Elhakim Tarig, Brea Allison R, Fidelis Wilton, Paravastu Sriram S, Malavia Mira, Omer Mustafa, Mort Ana, Ramasamy Shakthi Kumaran, Tripathi Satvik, Dezube Michael, Smolinski-Zhao Sara, Daye Dania
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Massachusetts General Hospital, Boston, Massachusetts.
Tufts University School of Medicine, Boston, Massachusetts.
J Am Coll Radiol. 2025 Jan;22(1):84-97. doi: 10.1016/j.jacr.2024.08.010. Epub 2024 Aug 30.
To evaluate the extent to which Generative Pre-trained Transformer 4 (GPT-4) can educate patients by generating easily understandable information about the most common interventional radiology (IR) procedures.
We reviewed 10 IR procedures and prepared prompts for GPT-4 to provide patient educational instructions about each procedure in layman's terms. The instructions were then evaluated by four clinical physicians and nine nonclinical assessors to determine their clinical appropriateness, understandability, and clarity using a survey. A grade-level readability assessment was performed using validated metrics to evaluate accessibility to a wide patient population. The same procedures were also evaluated from the patient instructions available at radiologyinfo.org and compared with GPT-generated instructions utilizing a paired t test.
Evaluation by four clinical physicians shows that nine GPT-generated instructions were fully appropriate, whereas arterial embolization instructions was somewhat appropriate. Evaluation by nine nonclinical assessors shows that paracentesis, dialysis catheter placement, thrombectomy, ultrasound-guided biopsy, and nephrostomy-tube instructions were rated excellent by 57% and good by 43%. The arterial embolization and biliary-drain instructions were rated excellent by 28.6% and good by 71.4%. In contrast, thoracentesis, port placement, and CT-guided biopsy instructions received 43% excellent, 43% good, and 14% fair. The readability assessment across all procedural instructions showed a better Flesch-Kincaid mean grade of GPT-4 instructions compared with radiologyinfo.org (7.8 ± 0.87 versus 9.6 ± 0.83; P = .007) indicating excellent readability at 7th- to 8th-grade level compared with 9th to 10th grade. Additionally there was a lower Gunning Fog mean index (10.4 ± 1.2 versus 12.7 ± 0.93; P = .006), and higher Flesch Reading Ease mean score (69.4 ± 4.8 versus 51.3±3.9; P = .0001) indicating better readability.
IR procedural instructions generated by GPT-4 can aid in improving health literacy and patient-centered care in IR by generating easily understandable explanations.
评估生成式预训练变换器4(GPT-4)通过生成关于最常见介入放射学(IR)程序的易于理解的信息来教育患者的程度。
我们回顾了10种IR程序,并为GPT-4准备了提示,以便用通俗易懂的语言提供关于每种程序的患者教育指导。然后,由四名临床医生和九名非临床评估人员对这些指导进行评估,通过一项调查来确定其临床适用性、可理解性和清晰度。使用经过验证的指标进行年级可读性评估,以评估广大患者群体的可及性。还从radiologyinfo.org上提供的患者指导中对相同的程序进行了评估,并使用配对t检验与GPT生成的指导进行比较。
四名临床医生的评估显示,九条GPT生成的指导完全合适,而动脉栓塞指导则有些合适。九名非临床评估人员的评估显示,腹腔穿刺术、透析导管置入术、血栓切除术、超声引导下活检和肾造瘘管指导被评为优秀的占57%,良好的占43%。动脉栓塞和胆道引流指导被评为优秀的占28.6%,良好的占71.4%。相比之下,胸腔穿刺术、端口置入术和CT引导下活检指导的优秀率为43%,良好率为43%,一般率为14%。所有程序指导的可读性评估显示,与radiologyinfo.org相比,GPT-4指导的弗莱施-金凯德平均年级更好(7.8±0.87对9.6±0.83;P = 0.007),表明与9至10年级相比,在7至8年级水平具有出色的可读性。此外,冈宁雾度平均指数更低(10.4±1.2对12.7±0.93;P = 0.006),弗莱施阅读简易度平均得分更高(69.4±4.8对51.3±3.9;P = 0.0001),表明可读性更好。
GPT-4生成的IR程序指导可以通过生成易于理解的解释,有助于提高IR中的健康素养和以患者为中心的护理。