BACKGROUND: The zone of stasis in burns is particularly vulnerable to progressive ischemia, making it a critical target for therapeutic interventions. Preventing damage in this zone is essential, as its viability can be preserved with adequate perfusion. Recognizing this, we aimed to investigate the systemic effects of nicardipine, a calcium channel blocker with vasodilatory properties, on the stasis zone in an experimentally induced burn model in rats. We hypothesized that nicardipine could mitigate ischemic progression in the stasis zone and thereby preserve tissue viability.
METHODS: A total of 20 Wistar-Albino rats were included in this study and divided into two groups: a control group (n=10) and a treatment group (n=10). The experimental burn model described by Regas and Ehrlich was employed. Under anesthesia, a 1 x 2 cm metal comb, preheated in boiling water, was applied to the dorsal skin of the rats for 30 seconds to create burn wounds. No treatment was administered to the control group. The treatment group, however, received a daily systemic dose of nicardipine (5 mg/kg) via gastric lavage for three days. Wound healing was monitored daily using a digital camera for three consecutive days. One rat in the treatment group was excluded due to mortality. After three days, the burned areas were excised from the dorsal skin of all rats and subjected to histopathological examination. Additionally, photo analysis of the burn areas was conducted using data obtained from the digital images.
RESULTS: Nicardipine treatment significantly improved burn healing parameters in the stasis zone. Compared to the control group, the treatment group demonstrated lower scores for edema (0.78 vs. 2.80, p<0.05), congestion (0.22 vs. 2.80, p<0.05), inflammation (0.67 vs. 2.90, p<0.05), vascularization (0.11 vs. 2.70, p<0.05), and fibrosis (0.22 vs. 2.90, p<0.05). Quantitative measurements also revealed a significant reduction in necrosis zone thickness (1079.75 µm vs. 2818.82 µm, p<0.05) and necrosis area (249.33 µm² vs. 400.13 µm², p<0.05). These findings indicate that nicardipine effectively mitigates ischemic progression and promotes tissue recovery in burn injuries.
CONCLUSION: Our experimental study demonstrated that nicardipine has the potential to prevent and treat damage in the burn stasis zone, suggesting its therapeutic role in burn injuries.

BACKGROUND: This study aimed to evaluate the efficacy of thrombopoietin (TPO), a growth factor and acute-phase reactant, as an early prognostic marker for predicting disease severity in patients with acute biliary pancreatitis.
METHODS: A total of 72 patients with acute pancreatitis admitted to the Ankara Numune Training and Research Hospital, General Surgery Department, were included in the study. The severity of acute pancreatitis was classified using the 2012 Revised Atlanta Classification, and blood samples were collected from each patient within the first six hours of hospitalization to measure TPO levels. TPO levels were then compared to C-reactive protein (CRP) levels and other prognostic scoring systems.
RESULTS: According to the Atlanta Classification, TPO levels were found to be statistically significant in distinguishing severe pancreatitis from moderate and mild cases. When evaluating the sensitivity and specificity ratios of serum TPO levels in predicting the severity of acute pancreatitis, a value of 81.61 pg/dL was identified, with a 86.6% sensitivity and 69% specificity. In our study, the accuracy of TPO levels in detecting severe pancreatitis was compared with other scoring systems. The Balthazar scoring system had the highest precision (area under the curve [AUC]: 0.905) in receiver operating characteristic (ROC) curve analysis for severe pancreatitis (95% confidence interval). Serum TPO levels were identified as the second strongest predictors of severe acute pancreatitis (AUC: 0.831).
CONCLUSION: These findings suggest that TPO is a valuable early marker and prognostic indicator for predicting disease severity in patients with acute biliary pancreatitis. However, further randomized studies with larger patient cohorts are still required.

BACKGROUND: This study aimed to evaluate the safety and efficacy of intranodal lymphangiography (IL) for the treatment of postoperative chyle leakage (CL), chylothorax, and chylous ascites.
METHODS: Between April 2018 and July 2022, eight patients who underwent IL for CL following thyroid and thoraco-abdominal surgeries were included in this retrospective study. Among these eight patients, six underwent bilateral total thyroidectomy, one underwent lobectomy of the lung, and one underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Prior to the procedure, thoracic duct ligation was attempted in one patient. Lymphangiographic findings, technical and clinical success rates, and complications were analyzed. Technical success was defined as the successful ultrasound-guided puncture of an inguinal lymph node and the opacification of the lymphatic system in the pelvis and abdomen by fluoroscopy. Clinical success was defined as a progressively decreasing drain output, culminating in the cessation of output within one week after the procedure.
RESULTS: Technical and clinical success was achieved in all patients. On lymphangiography, ethiodized oil leakage near the surgical bed was identified in seven of the eight patients. The median time from the procedure to drain removal was three days (range: 1-6 days) for patients who underwent surgical drainage. No recurrence of CL, chylothorax, or chylous ascites was observed during the follow-up period (range: 21-73 months; median: 38 months).
CONCLUSION: Intranodal lymphangiography appears to be a safe and effective minimally invasive treatment option for CL following thyroid and thoraco-abdominal surgeries, demonstrating acceptable technical and clinical success rates.

BACKGROUND: This study was conducted methodologically to evaluate the Turkish validity and reliability of the Feeling Safe During Surgery Scale and to assess its suitability for the Turkish population.
METHODS: This methodological validity and reliability study collected data from 148 patients who underwent elective surgery with regional anesthesia in the general surgery clinics of a university hospital in Istanbul between December 1, 2021 and June 30, 2022. Data were obtained through face-to-face interviews with patients using the Patient Information Form, developed by the researchers based on the literature, and the Turkish version of the Feeling Safe During Surgery Scale, originally created in Swedish. The Statistical Package for the Social Sciences (SPSS) Amos 26 was used for data analysis.
RESULTS: The content validity index of the scale was determined to be 0.96. Confirmatory factor analysis indicated that the Turkish version of the Feeling Safe During Surgery Scale was acceptably compatible with the original scale. The adapted Turkish version was found to have a comprehensible language structure and appropriate content. Cronbach's alpha coefficient for the total score was α=0.839, indicating a high level of reliability. Consequently, the Turkish version of the Feeling Safe During Surgery Scale was determined to be valid, reliable, and stable over time.
CONCLUSION: The Turkish version of the Feeling Safe During Surgery Scale is a valid and reliable instrument that can be used in the Turkish population for assessing the sense of safety in patients undergoing elective surgery with regional anesthesia in surgical units.

BACKGROUND: Explosions are not exclusive to battlefields; they also represent a global security concern that affects all societies worldwide. This study aims to elucidate the effects of injuries caused by explosions with multiple mechanisms, which clinicians may encounter at any time, particularly in the context of military personnel. Furthermore, the clinical characteristics of these injuries were examined.
METHODS: A total of 7,865 patient files evaluated between 2008 and 2017 by the Forensic Medicine Department of Gülhane Medical Faculty, Health Sciences University, were subjected to retrospective review. The study encompassed a total of 906 cases presenting with blast injuries. Medical records and health reports of these cases were reviewed and analyzed in terms of age- and gender-specific incidence, military ranks, type of explosion, origin of explosion, wound types, affected body areas, and sequelae.
RESULTS: The findings of this study indicate that blast injuries predominantly affect young males, particularly those in the military. The most common etiological factor identified was terrorism. Blast injuries were found to occur most frequently in non-vehicular pedestrians and were primarily caused by improvised explosive devices and landmines. Blast injuries most commonly resulted in multiplesite injuries with a shrapnel effect and frequently required surgical intervention. Despite all treatments, 53.4% of explosion-related injuries resulted in long-term sequelae.
CONCLUSION: The results of this study demonstrate that explosion-related injuries present a significant and complex problem. Blasts affect multiple body systems and cause severe injuries. Understanding the impact of explosions on the human body can help develop strategies to minimize or possibly eliminate serious injuries, particularly in explosion incidents encountered by security forces.

BACKGROUND: Effective management of postoperative analgesia following laparoscopic cholecystectomy (LC) is critical to ensure optimal patient comfort and recovery. This study evaluates the effects of erector spinae plane block (ESPB) and rectus sheath block (RSB) on opioid consumption to determine non-inferiority.
METHODS: This retrospective study analyzed 44 patients aged 18 to 75 years who underwent LC at our hospital between December 2022 and March 2023, with American Society of Anesthesiologists (ASA) scores of I-II. Patients were divided into two groups: ESPB (n=24) and RSB (n=20). The ESPB group received a preoperative bilateral injection of 20 mL of 0.25% bupivacaine, while the RSB group received a postoperative bilateral injection of 20 mL of 0.25% bupivacaine. The primary outcome measure was opioid consumption within the first 24 hours postoperatively.
RESULTS: The demographic characteristics of the RSB and ESPB groups were similar. Opioid consumption during the first 24 hours was 6.29±1.73 mg in the ESPB group and 6.60±3.41 mg in the RSB group, with no statistically significant difference between the two groups (95% confidence interval [CI]: -1.64 to 1.02; p=0.717). When the equivalence margin was set at -2 mg, opioid consumption in the RSB group was found to be similar to that in the ESPB group. Fentanyl rescue analgesia in the postoperative care unit was required by three patients in the ESPB group and five patients in the RSB group (p=0.400). Visual Analog Scale (VAS) pain scores and the number of patients who developed nausea and vomiting in the first 24 hours postoperatively were similar between the groups (p>0.05).
CONCLUSION: The erector spinae plane block and RSB demonstrated comparable analgesic efficacy. Rectus sheath block was found to be non-inferior to ESPB in LC surgery with respect to 24-hour opioid consumption. The groups were also similar regarding rescue analgesia, VAS scores, shoulder pain, and the frequency of nausea and vomiting.

BACKGROUND: The increase in liver cholestasis enzyme and bilirubin levels, especially due to pancreatitis, mimics choledocholithiasis. This study aimed to examine the relationship between demographic and laboratory cut-off values and the presence of choledocholithiasis in patients with acute biliary pancreatitis (ABP).
METHODS: Patients diagnosed with ABP in the Department of General Surgery at Istanbul Faculty of Medicine between January 2010 and December 2022 were retrospectively analyzed. The presence of stones in the common bile duct was determined based on the results of magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound (EUS), and endoscopic retrograde cholangiopancreatography (ERCP). Demographic and laboratory values of patients with and without bile duct stones were compared. Cut-off values were determined using receiver operating characteristic (ROC) curve analysis, and logistic regression analysis and modeling was performed for each variable.
RESULTS: A total of 1,026 ABP patients were evaluated. Patients whose enzyme levels were not elevated and those who did not undergo MRCP were excluded. A total of 584 patients were included in the study, and choledocholithiasis was detected in 188 (32.2%) patients. In multivariate analysis, age, gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), and direct bilirubin (DB) were found to be statistically associated with choledocholithiasis. The cut-off values were determined as 65 years for age, 394 U/L for GGT, 173 U/L for ALP, and 1.42 mg/dL for direct bilirubin. In the group where all four parameters were below these cut-off values, suggesting a clean common bile duct, it was observed that the negative predictive value was 97%.
CONCLUSION: Based on the demographic and laboratory data of patients with ABP, we were able to predict with more than 97% accuracy that the common bile duct was clean. Considering that our study only included patients who underwent MRCP due to elevated enzyme levels and suspicion of choledocholithiasis, the negative predictive value would be even higher if patients with acute biliary pancreatitis with normal enzyme levels were included. Additionally, no complications were observed in any of the patients during follow-up. This finding suggests that patients whose common bile duct is predicted to be clean can initially be monitored and supported with additional imaging methods if necessary. As a result, unnecessary imaging can be avoided, reducing costs and preventing the mortality and morbidity associated with unnecessary procedures.

BACKGROUND: The aim of this study was to compare gait parameters, balance, weight-bearing symmetry, functional capacity, functional mobility, prosthesis satisfaction, and quality of life between individuals with diabetes mellitus-induced and traumatic transtibial amputations (TTAs).
METHODS: Ten individuals with traumatic transtibial amputation and 10 individuals with diabetes mellitus-induced transtibial amputation were included in the study. All participants in both the trauma and diabetes groups used a vacuum-assisted suction suspension system (VASS) and a carbon composite foot transtibial prosthesis. Gait analysis and weight-bearing symmetry were assessed using a computerized gait analysis system. Balance was evaluated with the Biodex Balance System (BBS), functional capacity with the Six-Minute Walk Test (6MWT), functional mobility with the Timed Up and Go Test (TUG) and the Stair Climbing Test (SCT), prosthesis satisfaction with the Trinity Amputation and Prosthesis Experience Scale (TAPES), and quality of life with the Short Form-36 (SF-36).
RESULTS: When comparing the traumatic and diabetic groups, significant differences favoring the trauma group were found in the following parameters: stride length (SL) (p=0.004), amputated limb step length (ASL) (p=0.019), non-affected limb step length (NSL) (p=0.005), balance assessment parameters of general postural stability (p=0.000), anteroposterior (A-P) postural stability (p=0.000), mediolateral (M-L) postural stability (p=0.007), SCT performance (p=0.000), and the activity restriction subsection of TAPES (p=0.029). No significant differences were observed in gait velocity, cadence, step width, weight-bearing percentage of the amputated and non-affected limbs, TUG performance, SF-36 scores, or the psychosocial adjustment, prosthesis satisfaction, and daily use time subsections of the TAPES.
CONCLUSION: In this study, the use of a VASS prosthesis in both traumatic and diabetic amputees had a positive effect on out-comes in the diabetic group, resulting in comparable results to those of the traumatic group. The fact that diabetic amputees used their prostheses as frequently as traumatic amputees, remained active, and benefited from the choice of prosthesis and suspension system provides valuable insights for healthcare professionals as a facilitating factor in rehabilitation.

BACKGROUND: Traumatic peripheral nerve injuries are one of the leading causes of disability in young individuals. This study aims to evaluate cases of traumatic peripheral nerve injury from a forensic medical perspective and to identify their characteristic features.
METHODS: A retrospective analysis was conducted on 6,953 cases who presented to the Forensic Medicine Clinic of Gülhane Training and Research Hospital between September 1, 2016 and June 31, 2023. Among these, 393 cases with traumatic peripheral nerve injuries were included in the study. The age, gender, occupation, cause of trauma, scope of the legal case, injured peripheral nerves, associated bone fractures, muscle strength and sensory loss, functional recovery status, psychiatric diagnosis, and electromyography (EMG) results of the cases were examined. All medical reports of the cases were evaluated within the scope of relevant legal regula-tions.
RESULTS: This study analyzed 393 cases with ages ranging from 17 to 70 years (mean age: 28.2 years). Of these, 94.9% were security personnel. The most common causes of injury were explosive devices and firearm injuries. The most frequently damaged nerves were the peroneal, ulnar, and tibial nerves. According to EMG findings, partial axonal degeneration was detected in 82.79% of the injured nerves, while total axonal degeneration was identified in 17.21%. Injuries were most commonly observed in the elbow-forearm region. Full functional recovery was noted in 5.1% of the cases. Bone fractures, particularly in the knee-leg region, were present in 73.3% of the cases. Psychiatric disorders developed in 22.1% of the cases. Injuries were deemed permanent in 94.5% of the cases, and re-evaluation was required in 60.7% of the cases after 18 months post-injury. Permanent disability was identified in 94.9% of the cases.
CONCLUSION: A detailed forensic evaluation of traumatic peripheral nerve injuries was conducted, highlighting their frequent occurrence in military conflict zones. A meticulous assessment of symptoms resulting from these injuries is necessary. Electromyography findings are effective in evaluating nerve injuries and should be integrated with physical examinations.

BACKGROUND: Traumatic injuries, particularly abdominal trauma, are a major cause of mortality worldwide. This study aimed to evaluate predictive factors for mortality and morbidity in abdominal trauma patients using simple, rapid, and accessible clinical and laboratory parameters, with a focus on developing scoring systems for emergency department decision-making.
METHODS: A retrospective cohort study was conducted in a Level 1 Trauma Center between October 2022 and March 2024. Patients aged 18 and older with abdominal trauma or multi-trauma were included, while cases with incomplete records, known chronic diseases, or a recent trauma history were excluded. Data on demographics, vital signs, laboratory results, imaging findings, clinical scores, and outcomes were collected. Logistic regression and receiver operating characteristic (ROC) analyses were performed to identify independent mortality predictors and their cut-off values.
RESULTS: Out of 693 patients, the mortality rate was 3.6%. The most common mechanisms of trauma were road traffic accidents (59.3%) and falls (23.4%). Independent predictors of mortality included age ≥54 years, Glasgow Coma Scale (GCS) ≤14, Injury Severity Score (ISS) ≥24, and Shock Index ≥1.08. ROC analysis revealed that GCS had the highest predictive value for mortality (area under the curve [AUC]: 0.828), followed by ISS, age, and Shock Index. Elevated levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate, and creatinine were associated with worse outcomes, aligning with findings in the literature.
CONCLUSION: Age, GCS, ISS, and Shock Index are strong predictors of mortality in abdominal trauma patients. Integrating these parameters into clinical decision-making can enhance risk stratification and improve patient management. Prospective multicenter studies and national trauma registries are necessary to refine trauma care and reduce mortality rates.

BACKGROUND: This study aimed to examine the clinical and morphological characteristics associated with the risk of rupture of internal carotid artery (ICA) bifurcation aneurysms (ICAbifAn) by comparing ruptured and unruptured aneurysms.
METHODS: The two-center observational study included 66 patients with ICAbifAn (4.3%) identified from a database of 1,512 patients with intracranial aneurysms. The following data were collected and evaluated for their association with rupture risk: demo-graphic data, medical history, aneurysm neck and dome size, bottleneck factor, aspect ratio (AR), size ratio, dome projection and localization, ICA (D1), M1, and A1 diameters, and ICA-M1 (β), ICA-A1 (γ), and M1-A1 (α) angles.
RESULTS: Sixty ICAbifAn cases were included in the study. Of these, 26 (43.3%) were ruptured aneurysms, and 34 (56.7%) were un-ruptured aneurysms. Patients in the ruptured group were younger than those in the unruptured group (p=0.017). The ruptured group had a smaller α angle (p=0.018) and significantly narrower A1 (p=0.004) and M1 (p=0.005) vessel diameters compared to the unruptured group. Irregular shape (p=0.001), AR>1.7, and a narrow neck (p=0.007) were significant predictors of rupture. Logistic regression analysis revealed that AR, α angle, and M1 and A1 diameters were significant predictors of aneurysm rupture. In receiver operating characteristic (ROC) analysis, an α angle cutoff of 126.2° exhibited a sensitivity of 61.5% and a specificity of 67.7% (area under the curve [AUC]=0.67). A cutoff M1 diameter of 2 mm exhibited a sensitivity and specificity of 61.5% and 76.4%, respectively (AUC=0.71). Additionally, a cutoff A1 diameter of 1.5 mm exhibited a sensitivity and specificity of 73.1% and 71.1%, respectively (AUC=0.75).
CONCLUSION: This study provided insights into the impact of aneurysm and bifurcation geometry on the risk of ICAbifAn rupture, which may also be applicable to more common bifurcation site aneurysms. Simple morphological measurements at the bifurcation region, where instability prevails, may serve as useful indicators for clinicians evaluating the likelihood of ICAbifAn rupture.

BACKGROUND: In recent years, artificial intelligence (AI) applications have been increasingly used as sources of medical information, alongside their applications in many other fields. This study is the first to evaluate ChatGPT's performance in addressing urological emergencies (UE).
METHODS: The study included frequently asked questions (FAQs) by the public regarding UE, as well as UE-related questions formulated based on the European Association of Urology (EAU) guidelines. The FAQs were selected from questions posed by patients to doctors and hospital accounts on social media platforms (Facebook, Instagram, and X) and on websites. All questions were presented to ChatGPT 4 (premium version) in English, and the responses were recorded. Two urologists assessed the quality of the responses using a Global Quality Score (GQS) on a scale of 1 to 5.
RESULTS: Of the 73 total FAQs, 53 (72.6%) received a GQS score of 5, while only two (2.7%) received a GQS score of 1. The questions with a GQS score of 1 pertained to priapism and urosepsis. The topic with the highest proportion of responses receiving a GQS score of 5 was urosepsis (82.3%), whereas the lowest scores were observed in questions related to renal trauma (66.7%) and postrenal acute kidney injury (66.7%). A total of 42 questions were formulated based on the EAU guidelines, of which 23 (54.8%) received a GQS score of 5 from the physicians. The mean GQS score for FAQs was 4.38±1.14, which was significantly higher (p=0.009) than the mean GQS score for EAU guideline-based questions (3.88±1.47).
CONCLUSION: This study demonstrated for the first time that nearly three out of four FAQs were answered accurately and satisfactorily by ChatGPT. However, the accuracy and proficiency of ChatGPT's responses significantly decreased when addressing guideline-based questions on UE.

BACKGROUND: This prospective case series aimed to evaluate the short- to medium-term radiological and clinical outcomes of intramedullary screw (IMS) fixation in pediatric patients with extra-articular proximal phalanx fractures.
METHODS: Eleven patients (eight boys and three girls) aged 5-15 years underwent IMS fixation between January 2020 and June 2022. Antegrade or retrograde techniques were used depending on the fracture location. Postoperatively, patients were immobilized with finger splints for 3-5 days, followed by home exercises and physiotherapy. Bone union and functional status were assessed at one and four weeks after rehabilitation. Patient satisfaction, union status, and finger range of motion were also evaluated. Satisfaction outcomes were categorized as excellent, good, fair, or poor.
RESULTS: The mean patient age was 9.4 years (range: 5-15), and the mean follow-up period was 29.1 months (range: 24-36). The right hand was affected in eight cases, the left hand in three cases, and the dominant hand in eight cases. Fracture distribution included four neck, four shaft, and three base fractures. The mechanisms of injury included ball-related trauma (n=5), falls (n=3), crush injuries (n=2), and punching (n=1). The average time from injury to presentation was 2.5 days (range: 0-9). Seven patients underwent surgery using the retrograde fixation technique, while four patients underwent surgery using the antegrade fixation technique. Fracture union was observed within the first month in nine patients and was complete by the end of the second month in two patients. At the last follow-up, the range of motion of the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints of the operated finger was assessed. Deficits of 1.8 (range: 0-10), 2.7 (range: 0-10), and 0.9 (range: 0-10) were observed when compared to the contra-lateral side, respectively. Ten patients demonstrated excellent outcomes, while one patient exhibited a good outcome.
CONCLUSION: The intramedullary screw technique offers significant advantages in the surgical management of pediatric proximal phalanx fractures, particularly in rural areas with low socioeconomic status. This approach eliminates the need for pin-bottom fixation with a K-wire, significantly reduces hospitalization and additional treatment requirements, and minimizes the adverse impact of familial factors on the therapeutic process.

BACKGROUND: Although non-surgical management is a commonly used treatment for pediatric clavicle fractures, there is limited data in the literature regarding the most effective method. This study aims to compare the radiological outcomes of the figure-of-eight bandage versus the arm sling in the treatment of mid-shaft clavicle fractures in school-age children.
METHODS: Patients were divided into two groups based on the preferred conservative management method: Group 1 (arm sling) and Group 2 (figure-of-eight bandage). The degree of angulation and shortening was measured at initial admission and during follow-up. Demographic characteristics and radiological data were compared between the two groups.
RESULTS: Group 1 included 10 girls and 10 boys, while Group 2 included 12 girls and 17 boys (p=0.761). The mean shortening at initial presentation was 7.28±6.06 mm in Group 1 and 6.65±5.58 mm in Group 2 (p=0.625). At follow-up, the mean shortening was 6.24±5.59 mm in Group 1 and 5.59±4.91 mm in Group 2 (p=0.569). The mean angulation at initial presentation was 21.28±10.05° in Group 1 and 20.41±12.23° in Group 2 (p=0.752). At follow-up, the mean angulation was 14.45±9.41° in Group 1 and 11.82±10.27° in Group 2 (p=0.189). In intra-group comparisons, no significant difference was found between the initial shortening and follow-up shortening in either group (Group 1: p=0.062; Group 2: p=0.190). A significant reduction in angulation was observed in both groups during follow-up (p=0.001 for Group 1; p=0.001 for Group 2).
CONCLUSION: The radiological outcomes of the figure-of-eight bandage and the arm sling in the treatment of mid-shaft clavicle fractures in school-age children are similar.

BACKGROUND: Artificial intelligence has been shown to achieve successful outcomes in various orthopedic qualification examinations worldwide. This study aims to assess the performance of ChatGPT in the written section of the Turkish Orthopedics and Traumatology Board Examination, compare its results with those of candidates who took the exam, and determine whether ChatGPT is sufficient to achieve a passing score.
METHODS: This retrospective observational study evaluated whether ChatGPT achieved a passing grade on 400 publicly available questions from the Turkish orthopedics qualification exam over the past four years. ChatGPT’s performance was compared with the mean scores of the candidates who took the exam.
RESULTS: A total of 627 candidates participated in the four exams included in the study, of whom 292 (46.5%) passed. ChatGPT received higher scores than 619 (98.7%) of the candidates. In all exams conducted between 2020 and 2023, ChatGPT achieved significantly higher scores than the mean exam success rate (p=0.012, p=0.012, p=0.002, p=0.005, respectively). Of the 400 questions analyzed, 36 (9%) included figures.
CONCLUSION: This is the first study to evaluate the performance of ChatGPT in the Turkish orthopedics proficiency exam. Our findings indicate that ChatGPT demonstrated high success in the Turkish Orthopedics and Traumatology Board Examination (TOTBE) written exam, achieving higher scores than the vast majority of candidates taking the exam (98.7%). ChatGPT performed well in the first part of the proficiency exam, where only theoretical knowledge is assessed. However, the human factor, which synthesizes both theoretical and practical knowledge, remains essential in daily medical practice.