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Large Language Model-Assisted Shared Decision-Making (SDM) in Rhinology: A Randomized Controlled Pilot Study.

Omer Baker1, Clifford J He1, Andrew Yousef2

  • 1University of California San Diego School of Medicine La Jolla California USA.

Laryngoscope Investigative Otolaryngology
|May 18, 2026
PubMed
Summary

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This summary is machine-generated.

Generative AI tools like ChatGPT and Google can help reduce patient decisional conflict regarding sinus surgery. However, patients with pre-existing uncertainty may need additional support for shared decision-making.

Area of Science:

  • Rhinology
  • Medical Informatics
  • Patient Decision Making

Background:

  • Shared decision-making (SDM) is crucial for integrating patient preferences into evidence-based care.
  • Generative Artificial Intelligence (AI) presents a potential new avenue for enhancing SDM in rhinology.
  • The clinical utility of generative AI tools for SDM in rhinology remains largely unassessed.

Purpose of the Study:

  • To prospectively evaluate the clinical utility of generative AI tools in facilitating SDM for patients with chronic rhinosinusitis (CRS) or nasal obstruction.
  • To compare the effectiveness of ChatGPT-4 versus Google in assisting patients with treatment-related questions.

Main Methods:

  • A prospective randomized pilot study was conducted at a tertiary academic rhinology clinic.
Keywords:
ChatGPT sinusitis outcomesGenAIchronic rhinosinusitispatient satisfactionrhinitisshared decision making

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  • Adult patients with medically refractory CRS and/or nasal obstruction were randomized to use either ChatGPT-4 or Google for treatment inquiries.
  • Primary outcome: change in Decisional Conflict Scale (DCS) score; Secondary outcomes: changes in knowledge, usability, and response accuracy.

    • Main Results:

    • Fifty-seven participants completed the study, with both ChatGPT and Google arms showing significant reductions in DCS scores (p<0.01).
    • No significant difference in DCS score reduction was observed between the ChatGPT and Google groups.
    • ChatGPT responses were rated as moderately accurate (7.2/10), and usability scores were comparable between platforms.

    Conclusions:

    • Both ChatGPT and Google may aid in reducing decisional conflict for patients considering sinus surgery.
    • Patients experiencing baseline uncertainty may require supplementary support beyond these AI tools.
    • Further multi-center trials are necessary to validate these findings and explore broader integration.