ChatGPT as a patient education tool in colorectal cancer-An in-depth assessment of efficacy, quality and readability

• Published in: Colorectal disease 2024-12
• Main Authors: Siu, Adrian H Y, Gibson, Damien P, Chiu, Chris, Kwok, Allan, Irwin, Matt, Christie, Adam, Koh, Cherry E, Keshava, Anil, Reece, Mifanwy, Suen, Michael, Rickard, Matthew J F X
• Format: Article
• Language: English
• ISSN: 1463-1318; 1463-1318
• DOI: 10.1111/codi.17267

Artificial intelligence (AI) chatbots such as Chat Generative Pretrained Transformer-4 (ChatGPT-4) have made significant strides in generating human-like responses. Trained on an extensive corpus of medical literature, ChatGPT-4 has the potential to augment patient education materials. These chatbots may be beneficial to populations considering a diagnosis of colorectal cancer (CRC). However, the accuracy and quality of patient education materials are crucial for informed decision-making. Given workforce demands impacting holistic care, AI chatbots can bridge gaps in CRC information, reaching wider demographics and crossing language barriers. However, rigorous evaluation is essential to ensure accuracy, quality and readability. Therefore, this study aims to evaluate the efficacy, quality and readability of answers generated by ChatGPT-4 on CRC, utilizing patient-style question prompts. To evaluate ChatGPT-4, eight CRC-related questions were derived using peer-reviewed literature and Google Trends. Eight colorectal surgeons evaluated AI responses for accuracy, safety, appropriateness, actionability and effectiveness. Quality was assessed using validated tools: the Patient Education Materials Assessment Tool (PEMAT-AI), modified DISCERN (DISCERN-AI) and Global Quality Score (GQS). A number of readability assessments were measured including Flesch Reading Ease (FRE) and the Gunning Fog Index (GFI). The responses were generally accurate (median 4.00), safe (4.25), appropriate (4.00), actionable (4.00) and effective (4.00). Quality assessments rated PEMAT-AI as 'very good' (71.43), DISCERN-AI as 'fair' (12.00) and GQS as 'high' (4.00). Readability scores indicated difficulty (FRE 47.00, GFI 12.40), suggesting a higher educational level was required. This study concludes that ChatGPT-4 is capable of providing safe but nonspecific medical information, suggesting its potential as a patient education aid. However, enhancements in readability through contextual prompting and fine-tuning techniques are required before considering implementation into clinical practice.