Comparing Ophthalmologist and Artificial Intelligence Chatbot Responses to Patient Questions

We evaluated the ability of ChatGPT, an Artificial Intelligence (AI) Chatbot, to respond to patient eye health queries.

A retrospective, cross-sectional analysis of eye health questions and physician responses posted on the American Academy of Ophthalmology (AAO) "Ask an Ophthalmologist" forum was performed on a random sample from January 2016 to December 2022. We compared board-certified ophthalmologists' responses to ChatGPT (version GPT-4o, OpenAI) responses in September 2024. Primary outcomes included ophthalmologist-rated accuracy of ChatGPT and AAO responses using a 7-point Likert scale, as well as ophthalmologists' preferences between the two responses. Secondary outcomes assessed differences in readability, empathy, and response length between ChatGPT and ophthalmologists.

A random sample 250 questions and responses from 41 board-certified ophthalmologists were evaluated. ChatGPT and AAO responses had similar mean accuracy ratings (5.8 [SD=1.1] vs 5.5 [SD=1.1], p=0.07). Evaluators preferred ChatGPT over physician responses in half (49.5%) the cases. Ophthalmologist responses were easier to understand, with a lower mean Flesch-Kincaid Grade Level (Grade 11.0 [SD=2.7] vs Grade 12.7 [SD=1.9], p<0.001). Ophthalmologist responses were also significantly shorter than ChatGPT responses (80.6 [SD=56.4] words vs (337.8 [SD=141.6] words, p<0.001). Empathy ratings did not differ significantly between ChatGPT and ophthalmologists (4.4 [SD=0.6] vs 4.4 [SD=0.6], p=0.5).

Our findings suggest that Chatbot responses were as frequently preferred as physician responses, rated with higher accuracy, and demonstrated comparable empathy in addressing online patient eye health queries. AI chatbots may assist in drafting initial responses to patient concerns, potentially improving efficiency and reducing physician workload.