Use of ChatGPT to Generate Informed Consent for Surgery in Urogynecology

Abstract

IMPORTANCE: Use of the publicly available Large Language Model, Chat Generative Pre-trained Transformer (ChatGPT 3.5; OpenAI, 2022), is growing in health care despite varying accuracies. OBJECTIVE: The aim of this study was to assess the accuracy and readability of ChatGPT's responses to questions encompassing surgical informed consent in urogynecology. STUDY DESIGN: Five fellowship-trained urogynecology attending physicians and 1 reconstructive female urologist evaluated ChatGPT's responses to questions about 4 surgical procedures: (1) retropubic midurethral sling, (2) total vaginal hysterectomy, (3) uterosacral ligament suspension, and (4) sacrocolpopexy. Questions involved procedure descriptions, risks/benefits/alternatives, and additional resources. Responses were rated using the DISCERN tool, a 4-point accuracy scale, and the Flesch-Kinkaid Grade Level score. RESULTS: The median DISCERN tool overall rating was 3 (interquartile range [IQR], 3-4), indicating a moderate rating ("potentially important but not serious shortcomings"). Retropubic midurethral sling received the highest overall score (median, 4; IQR, 3-4), and uterosacral ligament suspension received the lowest (median, 3; IQR, 3-3). Using the 4-point accuracy scale, 44.0% of responses received a score of 4 ("correct and adequate"), 22.6% received a score of 3 ("correct but insufficient"), 29.8% received a score of 2 ("accurate and misleading information together"), and 3.6% received a score of 1 ("wrong or irrelevant answer"). ChatGPT performance was poor for discussion of benefits and alternatives for all surgical procedures, with some responses being inaccurate. The mean Flesch-Kinkaid Grade Level score for all responses was 17.5 (SD, 2.1), corresponding to a postgraduate reading level. CONCLUSIONS: Overall, ChatGPT generated accurate responses to questions about surgical informed consent. However, it produced clearly false portions of responses, highlighting the need for a careful review of responses by qualified health care professionals.

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