ChatGPT 3.5 and 4 Provide Mostly Accurate Information When Answering Patients' Questions Relating to Femoroacetabular Impingement Syndrome and Arthroscopic Hip Surgery

J ISAKOS. 2024 Dec 12:100376. doi: 10.1016/j.jisako.2024.100376. Online ahead of print.

Abstract

Objectives: This study aimed to evaluate the accuracy of ChatGPT in answering patient questions about femoroacetabular impingement (FAI) and arthroscopic hip surgery, comparing the performance of versions ChatGPT-3.5 (free) and ChatGPT-4 (paid).

Methods: Twelve frequently asked questions (FAQs) relating to FAI were selected and posed to ChatGPT-3.5 and ChatGPT-4. Responses were assessed for accuracy by three hip arthroscopy surgeons using a four-tier grading system. Statistical analyses included Wilcoxon signed-rank tests and Gwet's AC2 coefficient for interrater agreement corrected for chance and employing quadratic weights.

Results: Median ratings for responses ranged from "excellent not requiring clarification" to "satisfactory requiring moderate clarification." No responses were rated as "unsatisfactory requiring substantial clarification." Median accuracy scores were 2 (range 1-3) for ChatGPT-3.5 and 1.5 (range 1-3) for ChatGPT-4, with 25% of ChatGPT-3.5's responses and 50% of ChatGPT-4's responses rated as "excellent." There was no statistical difference in performance between the two versions (p = 0.279) although ChatGPT-4 showed a tendency towards higher accuracy in some areas. Interrater agreement was substantial for ChatGPT-3.5 (Gwet's AC2 = 0.79 [95%CI = 0.6 - 0.94]) and moderate to substantial for ChatGPT-4 (Gwet's AC2 = 0.65 [95%CI = 0.43 - 0.87]).

Conclusion: Both versions of ChatGPT provided mostly accurate responses to FAQs on FAI and arthroscopic surgery, with no significant difference between the versions. The findings suggest potential utility of ChatGPT in patient education, though cautious implementation and further evaluation are recommended due to variability in response accuracy and low power of the study.

Level of evidence: IV.

Keywords: Artificial intelligence; ChatGPT; Femoroacetabular Impingement; large language models; patient education.