ChatGPT for improving postoperative instructions in multiple fields of plastic surgery

Clear discharge instructions are vital for patients and caregivers to manage postoperative care at home. However, they often exceed the sixth-grade reading level recommended by national associations. It was hypothesized that ChatGPT could help rewrite instructions to this level for increased accessibility and comprehension. This study aimed to assess the readability, understandability, actionability, and safety of ChatGPT rewritten postoperative instructions in four plastic surgery subspecialties: breast, craniofacial, hand, and aesthetic surgery.

Postoperative instructions from four index procedures in plastic surgery were obtained. ChatGPT was used to rewrite at the sixth- and fourth-grade reading levels. Readability was determined by seven readability indexes, understandability and actionability by the Patient Education Materials Assessment Tool for printable materials questionnaire, and safety by the primary surgeons.

Overall, the average readability of the original postoperative instructions ranged between the seventh and eighth grade levels. Only one of the sixth-grade ChatGPT instructions was lowered to the sixth-grade level. Of the fourth-grade ChatGPT instructions, all were reduced to the sixth-grade-level or below, but none achieved the fourth-grade level. Understandability scores increased as reading levels decreased, whereas actionability scores decreased for fourth-grade rewrites. Safety was not compromised in all rewrites.

ChatGPT can adapt postoperative instructions to a more readable sixth-grade level without compromising safety. This study suggests prompting ChatGPT to write one to two grade levels lower than the desired reading level. While understandability increased for all ChatGPT rewrites, actionability decreased for fourth-grade-level instructions. Sixth-grade remains the optimal reading level for postoperative instructions. This study demonstrates that ChatGPT can help improve patient care by improving the readability of postoperative instructions.