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[Rotator Cuff Surgery and Artificial Intelligence: A Comparative Analysis of Quality and Readability Between ChatGPT
Vinicius Borges Alencar1, Matheus Mariano Teles2, Diogo Fonseca da Cunha1
1Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brasil.
Objective:
Artificial intelligence (AI) tools based on natural language, such as ChatGPT 4.1 mini (OpenAI Group PBC) and Gemini 2.5 Flash (Alphabet Inc.), are used by patients as sources of medical information. The current study aimed to evaluate and compare the quality and readability of responses provided by these AIs, in Brazilian Portuguese, regarding rotator cuff surgery.
Methods:
The present cross-sectional, descriptive, and comparative study followed qualitative and quantitative approaches. A total of 24 frequently-asked patient questions were used, classified according to Rothwell. Each question was entered individually into both platforms, and only the first response was considered. The quality assessment used the DISCERN instrument, developed by the University of Oxford and the British Library, and the Journal of the American Medical Association (JAMA) benchmark criteria. Readability was estimated using Análise de Legibilidade Textual (ALT, "Text Readibility Anallysis", in Portuguese) software, validated for Brazilian Portuguese. The statistical analyses included the Wilcoxon and Friedman tests, repeated-measures analysis of variance (ANOVA), and the Conover post-hoc test with Bonferroni correction.
Results:
ChatGPT achieved a mean DISCERN score of 58.7 ± 4.0, and Gemini, 56.3 ± 3.5, with no significant difference ( p = 0.174), but with a maximum effect size (rank-biserial correlation [rrb] = 1.0). Both models showed a mean readability corresponding to 13.3 years of schooling ( p = 1.000). No response met the JAMA benchmark criteria. Value-based questions achieved the highest quality scores, whereas policy-related questions were the most complex in terms of readability. The correlation between quality and readability was moderate (ρ = 0.73; p = 0.099).
Conclusion:
ChatGPT 4.1 mini and Gemini 2.5 Flash do not yet provide adequate medical information in Brazilian Portuguese regarding editorial reliability, quality, and textual accessibility for the general public.