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ORIGINAL RESEARCH article

Front. Digit. Health
Sec. Human Factors and Digital Health
Volume 6 - 2024 | doi: 10.3389/fdgth.2024.1480381

Enhancing Patient Education on the Role of Tibial Osteotomy in the Management of Knee Osteoarthritis Using a Customized ChatGPT: A Readability and Quality Assessment

Provisionally accepted
Stephen Fahy Stephen Fahy *Stephan Oehme Stephan Oehme Danko Dan Milinkovic Danko Dan Milinkovic Benjamin Bartek Benjamin Bartek
  • Charité University Medicine Berlin, Berlin, Germany

The final, formatted version of the article will be published soon.

    Knee osteoarthritis (OA) significantly impacts the quality of life of those afflicted, with many patients eventually requiring surgical intervention. While Total Knee Arthroplasty (TKA) is common, it may not be suitable for younger patients with unicompartmental OA, who might benefit more from High Tibial Osteotomy (HTO).Effective patient education is crucial for informed decision-making, yet most online health information has been found to be too complex for the average patient to understand. AI tools like ChatGPT may offer a solution, but their outputs often exceed the public's literacy level. This study assessed whether a customised ChatGPT could be utilized to improve readability and source accuracy in patient education on Knee OA and tibial osteotomy.Commonly asked questions about HTO were gathered using Google's "People Also Asked" feature and formatted to an 8th-grade reading level. Two ChatGPT-4 models were compared: a native version and a fine-tuned model ("The Knee Guide") optimized for readability and source citation through Instruction-Based Fine-Tuning (IBFT) and Reinforcement Learning from Human Feedback (RLHF). The responses were evaluated for quality using the DISCERN criteria and readability using the Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL).The native ChatGPT-4 model scored a mean DISCERN score of 38.41(range 25-46), indicating poor quality, while "The Knee Guide" scored 45.9 (range 33-66), indicating moderate quality. Cronbach's Alpha was 0.86, indicating good interrater reliability. "The Knee Guide" achieved better readability with a mean FKGL of 8.2 (range 5-10.7, ± 1.42) and a mean FRES of 60 (range 47-76, ± 7.83), compared to the native model's FKGL of 13.9 (range 11-16, ±1,39) and FRES of 32 (range 14-47, ±8.3). These differences were statistically significant (p < 0.001).Fine-tuning ChatGPT significantly improved the readability and quality of HTO-related information. "The Knee Guide" demonstrated the potential of customized AI tools in enhancing patient education by making complex medical information more accessible and understandable.

    Keywords: knee osteoarthritis, High tibial osteotomy, Patient Education, ChatGPT, readability, DISCERN Criteria, artificial intelligence

    Received: 14 Oct 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Fahy, Oehme, Milinkovic and Bartek. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Stephen Fahy, Charité University Medicine Berlin, Berlin, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.