How Well Do Different AI Language Models Inform Patients About Radiofrequency Ablation for Varicose Veins?

Introduction The rapid integration of artificial intelligence (AI) into healthcare has led to increased public use of large language models (LLMs) to obtain medical information. However, the accuracy and clarity of AI-generated responses to patient queries remain uncertain. This study aims to evaluate and compare the quality of responses provided by five leading AI language models regarding radiofrequency ablation (RFA) for varicose veins. Objective To assess and compare the reliability, clarity, and usefulness of AI-generated answers to frequently asked patient questions about RFA for varicose veins, as evaluated by expert vascular surgeons. Methods A blinded, comparative observational study was conducted using a standardized list of eight frequently asked questions about RFA, derived from reputable vascular surgery centers across multiple countries. Five top-performing, open-access LLMs (ChatGPT-4, OpenAI, San Francisco, CA, USA; DeepSeek-R1, DeepSeek, Hangzhou, Zhejiang, China; Gemini 2.0, Google DeepMind, Mountain View, CA, USA; Grok-3, xAI, San Francisco, CA, USA; and LLaMA 3.1, Meta Platforms, Inc., Menlo Park, CA, USA) were tested. Responses from each model were independently evaluated by 32 experienced vascular surgeons using four criteria: accuracy, clarity, relevance, and depth. Statistical analyses, including Friedman and Wilcoxon signed-rank tests, were used to determine model performance. Results Grok-3 was rated as providing the highest-quality responses in 51.6% of instances, significantly outperforming all other models (p < 0.0001). ChatGPT-4 ranked second with 23.1%. Gemini, DeepSeek, and LLaMA showed comparable but lower performance. Question-specific analysis revealed that Grok-3 dominated responses related to procedural risks and post-procedure care, while ChatGPT-4 performed best in introductory questions. A subgroup analysis showed that user experience level had no significant impact on model preferences. While 42.4% of respondents were willing to recommend AI tools to patients, 45.5% remained uncertain, reflecting ongoing hesitation. Conclusion Grok-3 and ChatGPT-4 currently provide the most reliable AI-generated patient education about RFA for varicose veins. While AI holds promise in improving patient understanding and reducing physician workload, ongoing evaluation and cautious clinical integration are essential. The study establishes a baseline for future comparisons as AI technologies continue to evolve.