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The Use of Artificial Intelligence to Improve Readability and Quality of Informed Consent Forms in Plastic and
Grace S Ryu1, Grace Hwang1, Charles C Lee2
1College of Medicine, Penn State Milton S. Hershey Medical CenterHershey PennsylvaniaUnited States.
Background:
The readability and length of informed consent forms have been debated for over three decades. Despite national guidelines promoting patient-friendly language, many forms fall short. This study compares the readability and content quality of informed consents from the American Society of Plastic Surgeons (ASPS) and ChatGPT for common plastic and reconstructive surgery (PRS) procedures.
Methods:
ASPS consents for seven common PRS procedures were obtained online. ChatGPT was then queried to create equivalent consents. Readability was assessed using the Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Lexical Density. Quality was graded using a modified National Quality Forum-based scale across domains: Procedure description, clinical rationale, patient-oriented benefit, quantitative and qualitative risks, and alternatives. Scores were compared between ASPS and ChatGPT consent forms.
Results:
ASPS versus ChatGPT conversion yielded mean Flesch scores of 30.09 versus 46.18 ( p = 0.00003), grade levels of 13.59 versus 10.53 ( p = 0.000004), and lexical densities of 56.7% versus 46.6% ( p = 0.00008). Word count decreased by 81% after conversion. ASPS consents exceeded ChatGPT quality in three of seven procedures (by 12.8 percentage points on average), while ChatGPT exceeded ASPS in four of seven (by 25 points on average). Average quality scores were not significantly different (64.83% vs. 73.63%, p = 0.27).
Conclusion:
ChatGPT improved the readability and brevity of PRS consent forms while maintaining accuracy. Readily available artificial intelligence (AI) tools may enhance descriptions of procedures, rationale, patient benefits, and quantitative risks, offering a practical tool to aid in patient-provider communication.