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An error occurred while generating the dataset All the data files must have the same columns, but at some point there are 7 new columns (Solution, Choices, ID, Question, Answer, Context, Subject) and 2 missing columns (explanation, id). This happened while the csv dataset builder was generating data using hf://datasets/SeanWu25/NEJM-AI_Benchmarking_Medical_Language_Models/NEJM_All_Questions_And_Answers.csv (at revision 7839934224e0c50e50143d98f8db1d56462b87b1) Please either edit the data files to have matching columns, or separate them into different configurations (see docs at https://hf.co/docs/hub/datasets-manual-configuration#multiple-configurations)
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id
int64
explanation
string
2,464
Answer D: About 50% of people with hypertension are controlled
2,465
Answer A: Increased long-term BP variability is associated with an increased risk of cardiovascular events despite adequate BP control on most visits
2,466
Answer D: Low dietary potassium promotes hypertension by increasing the activity of the sodium-chloride cotransporter (on a high sodium diet)
2,467
Answer D: Add amiloride
2,468
Answer B: In 1 year
2,469
Answer B: Obtain 24-hour ambulatory BP monitoring
2,470
Answer D: Add spironolactone
2,471
Answer B: Home BP tele-monitoring supervised by a health care provider results in higher rates of BP control than usual care Home BP monitoring, with or without remote telemonitoring, is associated with better BP control; therefore, choice B is correct, and choice A is incorrect. The best results occur when a healthcare provider, such as a physician, clinical pharmacist, or nurse, pairs the monitoring with interventions. Protocols involving patient education for self-titration of therapy are also quite effective for individuals with hypertension regardless of comorbid conditions, but it is estimated that only about 20% of hypertensive patients may be suitable to this intervention (incorrect choices C and D). Financial incentives to physicians result in modest increases in rates of BP control in hypertensive patients (incorrect choice E).
2,472
Answer D: 110/75 mmHg
2,473
Answer A: Droxidopa
2,474
Answer D: Make no changes to the current regimen
2,475
Answer D: Her BMI
2,476
Answer C: Inappropriately low atrial natriuretic peptide levels
2,477
Answer D: Regular use of continuous positive airway pressure for at least 4 hours per night Patients with obesity have an increased incidence of both sleep apnea and resistant hypertension. A recent study has shown that the combination of weight loss with regular use of CPAP improves BP and can reverse abnormal dipping patterns. The effects of CPAP on BP are also more pronounced with use of CPAP for more than 4 hours per night; hence, choice D is correct. Use of nocturnal oxygen supplementation has not been shown to be effective to reduce BP (choice A is incorrect). Behavioral and self-help psychotherapy are not effective in lowering BP as assessed by ambulatory blood pressure monitoring (choice B is incorrect). A randomized, double-blind, sham-controlled trial and a meta-analysis of device-guided breathing by Landman and coworkers found no benefit of device-guided breathing in lowering BP; thus, choice C is incorrect.
2,478
Answer D: Order a CT angiogram
2,479
Answer D: Refer for adrenal vein sampling
2,480
Answer C: A lateralization index of 6
2,481
Answer D: Plasma metanephrines
2,482
Answer C: Genetic testing
2,483
Answer D: Maintenance of his systolic BP at <120 mmHg
2,484
Answer C: Reversal of INR to <1.3 plus lowering of systolic BP <160 mmHg within 4 hours
2,485
Answer D: The absence of nocturnal dipping
2,486
Answer B: Underlying CKD
2,488
Answer D: Add amlodipine, targeting a systolic BP of <120 mmHg
2,489
Answer C: The low BP target (120 mmHg) resulted in a 38% reduction in the risk of heart failure In SPRINT, a systolic BP target of <120 mmHg, compared to a target of 140 mmHg, resulted in lower risk of several cardiovascular endpoints as well as all-cause death. Specifically, the composite endpoint of myocardial infarction and other coronary syndromes, stroke, heart failure, or cardiovascular death was decreased by 25%. This was driven largely by less heart failure (38%) and cardiovascular deaths (22%). All cause death was also decreased by 27%. Other components of the endpoint were also improved, but did not reach statistical significance (stroke was decreased by 11%, P=0.50, and myocardial infarction was decreased by 17%, P=0.19; other coronary syndromes were identical between the two groups). All subgroups benefited from the lower target, including patients older than 75 years. The differences between the two groups were substantial (15/8 mmHg at 12 months) an dpersisted for the duration of the trial. The risk of AKI was increased by 71% in the low BP target group, but the absolute risk was 4.4% (vs. 2.6% in the standard group, P<0.001).
2,490
Answer C: Refer for percutaneous renal angioplasty
2,491
Answer E: 25OHD replacement has no effect on BP in hypertensive patients with 25OHD deficiency
2,492
Answer C: Beetroot juice lowers ambulatory BP by about 8/5 mmHg compared with placebo Beetroot juice is a good source of nitrates, resulting in BP lowering through the provision of nitrates that result in vasodilatation, improved endothelial function, and lower BP (-7.7/5.2 mmHg on 24h ABPM). There is no known effect of beetroot juice on aldosterone. In the available clinical studies, the effect was sustained at least up to 4 weeks. Pulse wave reflections have not been studied with beetroot therapy, but pulse wave velocity tends to decrease, thus suggesting that wave reflection would also likely decrease. There are no reports of hypertension associated with beetroot juice.
2,493
Answer B: Target the hemoglobin A1c to <7.0 % before conception
2,494
Answer C: Increased AST and ALT
2,495
Answer E: Make no changes to the current regimen
2,496
Answer A: Induction of labor and delivery
2,497
Answer D: Continue intravenous magnesium and transition to oral antihypertensive medications
2,498
Answer A: Labetalol
2,499
Answer C: Aspirin at 81 mg daily
2,500
Answer C: It increases the risk of cardiovascular disease
2,501
Answer B: She is at increased risk of urinary tract infection
2,502
Answer D: Acute fatty liver of pregnancy (AFLP)
2,503
Answer A: Transfuse platelets and packed red blood cells
2,504
Answer B: Long-chain 3-hydroxyl CoA dehydrogenase
2,505
Answer C: Observation with expectant medical management
2,506
Answer D: Renal blood flow returns to pre-pregnancy levels
2,507
Answer D: Preeclampsia
2,508
Answer A: Intravenous normal saline plus furosemide
2,509
Answer D: Hemodialysis totaling ≥36 h/wk
2,510
Answer C: A low soluble fms-like tyrosine kinase-1 to placental growth factor ratio
2,511
Answer C: Enalapril
2,512
Answer B: She should start aspirin 81 mg daily immediately after pregnancy is diagnosed Approximately one in three women who have received a kidney transplant develop preeclampsia during pregnancy. Therefore, prophylaxis with low-dose aspirin is appropriate. In addition, heightened antenatal surveillance should be offered, including fetal growth and Doppler monitoring starting at 28 weeks gestation. The majority of women with kidney transplants are delivered by caesarean section. However, the indications for surgical delivery are the standard obstetric maternal or fetal indications, and vaginal delivery is not contraindicated. Therefore, option A is incorrect. Mycophenolate mofetil should be changed to azathioprine at least 3 months prior to attempting to conceive, to ensure graft stability; hence, option C is incorrect. Risk factors for adverse graft outcomes include hypertension, pre-pregnancy serum creatinine levels >1.5 mg/dl, and black ethnicity. There is no evidence to support an increased incidence of graft rejection after delivery, therefore commencing prednisone postpartum (option D) is incorrect.
2,513
Answer A: The probability of achieving pregnancy is reduced compared with spontaneous conception
2,514
Answer B: Stop mycophenolate mofetil and start azathioprine
2,515
Answer D: Anti-Ro and anti-La antibodies
2,516
Answer C: Furosemide
2,517
Answer B: Reduce the tacrolimus dose
2,518
Answer B: Enzyme replacement therapy
2,519
Answer D: It does not increase the risk for a small gestation baby
2,520
Answer C: A reduction in the loading dose and maintenance dose
2,521
Answer C: Empiric therapy with predisone and azathioprine, followed by adjusted treatment after delivery based on kidney biopsy performed postpartum
2,522
Answer A: Her risk of progression to ESRD during or shortly postpartum is about 20%
2,523
Answer D: IgA nephropathy
2,524
Answer C: Measure or estimate 24-hour creatinine excretion rate
2,525
Answer E: Rituximab
2,526
Answer D: Stain prior kidney biopsy with Congo Red
2,527
Answer E: No additional diagnostic studies are required
2,528
Answer A: Oral angiotensin receptor blockers (ARBs)d
2,529
Answer A: Oral glucocorticoids
2,530
Answer B: Oral cyclosporine and low-dose steroids for ≥4 months
2,531
Answer C: As in A plus widespread effacement of the podocyte foot processes by electron microscopy
2,532
Answer C: Hyperexpression of PLA2R antigen by immunohistochemical studies of pronasedigested, paraffin-preserved specimens
2,533
Answer E: Continued supportive care and observation
2,534
Answer B: Pronase digestion of paraffin-embedded material and staining for monoclonal IgG (light and heavy chains)
2,535
Answer A: Sarcoidosis causing secondary membranous nephropathy
2,536
Answer B: Oral ACEIs or ARBs
2,537
Answer D: Perform a laser dissection/mass spectrometry analysis of the biopsy specimen
2,538
Answer E: Serum immunofixation and free light-chain assays
2,539
Answer B: An underlying autoimmune disorder
2,540
Answer B: Staining the kidney biopsy for hepatitis B surface antigen and core antigen
2,541
Answer D: Sofosbuvir plus simeprevir plus rituximab
2,542
Answer C: IgA−dominant, infection−related GN
2,543
Answer C: Kidney prognosis is likely to be good long term, but uncertainty exists; therefore, yearly follow-up is advisable
2,544
Answer A: A calcineurin inhibitor
2,545
Answer C: Treat with cyclophosphamide and corticosteroids as outlined in choice B but reduce the doses by ≥20%
2,546
Answer B: Either intravenous cyclophosphamide or intravenous rituximab
2,547
Answer A: Rituximab > azathioprine > mycophenolate > extended cyclophosphamide
2,548
Answer A: Plasmapheresis, high−dose corticosteroids, and cyclophosphamide
2,549
Answer A: Provide supportive care and management for ESRD
2,550
Answer A: The long−term prognosis is favorable, because the proteinuria declined to <0.7 g/d after 1 year
2,551
Answer B: Add low−dose Euro lupus cyclophosphamide for 3 months to corticosteroids
2,552
Answer B: A sustained remission for at least 24 months
2,553
Answer E: Conduct a detailed evaluation of his diet
2,554
Answer E: Adynamic bone disease
2,555
Answer B: All surgical approaches, such as partial, subtotal, or total parathyroidectomy with or without autotransplantation, are effective
2,556
Answer B: Begin cinacalcet therapy
2,557
Answer D: Cinacalcet
2,558
Answer D: Add teriparatide
2,559
Answer A: The effect of phosphate binders does not increase linearly with dose
2,560
Answer C: Lithium-related primary hyperparathyroidism
2,561
Answer C: Elevated IgGκ monoclonal protein
2,564
Answer D: Add sodium thiosulfate
2,566
Answer A: Start bisphosphonate therapy
2,567
Answer C: Identify the method of serum phosphate measurement
End of preview.

A Comparative Study of Open-Source Large Language Models

Dataset Overview

Welcome to the dataset repository for our paper, "A Comparative Study of Open-Source Large Language Models, GPT-4 and Claude 2: Multiple-Choice Test Taking in Nephrology." The preprint of the paper can be accessed here.

Files

This repository contains two key files:

  1. NEJM_All_Questions_And_Answers.csv: This file includes all the questions and corresponding answers used in the study.

  2. Ground_Truth_Answers.csv: This file provides ground truth explanations associated with the questions in the main dataset.

Usage

To utilize this dataset for your research or experimentation:

  1. Download: Obtain the dataset files from this repository.
  2. Load: Import the dataset into your preferred data analysis or machine learning environment.
  3. Explore: Investigate the questions, answers, and ground truth explanations for your specific use case.

Paper

Our paper is accepted to NEJM-AI. For now please read the pre-print at the link: https://arxiv.org/abs/2308.04709

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