Novel Breast Reconstruction Generative Pretrained Transformer Promotes Decisional Confidence and Clinical Efficiency

Patients undergoing breast reconstruction face many decisions. A generative pretrained transformer (GPT) tool was custom built to assist patients at their initial reconstructive consultation. Twenty patients undergoing immediate breast reconstruction were enrolled, and 10 were randomized to interact with this GPT for 10 minutes at most before seeing the surgeon who was blinded. Patients then completed the 4-item abbreviated Decisional Conflict Scale SURE survey, the 12-item preoperative Consumer Assessment of Healthcare Providers and Systems survey, and a 3-item GPT-specific survey. Patients spent an average of 6.79 minutes asking an average of 6.5 questions, which were most commonly about recovery (34%), autologous reconstruction (23%), and complications (17%). With a 100% response rate (20 of 20), patients in the GPT cohort experienced less decisional conflict (Decisional Conflict Scale SURE-GPT: 3.9 versus control: 3.1, P = 0.03), had a shorter consultation time (GPT: 21.7 min versus control: 28.4 min, P = 0.02), and were more satisfied with surgical care across multiple domains, including shared decision-making (P = 0.04) and preoperative communication (P = 0.04). All patients (100%, 10 of 10) found this GPT to be very helpful and thought it should be made available for other patients. To our knowledge, custom GPTs built and trained by surgeons have not yet been studied in this setting, making this an innovation in our field. Other reconstructive breast surgeons may consider implementing this publicly available GPT into their practice to increase efficiency and satisfaction in patient care.