Schmidt Jacob, Lichy Isabel, Kurz Thomas, Peters Robert, Hofbauer Sebastian, Plage Hennig, Jeutner Jonathan, Schlomm Thorsten, Neymeyer Jörg, Ralla Bernhard
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Urology, Charitéplatz 1, 10117 Berlin, Germany.
Helios Klinikum Berlin-Buch, Schwanebecker Ch 50, 13125 Berlin, Germany.
J Clin Med. 2024 Dec 10;13(24):7482. doi: 10.3390/jcm13247482.
: Artificial intelligence (AI), particularly natural language processing (NLP) models such as ChatGPT, presents novel opportunities for patient education and informed consent. This study evaluated ChatGPT's use as a support tool for informed consent before penile prosthesis implantation (PPI) in patients with erectile dysfunction (ED) following radical prostatectomy. : ChatGPT-4 answered 20 frequently asked questions across four categories: ED and treatment, PPI surgery, complications, and postoperative care. Three senior urologists independently rated information quality using the DISCERN instrument on a Likert scale ranging from 1 (poor quality) to 5 (good quality). Readability was assessed using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) formulas, and inter-rater reliability was measured using intraclass correlation coefficients. : The inter-rater reliability coefficient was 0.76 (95% CI 0.71-0.80). Mean DISCERN scores indicated moderate quality: 2.79 ± 0.92 for ED and treatment, 2.57 ± 0.98 for surgery, 2.65 ± 0.86 for complications, and 2.74 ± 0.90 for postoperative care. High scores (>4) were achieved for clarity and relevance, while complex issues, such as risks and alternative treatments, scored the lowest (<2). The FRE scores ranged from 9.8 to 28.39, and FKGL scores ranged from 14.04 to 17.41, indicating complex readability suitable for college-level comprehension. : ChatGPT currently provides variable and often inadequate quality information without sufficient comprehensibility for informed patient decisions, indicating the need for further improvements in quality and readability.
人工智能(AI),尤其是自然语言处理(NLP)模型如ChatGPT,为患者教育和知情同意带来了新的机遇。本研究评估了ChatGPT在根治性前列腺切除术后勃起功能障碍(ED)患者阴茎假体植入(PPI)术前作为知情同意支持工具的应用。ChatGPT-4回答了四个类别的20个常见问题:ED与治疗、PPI手术、并发症及术后护理。三位资深泌尿科医生使用DISCERN工具,按照从1(质量差)到5(质量好)的李克特量表独立对信息质量进行评分。使用弗莱什易读性(FRE)和弗莱什-金凯德年级水平(FKGL)公式评估可读性,并使用组内相关系数测量评分者间信度。评分者间信度系数为0.76(95%CI 0.71 - 0.80)。平均DISCERN评分表明质量中等:ED与治疗方面为2.79±0.92,手术方面为2.57±0.98,并发症方面为2.65±0.86,术后护理方面为2.74±0.90。清晰度和相关性方面得分较高(>4),而风险和替代治疗等复杂问题得分最低(<2)。FRE得分范围为9.8至28.39,FKGL得分范围为14.04至17.41,表明可读性复杂,适合大学水平的理解。ChatGPT目前提供的信息质量参差不齐且往往不足,缺乏足够的可理解性以供患者做出明智决策,这表明需要在质量和可读性方面进一步改进。