The Use of Artificial Intelligence in Responding to Patient Questions About Anterolateral Thigh Flap Surgery for Diabetic Foot Ulcers.

Abstract

Background: Diabetic foot ulcer (DFU) care represents a significant challenge in plastic and reconstructive surgery. Oftentimes, patients encounter complex articles and websites to answer questions about their surgeries, including anterolateral thigh (ALT) flaps. Artificial intelligence (AI) represents a new and simplified resource for DFU patients seeking information regarding their care. To assess ChatGPT's utility as a patient resource, we evaluated the accuracy, comprehensiveness, and safety of AI-generated responses to frequently asked questions (FAQs) related to ALT flap surgery for DFU.

Methods: Ten DFU and ALT flap care FAQs were posed to ChatGPT Model 3.5 in June 2024. Four plastic surgeons evaluated responses using a 10-point Likert scale for accuracy, comprehensiveness, and danger of ChatGPT's answers. Surgeons also provided qualitative feedback. Response readability was assessed using 10 readability indexes, averaged to produce a reading grade level for each response.

Results: Overall, ChatGPT answered patient questions with a mean accuracy of 9.1 ± 1.2, comprehensiveness of 8.2 ± 1.5, and danger of 2.0 ± 1.0. ChatGPT answered at a mean grade level of 19.8 ± 20.1. Qualitatively, physician reviewers complimented the organizational clarity of the responses (n = 4/10) and the AI's ability to provide information on possible surgical complications (n = 4/10). While one response was noted to present explicitly incorrect information about preoperative preparation protocols and when they should be initiated, the majority of responses (n = 6/10) left out key postoperative information, notably dangle protocols and compression.

Conclusion: ChatGPT provides accurate and comprehensive responses to FAQs related to patients undergoing ALT flap surgery for the treatment of DFUs. The AI-generated responses were praised for organizational clarity and informative content regarding surgical complications, but lacked essential postoperative care details. Therefore, while ChatGPT is a valuable informational tool, further refinement is necessary to ensure that fully comprehensive information is provided to DFU patients.