RealMedQA

Generator stringclasses 2 values	Question stringlengths 72 310	Recommendation stringlengths 5 1.64k	Answered stringclasses 3 values	Plausible stringclasses 3 values
LLM	What are the dietary needs for newborns, babies, children, and adolescents?	1.2.15 Do not offer nutritional supplements specifically to prevent a pressure ulcer in neonates, infants, children and young people with adequate nutritional status for their developmental stage and clinical condition.	Not at all	Not at all
LLM	n/a	1.3.7 Offer paracetamol every 6 hours postoperatively unless contraindicated. [2011]	Not at all	Not at all
LLM	n/a	1.5.2 Consider providing a supervised exercise programme for people with intermittent claudication which involves: 2 hours of supervised exercise a week for a 3‑month periodencouraging people to exercise to the point of maximal pain. [2012]Angioplasty and stenting	Not at all	Not at all
LLM	What are the dangers and ramifications of failing to update and include medication allergy information in referral and discharge letters?	1.3.1	Not at all	Not at all
LLM	Should I give my patients with heart failure morphine?	1.3.2 Do not routinely offer opiates to people with acute heart failure.	Not at all	Not at all
LLM	Is an ultrasound of the achilles tendon required for a diagnosis of familial hypercholesterolaemia?	1.1.12 Coronary heart disease risk estimation tools, such as QRISK2 and those based on the Framingham algorithm, should not be used because people with FH are already at a high risk of premature coronary heart disease. [2008, amended 2017]	Not at all	Completely
LLM	How can healthcare providers guarantee that children and adolescents with spasticity are referred as soon as possible after their diagnosis?	1.1.4 Following diagnosis, ensure that all children and young people with spasticity are referred without delay to an appropriate member of the network team.	Not at all	Not at all
LLM	Can very potent corticosteroids be used in children with atopic eczema without specialist dermatological advice?	1.5.1.14 It is recommended that topical corticosteroids for atopic eczema should be prescribed for application only once or twice daily.	Not at all	Completely
LLM	What is the timed blood sample regimen for serum tryptase?	1.1.4 After a suspected anaphylactic reaction in adults or young people aged 16 years or older, take timed blood samples for mast cell tryptase testing as follows:a sample as soon as possible after emergency treatment has starteda second sample ideally within 1 to 2 hours (but no later than 4 hours) from the onset of s...	Completely	Completely
LLM	How might care coordination and psychosis treatment be delivered in collaboration with drug abuse services?	1.4.7 Consider seeking specialist advice and initiate joint working arrangements with specialist substance misuse services if the person's substance misuse:is difficult to control and/orleads to significant impairment of functioning, family breakdown or significant social disruption such as homelessness.	Not at all	Not at all
LLM	What are some of the most typical difficulties doctors experience while establishing a therapeutic connection with patients suffering from borderline personality disorder?	1.1.4.1 When working with people with borderline personality disorder: explore treatment options in an atmosphere of hope and optimism, explaining that recovery is possible and attainable build a trusting relationship, work in an open, engaging and non-judgemental manner, and be consistent and reliablebear in mind when...	Partially	Not at all
LLM	- What type of dietary advice should be given when offering diets that include soya protein to children aged 6 months or over?	1.4.1.9 Diets based on unmodified proteins of other species' milk (for example, goat's milk, sheep's milk) or partially hydrolysed formulas should not be used in children with atopic eczema for the management of suspected cow's milk allergy. Diets including soya protein can be offered to children aged 6 months or over ...	Completely	Completely
LLM	4) Are there any alternative treatments that could be used?	1.3.1.15 Do not use very potent corticosteroids in children and young people.	Not at all	Not at all
LLM	What are the benefits and drawbacks of each form of LARC?	1.1.2 Provision of information and informed choice	Not at all	Completely
LLM	How mant menstrual cycles are required to diagnose menstrual-related migraine?	1.3.1 Consider using a headache diary:to record the frequency, duration and severity of headachesto monitor the effectiveness of headache interventionsas a basis for discussion with the person about their headache disorder and its impact. [2012]	Not at all	Partially
LLM	What is the logic for aiming for a 4-week pause between rounds of psoriasis therapy with high or extremely potent corticosteroids?	1.3.1.11 Aim for a break of 4 weeks between courses of treatment with potent or very potent corticosteroids. Consider topical treatments that are not steroid based (such as vitamin D or vitamin D analogues or coal tar) as needed to maintain psoriasis disease control during this period.	Not at all	Completely
LLM	5) Have you experienced any other medical conditions or illnesses? ( medical history to rule out other conditions that may be causing your symptoms. )	1.2.1.7 Healthcare professionals should discourage the use of aloe vera in the treatment of IBS. [2008]	Not at all	Not at all
LLM	5) Have any past treatments or interventions for bedwetting been tried, and if so, what were the results?	1.4.3 Explore the child or young person's views about their bedwetting, including:what they think the main problem iswhether they think the problem needs treatment.	Not at all	Not at all
LLM	- Should multiple imaging modalities be used together or separately to assess metastases in the bone for advanced breast cancer?	1.1.2 Assess the presence and extent of metastases in the bones of the axial skeleton using bone windows on a CT scan or MRI or bone scintigraphy. [2009]	Partially	Completely
LLM	- what additional medication is recommended for pain relief in hip fractures, other than paracetamol?	1.3.5 Offer additional opioids if paracetamol alone does not provide sufficient preoperative pain relief. [2011]	Completely	Completely
LLM	What are the common signs and behaviours in persons with minor learning difficulties that indicate borderline personality disorder?	1.1.2.2 When a person with a mild learning disability has a diagnosis of borderline personality disorder, they should have access to the same services as other people with borderline personality disorder.	Not at all	Completely
LLM	What are the best practises for developing and maintaining collaborative working relationships between mental health and drug abuse services?	1.4.7 Consider seeking specialist advice and initiate joint working arrangements with specialist substance misuse services if the person's substance misuse:is difficult to control and/orleads to significant impairment of functioning, family breakdown or significant social disruption such as homelessness.	Not at all	Not at all
LLM	What are the warning signs and symptoms of a medication allergy?	1.2.3 When a person presents with suspected drug allergy, document their reaction in a structured approach that includes:the generic and proprietary name of the drug or drugs suspected to have caused the reaction, including the strength and formulation	Partially	Completely
LLM	Should CIWA-Ar be used on its own or alongside local protocols?	1.1.2.2 Follow locally specified protocols to assess and monitor patients in acute alcohol withdrawal. Consider using a tool (such as the Clinical Institute Withdrawal Assessment – Alcohol, revised [CIWA–Ar] scale) as an adjunct to clinical judgement. [2010]	Completely	Completely
LLM	What role does empathy have in creating a hopeful and trustworthy connection with patients suffering from BPD?	1.1.4.1 When working with people with borderline personality disorder: explore treatment options in an atmosphere of hope and optimism, explaining that recovery is possible and attainable build a trusting relationship, work in an open, engaging and non-judgemental manner, and be consistent and reliablebear in mind when...	Partially	Not at all
LLM	N/A	Note that for personal, familial or social factors, such as disclosure or evidence that raises concerns over possibility of child maltreatment, see recommendation 1.1.5.	Not at all	Not at all
LLM	4) What are the consequences of having a pressure ulcer, such as the chance of acquiring more pressure ulcers in the future?	1.3.2 Offer timely, tailored information to people who have been assessed as being at high risk of developing a pressure ulcer, and their family or carers. The information should be delivered by a trained or experienced healthcare professional and include:the causes of a pressure ulcer the early signs of a pressure ulc...	Not at all	Not at all
LLM	How should I titrate up beta-blockers in heart failure?	Introduce beta-blockers in a 'start low, go slow' manner. Assess heart rate and clinical status after each titration. Measure blood pressure before and after each dose increment of a beta‑blocker. [2010, amended 2018]	Completely	Completely
LLM	3) Is a high-quality foam mattress or overlay required for this patient?	1.2.19 Discuss with children and young people at high risk of developing a heel pressure ulcer and their parents and carers, where appropriate, a strategy to offload heel pressure as part of their individualised care plan.	Not at all	Not at all
LLM	What is an alternative to PPI treatment for severe oesophagitis?	1.6.8 If initial treatment for healing severe oesophagitis fails, consider a high dose of the initial PPI, switching to another full-dose PPI (see table 2) or switching to another high-dose PPI (see table 2 in appendix A), taking into account the person's preference and clinical circumstances (for example, tolerability...	Not at all	Completely
LLM	4) Is there any contraindications or hazards to providing this intervention to the patient?	1.3.8 For adults whose symptoms of social anxiety disorder have only partially responded to individual CBT after an adequate course of treatment, consider a pharmacological intervention (see	Not at all	Not at all
LLM	4) When designing risk management strategies, how should changes in personal connections, particularly the therapeutic relationship, be considered?	1.3.3.3 When managing the risks posed by people with borderline personality disorder in a community mental health service, risks should be managed by the whole multidisciplinary team with good supervision arrangements, especially for less experienced team members. Be particularly cautious when:evaluating risk if the pe...	Partially	Not at all
LLM	How does a drug allergy differ from other types of adverse drug reactions?	1.1.2 Be aware that the reaction is more likely to be caused by drug allergy if it occurred during or after use of the drug and: the drug is known to cause that type of reaction orthe person has previously had a similar reaction to that drug or drug class.	Completely	Not at all
LLM	1) Does the patient have suspected neutropenic sepsis?	1.4.3.2 Do not offer an aminoglycoside, either as monotherapy or in dual therapy, for the initial empiric treatment of suspected neutropenic sepsis unless there are patient-specific or local microbiological indications.Empiric glycopeptide antibiotics in patients with central venous access devices	Not at all	Not at all
LLM	How frequently should the kid or adolescent's management plan be reviewed?	1.4.7 If adverse effects (such as drowsiness) occur with oral diazepam or oral baclofen, think about reducing the dose or stopping treatment.	Not at all	Partially
LLM	What exactly is mast cell tryptase, and why is it crucial to assess it in suspected drug allergy cases?	1.1.6 Ensure that tryptase sampling tubes are included in emergency anaphylaxis kits.Measuring serum specific immunoglobulin E	Not at all	Completely
LLM	How may the amount of diazepam or baclofen taken orally be reduced?	1.4.7 If adverse effects (such as drowsiness) occur with oral diazepam or oral baclofen, think about reducing the dose or stopping treatment.	Not at all	Completely
LLM	3) How can the CPA help healthcare professionals and service consumers communicate better?	1.3.2.2 Teams should use the CPA when people with borderline personality disorder are routinely or frequently in contact with more than one secondary care service. It is particularly important if there are communication difficulties between the service user and healthcare professionals, or between healthcare profession...	Partially	Not at all
LLM	5) How frequently will the patient's risk of acquiring pressure ulcers be assessed?	1.2.19 Discuss with children and young people at high risk of developing a heel pressure ulcer and their parents and carers, where appropriate, a strategy to offload heel pressure as part of their individualised care plan.	Not at all	Completely
LLM	How can we guarantee that people understand the significance of reporting medication allergies to all healthcare personnel they come into contact with?	1.2.6	Not at all	Not at all
LLM	What can be used for patients with acute alcohol withdrawal?	1.1.5 Management of alcohol withdrawal seizures	Not at all	Not at all
LLM	How should the skin examination be performed in individuals who are at high risk of getting a pressure ulcer?	recommendation 1.3.4). The assessment should take into account any pain or discomfort reported by the patient and the skin should be checked for:skin integrity in areas of pressurecolour changes or discolorationHealthcare professionals should be aware that non-blanchable erythema may present as colour changes or discol...	Completely	Completely
LLM	What exactly is the Norton risk-adjustment scale?	1.1.4 Reassess pressure ulcer risk if there is a change in clinical status (for example, after surgery, on worsening of an underlying condition or with a change in mobility).Skin assessment	Not at all	Completely
LLM	What treatment should be used for severe oesophagitis if first line treatment is ineffective?	1.6.8 If initial treatment for healing severe oesophagitis fails, consider a high dose of the initial PPI, switching to another full-dose PPI (see table 2) or switching to another high-dose PPI (see table 2 in appendix A), taking into account the person's preference and clinical circumstances (for example, tolerability...	Completely	Completely
LLM	What are the difficulties to receiving services for borderline personality disorder that black and minority ethnic populations face?	1.1.1.3 Ensure that people with borderline personality disorder from black and minority ethnic groups have equal access to culturally appropriate services based on clinical need.	Not at all	Partially
LLM	Can ER and HER2 receptors indicate disease progress in breast cancer?	1.1.6 On recurrence, consider reassessing oestrogen receptor (ER) and human epidermal growth factor 2 receptor (HER2) status if a change in receptor status will lead to a change in management. [2017]Monitoring disease status	Not at all	Completely
LLM	If a patient is already on diuretics for acute heart failure, how should management proceed?	1.3.4 For people already taking a diuretic, consider a higher dose of diuretic than that on which the person was admitted unless there are serious concerns with patient adherence to diuretic therapy before admission.	Completely	Completely
LLM	5) What measures may be utilised to ensure that risk management plans are prepared collaboratively with the person suffering from borderline personality disorder?	1.3.3.3 When managing the risks posed by people with borderline personality disorder in a community mental health service, risks should be managed by the whole multidisciplinary team with good supervision arrangements, especially for less experienced team members. Be particularly cautious when:evaluating risk if the pe...	Completely	Not at all
LLM	How long should you trial hydrolysed protein formula in 6-8 week olds?	1.4.1.7 Healthcare professionals should offer a 6- to 8-week trial of an extensively hydrolysed protein formula or amino acid formula in place of cow's milk formula for bottle-fed infants aged under 6 months with moderate or severe atopic eczema that has not been controlled by optimal treatment with emollients and mild...	Completely	Completely
LLM	How frequently should community-dwelling persons receiving parenteral nourishment be examined and supervised by home care professionals and competent hospital teams?	1.5.6 People having oral nutrition support and/or enteral tube feeding in the community should be monitored by healthcare professionals with the relevant skills and training in nutritional monitoring. This group of people should be monitored every 3 to 6 months or more frequently if there is any change in their clinica...	Completely	Completely
LLM	What is first line with patients with ER-positive breast cancer?	1.3.6 Offer ovarian suppression to premenopausal and perimenopausal women who have previously been treated with tamoxifen and then experience disease progression. [2009]	Partially	Completely
LLM	What can determine severity of an anaphylactic reaction?	1.1.4 After a suspected anaphylactic reaction in adults or young people aged 16 years or older, take timed blood samples for mast cell tryptase testing as follows:a sample as soon as possible after emergency treatment has starteda second sample ideally within 1 to 2 hours (but no later than 4 hours) from the onset of s...	Partially	Completely
LLM	- If an increase in dietary fibre is advised, what type of fibre should be recommended?	1.2.1.6 People with IBS who choose to try probiotics should be advised to take the product for at least 4 weeks while monitoring the effect. Probiotics should be taken at the dose recommended by the manufacturer. [2008]	Not at all	Completely
LLM	1) Could you inform me about the current initiatives implemented to encourage healthy food and drink choices in our on-site catering services?	1.1.2.2 In their role as employers, NHS organisations should set an example in developing public health policies to prevent and manage obesity by following existing guidance and (in England) the local obesity strategy. In particular:on-site catering should promote healthy food and drink choices (for example by signs, p...	Completely	Not at all
LLM	How soon after changing a stable angina drug treatment should it be reviewed?	1.4.6 Titrate the drug dosage against the person's symptoms up to the maximum tolerable dosage.	Not at all	Completely
LLM	How can healthcare workers detect people who are at risk of acquiring pressure ulcers?	1.1.2 Carry out and document an assessment of pressure ulcer risk for adults:being admitted to secondary care or care homes in which NHS care is provided orreceiving NHS care in other settings (such as primary and community care and emergency departments) if they have a risk factor, for example:significantly limited mo...	Completely	Completely
LLM	How to assess for dehydration in patients?	1.4.6 Assess for hypoxia and optimise oxygen saturation if necessary, as clinically appropriate.Be aware that some pulse oximeters can underestimate or overestimate oxygen saturation levels, especially if the saturation level is borderline. Overestimation has been reported in people with dark skin. See also the NHS Eng...	Not at all	Completely
LLM	2) Have you used contraception before? If so, what type(s)?	1.1.3.5 Healthcare professionals should supply an interim method of contraception at first appointment if required.	Not at all	Not at all
LLM	What are the fundamental concepts for assessing people with borderline personality disorder?	1.1.6 Principles for assessment	Not at all	Not at all
LLM	What techniques may be used within the network of care to enhance good communication and integrated teamwork?	1.1.2 The network of care should provide access to a team of healthcare professionals experienced in the care of children and young people with spasticity. The network team should provide local expertise in paediatrics, nursing, physiotherapy and occupational therapy. Access to other expertise, including orthotics, ort...	Completely	Not at all
LLM	- What types of milk proteins should be avoided in children with suspected cow's milk allergy and atopic eczema?	1.4.1.9 Diets based on unmodified proteins of other species' milk (for example, goat's milk, sheep's milk) or partially hydrolysed formulas should not be used in children with atopic eczema for the management of suspected cow's milk allergy. Diets including soya protein can be offered to children aged 6 months or over ...	Completely	Completely
LLM	- what interventions are recommended for patients that have not not improved after education and active monitoring in primary care?	1.2.1 Follow the stepped-care model, offering the least intrusive, most effective intervention first. [2011]The stepped-care modelFocus of the interventionNature of the interventionSTEP 4: Complex treatment-refractory generalised anxiety disorder (GAD) and very marked functional impairment, such as self-neglect or a hi...	Completely	Partially
LLM	In this context, what is the definition of malnutrition and those at risk of malnutrition?	1.6.6 Healthcare professionals should consider oral nutrition support to improve nutritional intake for people who can swallow safely and are malnourished or at risk of malnutrition, as defined in	Not at all	Not at all
LLM	3) Is there any possible damage or danger in doing unneeded microbiological testing on individuals with mild pneumonia?	1.2.6 Do not routinely offer microbiological tests to patients with low‑severity community‑acquired pneumonia.	Not at all	Partially
LLM	2) Have you experienced any abdominal pain, nausea, or vomiting?	1.3.5 Do not use the albumin/bilirubin ratio when making decisions about the management of hyperbilirubinaemia. [2010]	Not at all	Not at all
LLM	1) What collaborations have local governments formed with business and non-profit organisations to build and administer safe venues for physical activity?	1.1.3.4 Local authorities should work with local partners, such as industry and voluntary organisations, to create and manage more safe spaces for incidental and planned physical activity, addressing as a priority any concerns about safety, crime and inclusion, by: providing facilities such as cycling and walking route...	Completely	Not at all
LLM	What are the many ways of nutrition assistance, and what are the risks and advantages of each?	1.5.2 People having nutrition support in hospital should be monitored by healthcare professionals with the relevant skills and training in nutritional monitoring.	Not at all	Completely
LLM	2) How does bedwetting influence the kid or adolescent, as well as the family? Does it cause any social, emotional, or practical issues?	1.3.16 Discuss factors that might affect treatment and support needs, such as:sleeping arrangements (for example, does the child or young person have his or her own bed or bedroom)the impact of bedwetting on the child or young person and familywhether the child or young person and parents or carers have the necessary l...	Not at all	Partially
LLM	What are symptoms which increase concern in a patient presenting with headache?	1.1.2 Consider further investigations and/or referral for people who present with new‑onset headache and any of the following:compromised immunity, caused, for example, by HIV or immunosuppressive drugsage under 20 years and a history of malignancya history of malignancy known to metastasise to the brainvomiting withou...	Completely	Completely
LLM	What is the strategy for ladies who have received nursing assistance?	1.2.2 Ensure that adequate support is offered to all women who intend to breastfeed exclusively. For information on breastfeeding support, see NICE's guideline on postnatal care. [2010]	Not at all	Not at all
LLM	n/a	1.2.3 Assess the patient's individual preference for how much they wish to be involved in decision making. Reassess this as circumstances change. [2009]	Not at all	Not at all
LLM	When should patients with severe oesophagitis have a clinical review?	1.6.10 If the person's severe oesophagitis fails to respond to maintenance treatment, carry out a clinical review. Consider switching to another PPI at full dose or high dose (see table 2 in appendix A), taking into account the person's preference and clinical circumstances, and/or seeking specialist advice. [new 2014]	Completely	Completely
LLM	3) What makes your symptoms worse? ( any foods, stressors, or other factors that seem to aggravate your symptoms. )	1.2.1.7 Healthcare professionals should discourage the use of aloe vera in the treatment of IBS. [2008]	Not at all	Not at all
LLM	Can soap or detergent cause atopic eczema?	1.4.1.1 When clinically assessing children with atopic eczema, healthcare professionals should seek to identify potential trigger factors including:irritants, for example soaps and detergents (including shampoos, bubble baths, shower gels and washing-up liquids)skin infectionscontact allergensfood allergensinhalant all...	Completely	Completely
LLM	What precautions may be done to lower the risk of pressure ulcers?	1.1.2 Carry out and document an assessment of pressure ulcer risk for adults:being admitted to secondary care or care homes in which NHS care is provided orreceiving NHS care in other settings (such as primary and community care and emergency departments) if they have a risk factor, for example:significantly limited mo...	Not at all	Completely
LLM	What do healthcare professional need to tell parents of children with atopic eczema?	1.2.1.3 Healthcare professionals should be aware that areas of atopic eczema of differing severity can coexist in the same child. If this is the case, each area should be treated independently.	Not at all	Partially
LLM	N/A	1.3.1.1 In children with gastroenteritis but without clinical dehydration:continue breastfeeding and other milk feedsencourage fluid intake	Not at all	Not at all
LLM	What are some general advice given for diet and nutrition for people with IBS?	1.2.1.4 Diet and nutrition should be assessed for people with IBS and the following general advice given. Have regular meals and take time to eat.Avoid missing meals or leaving long gaps between eating.Drink at least 8 cups of fluid per day, especially water or other non‑caffeinated drinks, for example herbal teas.Rest...	Completely	Completely
LLM	What variables should be considered during a wheelchair evaluation for a kid or adolescent?	1.2.21	Not at all	Not at all
LLM	When is important to take parents into account for children with atopic eczema?	1.2.1.5 Healthcare professionals should be aware that all categories of severity of atopic eczema, even mild, can have a negative impact on psychological and psychosocial wellbeing and quality of life. This should be taken into account when deciding on treatment strategies.	Not at all	Not at all
LLM	When should patients with acute alcohol withdrawal have their withdrawal drug regimens reviewed?	1.1.5.2 If alcohol withdrawal seizures develop in a person during treatment for acute alcohol withdrawal, review their withdrawal drug regimen. [2010]	Completely	Completely
LLM	Are there any additional factors, such as drugs or underlying medical problems, that might influence the interpretation of mast cell tryptase levels?	1.1.6 Ensure that tryptase sampling tubes are included in emergency anaphylaxis kits.Measuring serum specific immunoglobulin E	Not at all	Completely
LLM	2) Have you experienced any abdominal pain, nausea, or vomiting?	1.3.5 Do not use the albumin/bilirubin ratio when making decisions about the management of hyperbilirubinaemia. [2010]	Not at all	Not at all
LLM	Is there a preference between hydrophilic and gel reservoir catheters for intermittent self-catheterization?	1.2.3.4 Select the type and gauge of an indwelling urinary catheter based on an assessment of the patient's individual characteristics, including: ageany allergy or sensitivity to catheter materialsgenderhistory of symptomatic urinary tract infectionpatient preference and comfortprevious catheter historyreason for cath...	Not at all	Completely
LLM	What other treatments can be used to manage GORD and dyspepsia?	1.3.1 For people presenting with dyspepsia together with significant acute gastrointestinal bleeding, refer them immediately (on the same day) to a specialist. [2004] (Also see the NICE guideline on acute upper gastrointestinal bleeding.)	Not at all	Completely
LLM	5) What is the surgery's predicted outcome?	1.6.1 Operate on people with the aim to allow them to fully weight bear (without restriction) in the immediate postoperative period. [2011]	Not at all	Not at all
LLM	What criteria should be used to assess if a person suffering from psychosis and substance abuse requires specialised counsel and collaboration with substance abuse services?	1.4.7 Consider seeking specialist advice and initiate joint working arrangements with specialist substance misuse services if the person's substance misuse:is difficult to control and/orleads to significant impairment of functioning, family breakdown or significant social disruption such as homelessness.	Partially	Partially
LLM	What are the most typical difficulties that women experience when attempting to breastfeed exclusively?	1.2.2 Ensure that adequate support is offered to all women who intend to breastfeed exclusively. For information on breastfeeding support, see NICE's guideline on postnatal care. [2010]	Not at all	Partially
LLM	1) Have you had any intermittent claudication symptoms, such as pain or discomfort in your legs while walking or exercising?	1.5.2 Consider providing a supervised exercise programme for people with intermittent claudication which involves: 2 hours of supervised exercise a week for a 3‑month periodencouraging people to exercise to the point of maximal pain. [2012]Angioplasty and stenting	Not at all	Not at all
LLM	How can physicians strike a balance between patient autonomy and the requirement to deliver adequate and effective medical care?	1.1.3.1 Work in partnership with people with borderline personality disorder to develop their autonomy and promote choice by: ensuring they remain actively involved in finding solutions to their problems, including during crises encouraging them to consider the different treatment options and life choices available to ...	Not at all	Not at all
LLM	Is imaging of achilles tendon xanthomas necessary for FH diagnosis?	1.1.12 Coronary heart disease risk estimation tools, such as QRISK2 and those based on the Framingham algorithm, should not be used because people with FH are already at a high risk of premature coronary heart disease. [2008, amended 2017]	Not at all	Completely
LLM	What are the main components of a pressure ulcer skin assessment?	recommendation 1.3.4). The assessment should take into account any pain or discomfort reported by the patient and the skin should be checked for:skin integrity in areas of pressurecolour changes or discolorationHealthcare professionals should be aware that non-blanchable erythema may present as colour changes or discol...	Completely	Completely
LLM	What are the different types of long-acting reversible contraception (LARC) methods available for women?	1.1.1.1 Women requiring contraception should be given information about and offered a choice of all methods, including long-acting reversible contraception (LARC) methods.	Not at all	Completely
LLM	What are the common signs and symptoms of neutropenic sepsis in patients undergoing cancer treatment?	1.1.1.1 Provide patients having anticancer treatment and their carers with written and oral information, both before starting and throughout their anticancer treatment, on:neutropenic sepsishow and when to contact 24-hour specialist oncology advice how and when to seek emergency care.	Not at all	Completely
LLM	What are the methods for preventing and dealing with typical breastfeeding issues?	1.2.2 Ensure that adequate support is offered to all women who intend to breastfeed exclusively. For information on breastfeeding support, see NICE's guideline on postnatal care. [2010]	Partially	Partially
LLM	- what should be the next step if ultrasound has not detected common bile duct stones but the bile duct is dilated and/or liver function test results are abnormal?	1.1.2 Consider magnetic resonance cholangiopancreatography (MRCP) if ultrasound has not detected common bile duct stones but the:bile duct is dilated and/orliver function test results are abnormal.	Completely	Completely
LLM	1) Have you noticed any yellowing of your skin or eyes?	1.3.5 Do not use the albumin/bilirubin ratio when making decisions about the management of hyperbilirubinaemia. [2010]	Not at all	Not at all
LLM	What treatment can you offer for alcohol withdrawal?	1.1.1.1 For people in acute alcohol withdrawal with, or who are assessed to be at high risk of developing, alcohol withdrawal seizures or delirium tremens, offer admission to hospital for medically assisted alcohol withdrawal. [2010]	Not at all	Completely
LLM	What levels of NT‑proBNP suggest that a patient should be referred to a specialist?	Review alternative causes for symptoms of heart failure in people with NT-proBNP levels below 400 ng/litre. If there is still concern that the symptoms might be related to heart failure, discuss with a physician with subspeciality training in heart failure. [2018]	Partially	Completely
LLM	N/A	1.2.2 Suspect aura in people who present with or without headache and with neurological symptoms that: are fully reversible anddevelop gradually, either alone or in succession, over at least 5 minutes andlast for 5 to 60 minutes. [2012]	Not at all	Not at all

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RealMedQA

RealMedQA is a biomedical question answering dataset consisting of realistic question and answer pairs. The questions were created by medical students and a large language model (LLM), while the answers are guideline recommendations provided by the UK's National Institute for Health and Care Excellence (NICE). The full paper describing the dataset and the experiments has been accepted to the American Medical Informatics Association (AMIA) Annual Symposium and is available here.

Dataset creation

Data collection

Initially, 12,543 guidelines were retrieved using the NICE syndication API. As we were interested in only the guidelines that pertain to clinical practice, we only used the guidelines that came under 'Conditions and diseases' which reduced the number to 7,385.

Question generation

We created an instruction sheet with examples which we provided to both the humans (medical students) and the LLM to generate the several questions for each guideline recommendation. The instruction sheet was fed as a prompt along with each recommendation to the LLM, while the humans created the questions using Google forms.

Question verification

Both the QA pairs generated by the LLM and those generated by human annotators were verified by humans for quality. The verifiers were asked whether each question:

Could plausibly be asked by a clinician would ask in practice;
Was adequately answered by the accompanying recommendation.

A total of 800 human QA pairs and 400 LLM QA pairs were verified.

Dataset structure

The dataset is structured according to the following columns:

Generator: whether the question was generated by a 'Human' or 'LLM';
Question: the question created by either the human or LLM;
Recommendation: the recommendation that is supposed to address the question;
Plausible: whether the question could plausibly be asked by a clinician in practice (as assessed by the verifier);
Answered: whether the question is adequately answered by the clinician (as assessed by the verifier).

Citation

If you use the dataset, please cite our work using the following reference:

@misc{kell2024realmedqapilotbiomedicalquestion,
      title={RealMedQA: A pilot biomedical question answering dataset containing realistic clinical questions}, 
      author={Gregory Kell and Angus Roberts and Serge Umansky and Yuti Khare and Najma Ahmed and Nikhil Patel and Chloe Simela and Jack Coumbe and Julian Rozario and Ryan-Rhys Griffiths and Iain J. Marshall},
      year={2024},
      eprint={2408.08624},
      archivePrefix={arXiv},
      primaryClass={cs.CL},
      url={https://arxiv.org/abs/2408.08624}, 
}

Contact

Gregory Kell: gregory.kell@kcl.ac.uk
Iain Marshall: iain.marshall@kcl.ac.uk

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Paper for 19-yihan/RealMedQA

RealMedQA: A pilot biomedical question answering dataset containing realistic clinical questions

Paper • 2408.08624 • Published Aug 16, 2024 • 1