{"title":"Readability, understandability, and quality of online education materials and large language models for retrograde cricopharyngeal muscle dysfunction.","authors":"Nurullah Türe, Emel Tahir, Necati Enver","doi":"10.1007/s00405-025-09628-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate online patient education materials on retrograde cricopharyngeal dysfunction (RCPD) by comparing the readability, understandability, and quality of content generated by large language models (LLM).</p><p><strong>Method: </strong>A web search in December 2024 evaluated 51 online resources and four LLMs (ChatGPT 4.0, Gemini 1.5 Flash, Perplexity GPT-3.5, DeepSeek-V2.5). Readability was analyzed using Readable.io, understandability actionability was assessed using PEMAT, and information quality was assessed using DISCERN.</p><p><strong>Results: </strong>The average readability level of the online material and the LLM responses was at the 11th-12th grade level. The Flesch Reading Ease score was lowest for the LLMs, especially for the DeepSeek-V2.5 model (24.21). While PEMAT understandability scores were adequate for online (82%) and LLMs (79%), actionability was low across all groups (25-37%). DISCERN analyses showed that both sources of information were of limited quality in supporting treatment decisions.</p><p><strong>Conclusion: </strong>This study revealed that both online and LLM-generated materials on RCPD exceeded the recommended readability levels. Although the materials demonstrated acceptable understandability, they exhibited low actionability and inadequate overall quality, emphasizing the need for more patient-centered digital health communication.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":"4711-4720"},"PeriodicalIF":2.2000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s00405-025-09628-x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/13 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: This study aims to evaluate online patient education materials on retrograde cricopharyngeal dysfunction (RCPD) by comparing the readability, understandability, and quality of content generated by large language models (LLM).
Method: A web search in December 2024 evaluated 51 online resources and four LLMs (ChatGPT 4.0, Gemini 1.5 Flash, Perplexity GPT-3.5, DeepSeek-V2.5). Readability was analyzed using Readable.io, understandability actionability was assessed using PEMAT, and information quality was assessed using DISCERN.
Results: The average readability level of the online material and the LLM responses was at the 11th-12th grade level. The Flesch Reading Ease score was lowest for the LLMs, especially for the DeepSeek-V2.5 model (24.21). While PEMAT understandability scores were adequate for online (82%) and LLMs (79%), actionability was low across all groups (25-37%). DISCERN analyses showed that both sources of information were of limited quality in supporting treatment decisions.
Conclusion: This study revealed that both online and LLM-generated materials on RCPD exceeded the recommended readability levels. Although the materials demonstrated acceptable understandability, they exhibited low actionability and inadequate overall quality, emphasizing the need for more patient-centered digital health communication.