Role of artificial intelligence in answering common patient queries: Osteoarthritis: A viewpoint

Abstract

Introduction The newest artificial intelligence conversational chatbot, ChatSonic, released by Writesonic, has been making waves in the tech industry and is touted to be an improvement over the existing chatbots. The benefit of ChatSonic is that it uses Google’s Knowledge Graph to continuously update factual content giving accurate and reliable information in real-time, thus giving it an edge as it doesn’t need to be constantly updated from time to time with the latest information (https://writesonic.com/chat). Such AI-based conversational chatbots have immense application in the health care industry with respect to identifying symptoms, managing medications, and assisting with chronic health issues. A recent study1 reported that chatbots were able to provide high-quality and empathetic responses when answering patient questions posted on an online forum. The AI system demonstrated its potential to assist health care professionals in promptly addressing patient concerns through digital platforms and consultations. One such condition is osteoarthritis (OA), one of the most common joint disorders and the most frequent causes of pain, loss of function, and disability in adults. It is a chronic, progressive musculoskeletal disorder characterized by inflammation, breakdown, and eventual loss of cartilage in the joints, affecting over 528 million people globally with its prevalence projected to rise further due to aging populations and lifestyle factors2. It imposes a significant societal and economic burden, extending far beyond individual suffering. Direct medical costs, including expenses for medications, hospitalizations, and surgeries like total joint replacements, are substantial, with patients incurring health care costs 1.5–2.6 times higher than individuals without OA globally2. Indirect costs, such as lost workplace productivity, absenteeism, early retirement due to disability, and informal caregiving, further exacerbate the economic impact, often accounting for 75% of total costs in employed populations3. Further, inadequate doctor-patient ratios and limited consultation times hinder effective management of OA, preventing physicians from addressing critical lifestyle interventions such as weight management and physical activity4. Moreover, the lack of extended consultations prevents health care providers from thoroughly addressing patients’ individual needs and empowering them to adopt nonpharmacological therapies, which are essential for improving OA outcomes5,6. While structured interventions combining patient education and provider-guided recommendations have shown promise, implementing them within time-constrained consultations remains challenging7. These systemic barriers compromise patient outcomes and contribute to the long-term health care burden through preventable disease progression and increased costs. With ChatSonic revolutionizing how we engage with digital conversations by providing real-time facts and data, and its ability to customize conversations based on the user’s needs, the public may soon begin to use it to research their own rheumatological concerns. An instrument called DISCERN has been used as a valid and reliable tool for assessing the quality of such written information on treatment choices as well as the production of high-quality, evidence-based consumer health information8. Further, this tool has proven effective in assessing the reliability of chatbot-generated health information across various domains9,10 Thus, given its proven applicability and adaptability, DISCERN could also be leveraged to assess chatbot-generated information for osteoarthritis, ensuring patients receive reliable guidance tailored to their needs. Methodology The author devised 11 common patient queries about OA, focusing on topics frequently searched online by individuals seeking information about OA symptoms, treatments, lifestyle modifications, and misconceptions. These questions were curated based on popular search trends and insights, ensuring relevance to patient concerns and misconceptions. The chatbot responses were evaluated across several key domains relevant to OA management: Symptoms: Addressing pain, stiffness, and joint functionality. Treatment options: Covering pharmacological interventions, physical therapy, and surgical alternatives. Lifestyle modifications: Including recommendations on exercise, weight management, and dietary changes. Myth-busting: Clarifying common misconceptions about OA causes and treatments. This comprehensive approach ensured that the chatbot’s responses were aligned with the multifaceted needs of OA patients. The curated queries were individually input into ChatSonic, which generated responses using its real-time access to Google’s Knowledge Graph. These interactions were documented and analyzed for their accuracy, relevance, and ability to address patient concerns, by cross-referencing chatbot outputs with peer-reviewed medical literature and established clinical guidelines. Table1 demonstrates a conversation comprising of frequently asked questions and common myths about osteoarthritis between a a typical user and ChatSonic. Table 1 - Conversation between a layperson and ChatSonic addressing frequently asked questions about osteoarthritis. No. Question 'Response by ChatSonic 1. What is osteoarthritis? Osteoarthritis is a degenerative joint disorder that affects the hands, knees, hips, and spine, most commonly in older people. Symptoms of osteoarthritis include joint pain and stiffness, changes in joint movement, and swelling. It is the most common form of arthritis, commonly referred to as “wear and tear” arthritis. The main cause of osteoarthritis is aging, but obesity, injury, and genetics can also play a role. Treatment of osteoarthritis usually involves medications, physical therapy, lifestyle modifications, and, in some cases, surgery (https://writesonic.com/chat). Self-management strategies such as learning self-management skills, getting physically active, participating in effective physical activity programs, and talking to your doctor can also help1. Research is still being done on the cause of osteoarthritis, and clinical trials may be an option for some people2References: https://writesonic.com/chat Osteoarthritis - Symptoms and causes - Mayo Clinic1 Osteoarthritis (OA) | Arthritis | CDC2 What Causes Osteoarthritis, Symptoms and More | NIAMS 2. How to treat osteoarthritis at home? Treating osteoarthritis at home typically involves a combination of lifestyle modifications and self-management strategies. These can include the following:• Taking medications as prescribed by your doctor • Doing low-impact exercises such as walking, swimming, or cycling to reduce joint pain and stiffness • Losing weight if necessary to reduce stress on the joints • Practicing range of motion and strength exercises to improve joint mobility • Using hot and cold therapies to reduce stiffness and pain • Eating a balanced, nutritious diet to support joint health • Using assistive devices such as cane, walker, or wheelchair to reduce stress on the joints • Taking part in activities that reduce stress and improve overall mental health • Regularly attending physical therapy sessions to learn proper exercises and stretching techniques • Getting enough rest and avoiding overexertion • Keeping joints flexible and mobile by using joint protectors and braces • Talking to your doctor about other treatment options such as steroid injections, surgery, and alternative therapies 3. What are the risk factors for developing osteoarthritis? Osteoarthritis (OA) is a degenerative joint disease that is caused by wear and tear on the joints. The risk factors for OA include age, gender, ethnicity, family history, previous injury or joint trauma, obesity, certain occupations, poor posture, and other types of arthritis. In addition, medical conditions such as diabetes, underactive thyroid, and bleeding disorders may increase the risk of developing OA. Stress has been linked to increased pain perception in people with OA, and changes in weather can worsen OA symptoms.References: https://writesonic.com/chat Osteoarthritis (OA) | Arthritis | CDC1 Osteoarthritis (OA) Risk Factors and Causes2 OA Pathogenesis and Risk Factors Can cracking knuckles lead to osteoarthritis? There is no scientific evidence to suggest that cracking your knuckles can lead to osteoarthritis. In fact, a study published in the Annals of Rheumatic Diseases found that cracking knuckles does not appear to affect the risk of developing osteoarthritis Is there a cure for osteoarthritis? Unfortunately, there is no cure for osteoarthritis. However, treatments are available to help manage symptoms, such as pain, stiffness, and swelling. Treatment options include medications like acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and duloxetine. Physical therapies such as stretching, strength training, and aerobic exercise can help reduce pain and improve joint flexibility. Surgery may be recommended in some cases. In addition, research suggests that a simple knee injection may be able to stop the effects of OA, but further research is needed (http://writesonic.com/chat)1,2References: http://writesonic.com/chat Osteoarthritis - Diagnosis and treatment - Mayo Clinic1 What Are the Treatments for Osteoarthritis? - WebMD2 New Treatment Target Discovered That Halts Osteoarthritis 4. What herbal remedies can be used to treat osteoarthritis? Herbal remedies may be helpful in the treatment of osteoarthritis. Some of the most commonly used herbal remedies include avocado soybean unsaponifiables (ASU), Boswellia serrata or Indian frankincense, green tea, ginger, and capsaicin. ASU and Boswellia serrata may help reduce inflammation and improve joint health. Green tea and ginger may help reduce pain and improve mobility. Capsaicin may be used in combination with topical ointments to reduce pain. However, it is important to consult with a health care provider before taking any herbal remedies to ensure their safety https://writesonic.com/chat.1[2]References: https://writesonic.com/chat5 Home Remedies for Osteoarthritis - Healthline1 13 Natural Treatments for Osteoarthritis - Everyday Health2 Using Herbal Remedies for Osteoarthritis - Verywell Health 5. Can I use steroid injections for osteoarthritis treatment? Steroid injections may be used as a treatment option for symptoms of osteoarthritis. Steroid injections are injected directly into the affected joint and can help reduce pain and inflammation. However, steroid injections are not a cure and can only provide temporary relief. It is important to consider the risks and benefits of using steroid injections for OA before deciding to use them. Talk to a health care provider before deciding if steroid injections are right for you 6. What is the best exercise for osteoarthritis? The best exercises for people with osteoarthritis are low-impact exercises that put minimal strain on the joints. Good choices include bicycling, walking, swimming, rowing, and the use of an elliptical trainer. Water exercise takes weight off painful joints. Other low-impact exercises like yoga and tai chi can also be beneficial. It is important to talk to a health care provider about what type of exercise is best for your individual needs https://writesonic.com/chat.1[,2]References: https://writesonic.com/chat Exercises for Knee Osteoarthritis and Joint Pain1 Benefits of Exercise for Osteoarthritis2 Exercise: Rx for overcoming osteoarthritis 7. How do I know I need surgery for osteoarthritis? Surgery is usually considered as a last resort for people with osteoarthritis, and it should only be done if other treatments have not been successful. Some signs that surgery may be needed include persistent pain that does not respond to other treatments, severe joint deformity, and a decreased range of motion. Your doctor may also recommend an arthroscopic procedure to diagnose the severity of the arthritis and to determine if surgery is the best option (https://writesonic.com/chat)1References: https://writesonic.com/chat Do I Need Surgery for Osteoarthritis? - WebMD1 Understand Your Joint Surgery Options - Arthritis Foundation2 Basics of Surgery for Arthritis 8. What should i avoid eating if i have osteoarthritis? If you suffer from osteoarthritis, you should avoid eating foods that are high in saturated fats, such as red meat, processed meats, and fried foods. Eating too much salt can also increase inflammation, so try to limit your intake. Eating foods that are high in sugar can also cause inflammation, so it is best to limit sugar. Finally, eating an anti-inflammatory diet with lots of whole foods, fruits, and vegetables can help reduce inflammation and joint pain. Eating foods high in omega-3 fatty acids, such as salmon, sardines, and chia seeds, can also help reduce inflammation 9. Can chondroitin and glucosamine cure osteoarthritis? The research on glucosamine and chondroitin for the treatment of osteoarthritis is mixed (https://writesonic.com/chat). Glucosamine and chondroitin are popular supplements that are believed to help with the symptoms of osteoarthritis, such as pain and stiffness. However, there is limited evidence to support their effectiveness1. The American College of Rheumatology (ACR) has recommended that people with moderate to severe osteoarthritis pain may find some relief from the combination of glucosamine and chondroitin2. However, it is important to note that the effects of glucosamine and chondroitin are not consistent, and there is no evidence that these supplements can cure osteoarthritis 10. Can I take ibuprofen for osteoarthritis? Yes, ibuprofen can be taken to help manage the symptoms of osteoarthritis. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) which can help reduce inflammation and reduce pain. It is important to take the ibuprofen as prescribed by your doctor, and to not take more than the recommended dosage. It is also important to take the ibuprofen with food, and to avoid taking it if you have any health conditions such as stomach problems, kidney or liver disease, or if you are taking other medications. If you have any questions or concerns about taking ibuprofen for osteoarthritis, it is important to consult with your doctor 11. What are the common symptoms of osteoarthritis? The common symptoms of osteoarthritis include pain, stiffness, decreased range of motion, swelling, clicking or popping sound when a joint bends, muscle weakness around the joint, and joint instability or buckling (https://writesonic.com/chat). Pain or aching in a joint during activity, after long activity or at the end of the day is a common symptom of osteoarthritis1. Joint stiffness usually occurs first thing in the morning or after periods of inactivity2. Swelling around a joint can be a sign of advanced osteoarthritis, as can bony enlargements and shape changes in the finger joints3. Knees can also be affected by osteoarthritis, with difficulty walking or pain when climbing stairs4References: https://writesonic.com/chat What Causes Osteoarthritis, Symptoms and More | NIAMS1 Osteoarthritis: Symptoms, Diagnosis, and Treatment2 Osteoarthritis (OA) | Arthritis | CDC Results It was observed that ChatSonic generated detailed write-ups with factually correct information in a clear, easy-to-understand language such as “Pain or aching in a joint during activity, after long activity or at the end of the day is a common symptom of osteoarthritis.” To support the content it delivered, ChatSonic cited references from a combination of sources such as academic journals, online articles, and websites. It also debunked popular existing myths about OA such as “There is no scientific evidence to suggest that cracking your knuckles can lead to osteoarthritis.” It was also interesting to note that ChatSonic directed the users to seek advice from a health care provider for addressing specific concerns that involved personalized care and treatment, drug dosages, or safety issues. It also gave information like recommending home remedies and low-impact exercises for people with OA and to avoid using ibuprofen for OA if suffering from stomach problems or kidney or liver disease. Conclusion This is an instance wherein ChatSonic generated realistic information, and thus it can prove to be an invaluable source for medical patients in the future. It can provide accurate and concise information quickly, allowing patients to easily access medical information in an easy-to-understand language and help better understand their condition without the need to search for data. It also can prove to be a great tool for staying up-to-date on the latest medical research and treatments, as well as providing helpful tips on managing chronic diseases and other long-term health issues11. Challenges The use of ChatSonic for OA management presents several challenges, particularly regarding the quality of information and limitations in replicating patient-doctor interactions. While AI tools like ChatSonic offer accessible health guidance, their outputs often lack scientific references or credible sources, raising concerns about reliability. For instance, studies evaluating comparable tools like ChatGPT found that responses to OA-related queries are frequently generic or omit critical details about treatment risks and benefits12,13. In addition, ChatSonic’s one-way communication model fails to replicate the dynamic Q&A of clinical consultations, where doctors probe symptoms, adjust advice based on patient feedback, and address individual concerns14. Moreover, the ability to provide advice that is specifically tailored to a patient’s needs and prescribing medication is beyond ChatSonic’s current capabilities and would require the expertise and knowledge of a health care professional. Further, their effectiveness is hindered by the non-deterministic nature of their responses, which can vary greatly with slight changes in input. Further, several ethical concerns have surfaced about the use of chatbots in health care settings15,16. Furthermore, the potential for generating inaccurate content could have serious negative implications in health care, making it essential to approach this issue with caution in medical practice17. In the future, ChatSonic has the potential to assist health care professionals by providing rapid, empathetic, and high-quality responses to patient inquiries during online consultations. This capability can enhance the efficiency of health care delivery, allowing doctors to focus on more complex cases. To maximize its utility, health care providers can play a vital role in overseeing and validating the information generated by ChatSonic, ensuring that it aligns with trustworthy sources such as medical journals, thereby ensuring that accurate and verified information is shared with patients, ultimately improving the quality of care and patient satisfaction. To maximize this potential, several remedies are necessary to address existing challenges. For instance, ChatSonic should integrate systems that automatically cite credible sources, such as medical journals or clinical guidelines, to ensure transparency and reliability. Training models on domain-specific data sets would enable the chatbot to deliver more comprehensive and context-aware responses tailored to patient needs. Incorporating interactive features that simulate patient-doctor consultations—where follow-up questions and tailored advice are exchanged—could further enhance its utility in providing personalized care. In addition, embedding warnings for critical decisions like surgery or medication changes and simplifying medical jargon would improve accessibility and safety for patients. Further research should focus on evaluating the reliability and accuracy of ChatSonic’s responses to patient inquiries. Collaboration among health care professionals interested in AI could lead to the development of new AI software based on large language models (LLMs) that generate verified, high-quality, and reliable answers to patient questions. This partnership can enhance the precision of AI-generated medical information and address current limitations. CRediT author statement Conceptualization: [RS]; Methodology: [RS]; Formal analysis: [RS]; Investigation: [RS]; [RS]; [RS]; have and the of The author that there is no of with to the content of this statement This study not or patient data, and not require ethical statement new data were generated or analyzed in this data the of this are available within the and its The not receive any specific or support for this individuals or other than the to the of this of AI and in the AI or were used in the or of this content was by the

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