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Öğe A comparative analysis of the performance of large language models in the basic life support exam: comprehensive evaluation of ChatGPT-4o, Gemini 2.0, Claude 3.5, and DeepSeek R1(Bayrakol Medical Publisher, 2025) Bulut, Bensu; Öz, Medine Akkan; Genç, Murat; Gür, Ayşenur; Yortanlı, Mehmet; Yortanlı, Betül Çiğdem; Yazıcı, Ramiz; Mutlu, Hüseyin; Kotanoğlu, Mustafa Sırrı; Çınar, ErayConsidering the growing role artificial intelligence technologies play in medical education, this study aims to provide a comparative evaluation of the performances of large language models ChatGPT-4o, Gemini 2.0, Claude 3.5 , DeepSeek R1 in the Basic Life Support (BLS) Exam. Materials , Methods: In this observational study, we presented four large language models with 25 multiple-choice questions based on the American Heart Association (AHA) guidelines. Questions were divided into two categories as knowledge-based (n = 14, 56%) and case-based (n = 11, 44%). Response consistency was ensured by presenting each question on three separate days to all models. Models' accuracy rates were assessed using overall accuracy, strict accuracy, and ideal accuracy criteria. Results: In the overall accuracy assessment, ChatGPT-4o and DeepSeek R1 models showed 100% success, and Gemini 2.0 and Claude 3.5 models achieved 96% success rate. All models performed perfectly on the case-based questions. On the knowledge-based questions, ChatGPT-4o and DeepSeek R1 scored full points, while Gemini 2.0 and Claude 3.5 achieved 90.9% success. Statistical analysis showed no significant difference between results (p = 0.368). Discussion: Large language models show high accuracy rates in BLS training. These technologies can be used in supportive roles in medical education, but human supervision is critical in clinical decision-making.Öğe All-terrain vehicle related trauma: Analysis of injury patterns, safety equipment use and mortality(Effect Publishing Agency ( EPA ), 2025) Bulut, Bensu; Genç, Murat; Öz, Medine Akkan; Ecevit Kaya, Aynur; Topuz, Muhammed Ali; Borazan, İsmail; Kokulu, Kamil; Sert, Ekrem Taha; Mutlu, Hüseyin; Yazıcı, RamizTo determine age-specific patterns, effects of protective equipment use, and predictors of mortality in all-terrainvehicle (ATV)-related injuries. A total of 55 ATV-related trauma patients were retrospectively analyzed during the study period. Demographic characteristics, injury mechanisms, clinical findings and outcomes were evaluated. Injury patterns were compared according to age groups. Risk factors for mortality were determined by multivariate logistic regression analysis. The mean age of the patients was 22.3±12.8 years and 67.3% were male. Half of the victims (50.9%) were aged 18 years or younger. The majority of accidents occurred with drivers (70.9%) and on the street (70.9%). The rate of protective equipment use at the time of the accident was 21.8%. The most common mechanism of injury was ejection from the vehicle (63.6%), followed by impingement injuries (21.8%) and direct collisions (14.5%). Limb injuries were more common in patients younger than 18 years of age (68.2% vs. 43.5%), while more severe thoracic trauma was observed in patients older than 40 years. Off-road accidents were associated with higher injury severity scores than street/street accidents (mean Injury Severity Score (ISS) 22.6 vs. 16.8, p25 (odds ratio (OR), 8.64), severe head injury (OR 6.92), multiple system involvement (OR 5.78) and lack of protective equipment (OR 4.23) were independent predictors of mortality. ATV accidents are an important public health problem that can lead to serious injuries and fatalities. Injury patterns differ according to age groups. Inadequate use of protective equipment and the severity of off-road accidents are noteworthy. It is important to develop safety measures specific to age groups and to expand the use of protective equipment.Öğe Clinical outcomes of patients transported to the obstetric emergency department directly by ambulance and via inter-hospital transfer(Effect Publishing Agency ( EPA ), 2025) Kaya, Seray; Genç, Murat; Bulut, Bensu; Akkan Öz, Medine; Yazıcı, Ramiz; Mutlu, Hüseyin; Önder Gönen, MustafaThe aim of this study was to investigate the characteristics of pregnant patients transported directly by ambulance or by transfer between hospitals to the obstetric emergency department. The study was conducted among patients aged 18 years and over who were presented to the obstetric emergency department by ambulance between January 2024 and June 2024. Patients were divided into two groups as direct admission and inter-hospital transfer. Demographic characteristics, triage categories, indications for transfer, hospitalisation rates and length of hospital stay were recorded. Data were statistically analysed. A total of 600 patients were included in the study. In the inter-hospital transfer group, the hospitalisation rate and mean length of stay were significantly higher than in the direct admission group (30% vs 15% and 7 days vs 3 days, respectively). The rate and length of stay of patients in the Code Red triage category were higher in the transfer group. The most common indication for transfer was the need for a specialist. The rate and length of stay for patients requiring intensive care were higher than for other indications of transfer. Inter-hospital transfer is an important factor that may affect patient outcomes in the obstetric emergency department. Transferred patients were found to be more likely to be hospitalised and to have a longer length of stay. Optimising the transfer process is essential to ensure patient safety and minimise adverse outcomes.Öğe How important is group size in selecting rats for experimental studies? evolution with zootechnical and biochemical findings(Parlar Scientific Publications, 2022) Kandemir, Özge; Genç, MuratIn this study, which was conducted to investigate the growth performances of male Sprague-Dawley rats grown in different group sizes and changes that occurred in their oxidative statuses, 60 male 4-week-old Sprague-Dawley rats were used. Two different cages with different dimensions were used, and 4 rats were put into each of the small cages, while 6 were put into each of the large cages. The trial was carried out with 6 replications. The rats were weighed each week for one month on the same day and at the same hour, and the average cage values were recorded. It was determined that the live weights showed a regular increase in both groups, and the growth performances did not differ based on group size. Group size was highly effective on the antioxidant components of the rats, and growing the rats in more crowded environments led to oxidative stress by changing their Total Antioxidant Capacity (TAC) (p<0.05), Total Oxidant Capacity (TOC) (p<0.05), Nitric Oxide (NO) (p<0.001), glutathione (GSH) (p<0.0001) and malondialdehyde (MDA) (p<0.001) levels. In the light of the data obtained, it was concluded that, when dense rat breeding is carried out to achieve more production from a unit area, even though no changes occur in the morphological structures of the animals, their oxidant balance is disrupted. This prevents obtaining accurate and reliable data in scientific studies. Consequently, it was determined that group size is a criterion that needs to be kept in mind in selection of rats to be used in scientific studies, and the appropriate group size should be provided for these animals.Öğe New frontiers in radiologic interpretation: evaluating the effectiveness of large language models in pneumothorax diagnosis(PLOS One, 2025) Bulut, Bensu; Akkan Öz, Medine; Genç, Murat; Gür, Ayşenur; Yortanlı, Mehmet; Yortanlı, Betül Çiğdem; Sarıyıldız, Oğuz; Yazıcı, Ramiz; Mutlu, Hüseyin; Kotanoğlu, Mustafa Sırrı; Çınar, Eray; Uykan, ZekeriyaBackground: This study evaluates the diagnostic performance of three multimodal large language models (LLMs)-ChatGPT-4o, Gemini 2.0, and Claude 3.5-in identifying pneumothorax from chest radiographs. Methods: In this retrospective analysis, 172 pneumothorax cases (148 patients aged >12 years, 24 patients aged ≤12 years) with both chest radiographs and confirmatory thoracic CT were included from a tertiary emergency department. Patients were categorized by age and pneumothorax size (small/large). Each radiograph was presented to all three LLMs accompanied by basic symptoms (dyspnea or chest pain), with each model analyzing each image three times. Diagnostic accuracy was evaluated using overall accuracy (all three responses correct), strict accuracy (≥2 responses correct), and ideal accuracy (≥1 response correct), alongside response consistency assessment using Fleiss' Kappa. Results: In patients older than 12 years, ChatGPT-4o demonstrated the highest overall accuracy (69.6%), followed by Claude 3.5 (64.9%) and Gemini 2.0 (57.4%). Performance was significantly poorer in pediatric patients across all models (20.8%, 12.5%, and 20.8%, respectively). For large pneumothorax in adults, ChatGPT-4o showed significantly higher accuracy compared to small pneumothorax (81.6% vs. 42.2%; p < 0.001). Regarding consistency, Gemini 2.0 demonstrated excellent reliability for large pneumothorax (Kappa = 1.00), while Claude 3.5 showed moderate consistency across both pneumothorax sizes. Conclusion: This study, the first to evaluate these three current multimodal LLMs in pneumothorax identification across different age groups, demonstrates promising results for potential clinical applications, particularly for adult patients with large pneumothorax. However, performance limitations in pediatric cases and with small pneumothoraces highlight the need for further validation before clinical implementation.Öğe Predictive factors of mortality in patients with abdominal trauma(Turkish Association of Trauma and Emergency Surgery, 2025) Turan, Ömer Faruk; Gökdere, Didem Çankaya; Genç, Murat; Bulut, Bensu; Akkanöz Öz, Medine; Mutlu, Hüseyin; Yazıcı, RamizTraumatic 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.Öğe Prehospital and emergency data analysis in burn patients: Mortality predictors and response times over five years(Turkish Association of Trauma and Emergency Surgery, 2025) Bulut, Bensu; Genç, Murat; Öz, Medine Akkan; Yazıcı, Ramiz; Mutlu, Hüseyin; Sert, Ekrem Taha; Kokulu, Kamil; Borazan, İsmail; Turan, Ömer Faruk; Kahraman, Fatih Ahmet; Ay, SerdenBackground: This study aimed to retrospectively examine the prehospital and emergency department processes of burn cases to evaluate process effectiveness, establish regional data, and identify factors affecting mortality in burn patients. Methods: The study included 784 burn cases treated by Ankara 112 Emergency Health Services and transferred to Ankara Bilkent City Hospital Emergency Department between January 1, 2019 and December 31, 2023. Demographic data, burn characteristics, response times of 112 emergency health services, and patient outcomes were retrospectively analyzed. Results: The mean age of the patients included in the study was 23.4+-20.7 years, with 36.7% being female. The most common type of burn was hot liquid burns (49.9%) and 73.7% of cases involved second-degree burns. The overall mortality rate was 5%. Logistic regression analysis identified advanced age (odds ratio [OR]: 1.02), presence of inhalation burns (OR: 3.33), and burn percentage as independent risk factors for mortality. Receiver operating characteristic (ROC) analysis showed that age >44 years (38.5% sensitivity, 83.8% specificity) and burn surface >16% (89.7% sensitivity, 77.5% specificity) were predictive thresholds for mortality. Conclusion: Advanced age, extensive burn surface area, residence in rural areas, and inhalation injuries are key predictors of mortality in burn patients. Enhancing prehospital emergency services, implementing community education programs, and adopting a multidisciplinary approach are critical for preventing and effectively managing burn injuries.Öğe Prognostic value of glucose-to-potassium ratio and other biomarkers in in-hospital cardiac arrest(MRE Press, 2025) Vişneci, Emin Fatih; Demirci, Osman Lütfi; Tekin, Fatih Cemal; Kadıoğlu, Emine; Mutlu, Hüseyin; Genç, Murat; Bulut, Bensu; Akkan Öz, Medine; Yazıcı, RamizThis study aimed to evaluate the prognostic value of the serum glucose/potassium ratio (GPR) for sustained return of spontaneous circulation (ROSC) and 30-day mortality in patients with in-hospital cardiac arrest (IHCA). Methods: Patients aged 18 years or older who underwent cardiopulmonary resuscitation (CPR) for cardiac arrest in the emergency department (ED) were included. Routine laboratory parameters were obtained from the first blood sample collected during CPR in the ED. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated by dividing the absolute number of neutrophils and platelets, respectively, by the absolute number of lymphocytes. The GPR was calculated as serum glucose divided by potassium levels. Results: The 30-day mortality rate was 82.2% (n = 291). Multivariate logistic regression analysis identified lactate, NLR, PLR and GPR as independent predictors of mortality. Among these markers, lactate exhibited the highest predictive power for mortality, with an area under the curve (AUC) of 0.817, compared to NLR (AUC: 0.676), PLR (AUC: 0.679) and GPR (AUC: 0.688). The optimal cut-off values for predicting mortality were 7.83 for lactate (sensitivity: 75.3%, specificity: 89.4%), 1.68 for NLR (sensitivity: 78.8%, specificity: 71.7%), 199.26 for PLR (sensitivity: 76.4%, specificity: 92.3%) and 57.81 for GPR (sensitivity: 71.8%, specificity: 84.1%). Conclusions: Our findings suggest that GPR is a promising prognostic marker for predicting mortality in patients with IHCA.
