Validity, reliability, and readability of Artificial Intelligence chatbots as public sources of information on hearing loss: a comparative evaluation of ChatGPT, Bing, Gemini, and Perplexity

Abstract

OBJECTIVE: To assess the validity, reliability and readability of four AI chatbots for hearing-health information. DESIGN AND STUDY SAMPLE: Three audiologists created 100 questions covering adult hearing loss, paediatric hearing, hearing aids, tinnitus and cochlear implants (20 each). Questions were submitted twice to ChatGPT-3.5, Bing AI, Gemini and Perplexity. Answers were scored for factual accuracy and completeness on a five-point Global Quality Score. Validity was defined using low (score = 5) and high (score ≥ 4) thresholds. Internal consistency was estimated with Cronbach's α; readability with the Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL). All scoring was completed independently by two blinded reviewers; discrepancies were resolved by consensus. RESULTS: Under the low threshold ChatGPT-3.5 and Perplexity were most valid (84% and 79%); high-threshold validity fell to 37% and 34%. Perplexity had the highest overall reliability (α = 0.83) yet α dropped below 0.70 for cochlear-implant, tinnitus and hearing-aid questions. 84% percent of outputs were "Difficult"/"Very Difficult" and 68% read at college level. CONCLUSIONS: AI chatbots deliver generally accurate hearing-health content, but high-threshold accuracy, domain-specific reliability and readability remain suboptimal. They should supplement, not replace the professional counselling. Continued optimisation and external validation are needed before routine clinical recommendation.

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