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Online and ChatGPT-generated patient education materials regarding brain tumor prognosis fail to meet readability
Ishav Y Shukla1, Matthew Z Sun1
1Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Objective:
Online healthcare literature often exceeds the general population's literacy level. Our study assesses the readability of online and ChatGPT-generated materials on glioblastomas, meningiomas, and pituitary adenomas, comparing readability by tumor type, institutional affiliation, authorship, and source (websites vs. ChatGPT).
Methods:
This cross-sectional study involved a Google Chrome search (November 2024) using 'prognosis of [tumor type],' with the first 100 English-language, patient-directed results per tumor included. Websites were categorized by tumor, institutional affiliation (university vs. non-affiliated), and authorship (medical-professional reviewed vs. non-reviewed). ChatGPT 4.0 was queried with three standardized questions per tumor, based on the most prevalent content found in patient-facing websites. Five metrics were assessed: Flesch Reading Ease, Flesch-Kincaid Grade Level, Gunning Fog Index, Coleman-Liau Index, and SMOG Index. Comparisons were conducted using Mann-Whitney U tests and t-tests.
Results:
Zero websites and ChatGPT responses met the readability benchmarks of 6th grade or below (AMA guideline) or 8th grade or below (NIH guideline). Of the websites, 50.4 % were at a 9th-12th grade level, 47.9 % at an undergraduate level, and 1.7 % at a graduate level. Websites reviewed by medical professionals had higher FRE (p = 0.03) and lower CLI (p = 0.009) compared to non-reviewed websites. Among ChatGPT responses, 93.3 % were graduate level. ChatGPT responses had lower readability than websites across all metrics (p < 0.001).
Conclusion:
Online and ChatGPT-generated neuro-oncology materials exceed recommended readability standards, potentially hindering patients' ability to make informed decisions. Future efforts should focus on standardizing readability guidelines, refining AI-generated content, incorporating professional oversight consistently, and improving the accessibility of online neuro-oncology materials.
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