Large language models: Are artificial intelligence-based chatbots a reliable source of patient information for spinal surgery?

Purpose: Large language models (LLM) have recently attracted attention because of their enormous performance. Based on artificial intelligence, LLM enable dialogic communication using quasi-natural language that approximates the quality of human communication. Thus, LLM could play an important role for patients to become informed. To evaluate the validity of an LLM in providing medical information, we used one of the first high-performance LLM (ChatGPT) on the clinical example of acute lumbar disc herniation (LDH).

Methods: Twenty-four spinal surgeons experienced in LDH surgery directed questions to ChatGPT about the clinical picture of LDH from a patient's perspective. They evaluated the quality of ChatGPT responses and its potential use in medical communication. The responses were compared with the information content of a standard informed consent form.

Results: ChatGPT provided good results in terms of comprehensibility, specificity, and satisfaction of responses and in terms of medical accuracy and completeness. ChatGPT was not able to provide all the information that was provided in the informed consent form, but did communicate information that was not listed there. In some cases, albeit minor, ChatGPT made medically inaccurate claims, such as listing kyphoplasty and vertebroplasty as surgical options for LDH.

Conclusion: With the incipient use of artificial intelligence in communication, LLM will certainly become increasingly important to patients. Even if LLM are unlikely to play a role in clinical communication between physicians and patients at the moment, the opportunities-but also the risks-of this novel technology should be alertly monitored.