Background: Although discharge summaries in patient-friendly language can enhance patient comprehension and satisfaction, they can also increase medical staff workload. Using a large language model, we developed and validated software that generates a patient-friendly discharge summary. Methods: We developed and tested the software using 100 discharge summary documents, 50 for patients with myocardial infarction and 50 for patients treated in the Department of General Surgery. For each document, three new summaries were generated using three different prompting methods (Zero-shot, One-shot, and Few-shot) and graded using a 5-point Likert Scale regarding factuality, comprehensiveness, usability, ease, and fluency. We compared the effects of different prompting methods and assessed the relationship between input length and output quality. Results: The mean overall scores differed across prompting methods (4.19 ± 0.36 in Few-shot, 4.11 ± 0.36 in One-shot, and 3.73 ± 0.44 in Zero-shot; P < 0.001). Post-hoc analysis indicated that the scores were higher with Few-shot and One-shot prompts than in zero-shot prompts, whereas there was no significant difference between Few-shot and One-shot prompts. The overall proportion of outputs that scored ≥ 4 was 77.0% (95% confidence interval: 68.8–85.3%), 70.0% (95% confidence interval [CI], 61.0–79.0%), and 32.0% (95% CI, 22.9–41.1%) with Few-shot, One-shot, and Zero-shot prompts, respectively. The mean factuality score was 4.19 ± 0.60 with Few-shot, 4.20 ± 0.55 with One-shot, and 3.82 ± 0.57 with Zero-shot prompts. Input length and the overall score showed negative correlations in the Zero-shot (r = −0.437, P < 0.001) and One-shot (r = −0.327, P < 0.001) tests but not in the Few-shot (r = −0.050, P = 0.625) tests. Conclusion Large-language models utilizing Few-shot prompts generally produce acceptable discharge summaries without significant misinformation. Our research highlights the potential of such models in creating patient-friendly discharge summaries for Korean patients to support patient-centered care.

Background: Topical timolol is widely used for treatment of superficial infantile hemangioma (IH). However, little is known about factors that affect the response to topical timolol treatment. Objective: This study aimed to investigate the efficacy, safety, and predictive value for good response to topical timolol for IH. Methods: A retrospective review of medical records and clinical photos of 328 patients with IH treated with topical timolol 0.5% solution was conducted. Serial clinical photographs were compared with those at the initial visit using a 100-mm visual analogue scale (VAS). Treatment response was defined as an improvement of at least 75% from baseline in IH lesions within 12 months of treatment. Results: Overall, IH patients treated with topical timolol showed significant improvement from baseline, showing that the final VAS score within 12 months of treatment was 69.7±20.4. The multivariable logistic regression analysis showed age at initiation of treatment (p=0.007), length of gestation and fetal growth (p=0.03), depth (p=0.01), and flexural area (p=0.007) were significantly associated with treatment response. Only four patients (1.1%) reported local irritation. Conclusion This study demonstrated that topical timolol treatment was an effective and well-tolerated treatment for IHs. Physicians are encouraged to consider several patient- or lesional factors that might affect treatment response to achieve better clinical outcomes.

Background: Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital cutaneous anomaly characterized by persistent reticular skin lesion with a blue to purple color change. While the natural prognosis of the disease is generally considered good, limited data are available regarding the natural course of Korean patients with CMTC. Objective: To investigate the clinical features and natural course of Korean patients with CMTC. Methods: We performed a single-center retrospective study of 34 Korean patients diagnosed with CMTC at our institution between January 1999 and June 2019. Results: A slight female predominance was observed (male:female ratio, 1：1.4) and 82.4% of the patients were diagnosed before 2 years of age. Body asymmetry (32.4%) and other vascular anomalies (14.7%) were the two anomalies most frequently associated with CMTC. Most of the skin lesions developed on the lower extremities (67.6% lower extremity only, 20.6% lower extremity and other body regions) and 85.3% of the lesions occurred unilaterally. Among 25 patients with one or more follow-up evaluations, 20 (80.0%) showed spontaneous fading of the skin lesion. However, none showed a complete resolution. Finally, statistical analysis did not reveal any significant variable associated with the natural prognosis of CMTC. Conclusion Korean patients with CMTC had similar clinical features and natural course as those described in the previous literature. Notably, a greater portion of the patients showed improvement in skin lesions compared to those in previous studies. However, complete resolution of the skin lesion seems to be rare, if not impossible.