Exploring Patient Perspectives, Engagement, and Output Quality in Doctor-Supervised Use of Artificial Intelligence...

Area of Science:

• Medical Informatics
• Artificial Intelligence in Healthcare
• Surgical Education

Background:

• Comprehensive preoperative education is crucial for total hip arthroplasty (THA) outcomes and informed consent.
• Artificial intelligence (AI) tools like ChatGPT offer potential for scalable patient education.
• Clinical validation of AI in healthcare is necessary to ensure accuracy, safety, and trust.

Purpose of the Study:

• To assess patient preferences and satisfaction with AI-assisted informed consent for THA.
• To compare traditional physician consultations with AI-supported (native ChatGPT and RAG-enhanced ChatGPT) consultations.
• To investigate the influence of anxiety and AI attitudes on consent preferences and the impact of RAG on AI response quality.

Main Methods:

• 36 patients undergoing THA were divided into three groups: physician-only, physician-assisted with native ChatGPT, and physician-assisted with RAG-enhanced ChatGPT.
• Patient satisfaction, perceived informedness, anxiety, and AI attitudes were measured using Likert scale questionnaires.
• Physicians evaluated ChatGPT responses for accuracy, clarity, completeness, and hallucinations.

Main Results:

• ChatGPT with RAG significantly improved patient satisfaction and perceived informedness compared to native ChatGPT.
• Patients interacting with RAG-enhanced ChatGPT asked more questions (52) than native ChatGPT (39) or control (20).
• The majority of patients preferred human clinicians over AI, regardless of accuracy; RAG significantly reduced AI hallucinations.

Conclusions:

• Retrieval-augmented generation (RAG) integration enhances ChatGPT's preoperative information quality for THA patients.
• AI chatbots can improve patient satisfaction and engagement but should complement, not replace, physician-led informed consent.
• Customized AI assistants show promise for augmenting human interaction in surgical consent processes.