In Reply: Usefulness and Accuracy of Artificial Intelligence Chatbot Responses to Patient Questions for Neurosurgical Procedures

Abstract

To the Editor: We extend our gratitude to Drs. Daungsupawong and Wiwanitkit for their engagement and constructive critique of our work, "Usefulness and Accuracy of Artificial Intelligence Chatbot Responses to Patient Questions for Neurosurgical Procedures."1,2 Their observations have highlighted essential aspects of artificial intelligence (AI) communication in the context of patient education, specifically pointing out the challenges in the interpretability and the sophisticated reading levels of AI-generated responses. The critiques presented by Drs Daungsupawong and Wiwanitkit underscore 2 pivotal concerns: the difficulty in interpreting AI-generated responses and the elevated reading level required for understanding such material. These observations align with a broader recognition within healthcare communication that content complexity often surpasses the average reader's comprehension abilities. In the United States, the average American reads at a 7th to 8th grade reading level, although patient educational materials are often at a postgraduate level.3-7 In addressing these points, we acknowledge the significance of these challenges in hindering effective communication and, consequently, the utility of AI-generated responses for patient education. However, it is pertinent to note that the aim of our approach to evaluate these responses from a clinical perspective, focusing on their accuracy and usefulness as appraised by highly trained professionals, including board-certified fellowship-trained neurosurgeons and neurosurgery-dedicated nurses. These individuals possess a level of education and experience that inherently equips them with the capacity to understand complex medical content, which was a primary consideration in our methodology. In response to the suggestion for simplifying terminology and making the content more accessible to a broader audience, we recognize the importance of such measures in enhancing patient education. Our study does reference the potential of ChatGPT and other advanced language models to adapt the reading level to better suit patient needs, acknowledging the importance of making healthcare information comprehensible to individuals across different educational backgrounds.8 Furthermore, the letter's recommendation to identify specific areas within neurosurgery where AI-generated responses might be less effective or reliable is well taken. This direction not only holds promise for refining AI models but also underscores the need for ongoing research to enhance the accuracy and applicability of AI in patient education. In closing, we thank the authors once again for their valuable feedback. Their insights not only contribute to a more nuanced understanding of the current limitations of AI in patient communication but also chart a course for future research aimed at maximizing the potential of AI tools to support patient education. Moving forward, it is imperative that we continue to refine AI models to ensure that they serve as effective, understandable, and accessible educational resources for patients across all levels of health literacy.

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