Volume 12 Issue 10
The Association Between Delirium Upon Admission to a Rehabilitation Hospital and Motor Rehabilitation Outcomes Among Hip Fracture Surgery Patients: A Historical Cohort Study
Anna Balzer,Anne Marie Novak,Pnina Marom,Oren Schwartz,Michael Brik,Katia Slutzki,Rafi J. Heruti andRachel Dankner
1Department of Pulmology, Special Hospital for Pulmonary Diseases, 10000 Zagreb, Croatia
2Department of Dermatovenereology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
3School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
4Department for Respiratory Infections, Dr. Fran Mihaljević University Hospital for Infections Diseases, 10000 Zagreb, Croatia
5Faculty of Dental Medicine and Health Osijek, 31000 Osijek, Croatia
6Department of Dental Medicine, University Hospital of Split, 21000 Split, Croatia
7Department of Oral Medicine, Study of Dental Medicine, School of Medicine, University of Split, 21000 Split, Croatia
8Department of Emergency Medicine, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
9Department of Clinical Chemistry, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
Author to whom correspondence should be addressed.
Abstract
Background/Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.
Keywords:
erectile dysfunction; penile prosthesis; ChatGPT; natural language processing; informed consent; patient education