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Bridging Health Literacy Gaps in Spine Care: Using ChatGPT-4o to Improve Patient-Education Materials
Joseph E Nassar1, Michael J Farias, Lama A Ammar
1Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
The Journal of Bone and Joint Surgery. American Volume
|June 19, 2025
Summary
Patient education materials on spine conditions are too complex for many patients. Artificial intelligence (AI) tools like ChatGPT-4o can significantly improve readability, making health information more accessible.
Area of Science:
- Medical Education
- Health Literacy
- Artificial Intelligence in Healthcare
Background:
- Patient education materials (PEMs) are crucial for health literacy and treatment adherence.
- Many existing PEMs exceed recommended readability levels, disadvantaging patients with limited health literacy.
- Spine-related PEMs from major orthopedic and neurosurgical associations were evaluated for readability.
Purpose of the Study:
- To assess the readability of spine-related patient education materials from leading professional organizations.
- To investigate the effectiveness of artificial intelligence (AI) in improving the readability of these materials.
- To evaluate the potential of AI to optimize PEMs for enhanced patient comprehension.
Main Methods:
- Analysis of 146 spine-related PEMs from AAOS, NASS, and AANS websites.
- Readability assessment using Flesch-Kincaid Grade Level (FKGL) and SMOG Index.
- Revision of PEMs using ChatGPT-4o to target a sixth-grade reading level.
- Comparison of pre- and post-revision readability metrics, including language complexity and passive voice usage.
Main Results:
- Original PEMs had a mean FKGL of 10.2, significantly above the recommended sixth-grade level.
- ChatGPT-4o reduced the mean FKGL to 6.6, a significant improvement (p < 0.05).
- AI revision enhanced other readability metrics (SMOG, language complexity, passive voice) while preserving content accuracy.
Conclusions:
- Spine-related patient education materials remain overly complex, despite some improvements.
- Artificial intelligence, specifically ChatGPT-4o, shows significant potential for enhancing PEM readability.
- Future development should integrate AI with visual aids and user-friendly platforms for inclusive patient education.
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