281/zenodo.10120006

Addressing Gender Bias in Heart Attack Treatment

noreply@blogger.com (Tom Heston MD) — Fri, 10 Nov 2023 18:25:00 +0000

Despite increased awareness, gender bias persists in how women with heart attacks are diagnosed and treated versus men. Delays in ECG and ICU admission for women can negatively impact outcomes. Protocols and training must be updated to eliminate disparities. Improving heart attack care for women will improve outcomes for all.

Citation: Heston, T. F., & Lewis, L. M. (1997). Gender bias in acute myocardial infarction. The American Journal of Cardiology, 79(6), 844. https://doi.org/10.5281/zenodo.10095950

Impact of Self-Monitoring on Weight Reduction

noreply@blogger.com (Tom Heston MD) — Tue, 07 Nov 2023 19:08:00 +0000

This study delves into the impact of self-monitoring on weight reduction in participants of a hypertension prevention trial. The research, involving 32 overweight individuals, focused on the effectiveness of a 14-week dietary and exercise regimen. The findings reveal that consistent food logging and initial BMI are crucial in predicting weight loss success. The study's intervention, comprising professional-led sessions, aimed at a modest caloric deficit and increased physical activity. The outcome demonstrates a clear link between self-monitoring habits and weight loss, providing valuable insights for health professionals and individuals aiming for weight management.

Citation: Heston, T. F. (1992). Predictors of weight loss in a hypertension prevention program. Southern Medical Journal, 85(Supplement), 3S-31. https://doi.org/10.5281/zenodo.10079949

Assessing Research Findings: Moving Beyond Statistical Significance

noreply@blogger.com (Tom Heston MD) — Fri, 03 Nov 2023 19:23:00 +0000

Traditionally, p-values have been used to determine the statistical significance of research findings. However, statistical significance does not always equate to clinical relevance. The fragility index provides additional insight into robustness but still hinges on p-values. In contrast, the relative risk index focuses on divergence from therapeutic equivalence, independent of statistical significance. A recent simulation analysis found the relative risk index correlates only weakly with p-values, suggesting it conveys distinct information. The relative risk index may better capture clinical relevance. Rather than relying solely on p-values and fragility indices, the relative risk index deserves consideration as a complementary metric when evaluating research findings to guide evidence-based practice.

Citation: Heston TF. Statistical significance versus clinical relevance: a head-to-head comparison of the fragility index and relative risk index. Cureus. 2023;15(10):e47741. DOI:10.7759/cureus.47741.

Tackling the Economic Roots of Homelessness

noreply@blogger.com (Tom Heston MD) — Wed, 01 Nov 2023 16:04:00 +0000

New research shines a light on the predominant cause of homelessness - high costs of living, especially housing. Looking across the US, states with more affordable housing had lower rates of homelessness. But it's not just housing - transportation, food, and healthcare costs were also linked. Unemployment, problematic drinking, and even opioid prescription rates influenced homelessness, too. This highlights the need for multifaceted solutions. Making housing more affordable is crucial. But also addressing income, transportation access, problematic substance use, and healthcare costs will maximize impact. With creative, collaborative policy solutions rooted in these evidence-based insights, progress is possible against this complex public health challenge.

Citation: Heston TF. The Cost of Living Index as a Primary Driver of Homelessness in the United States: A Cross-State Analysis. Cureus. 2023;15(10):e46975. Published 2023 Oct 13. doi:10.7759/cureus.46975