The Role of AI in Foot and Ankle Patient Education: A Comparative Analysis of ChatGPT and AOFAS Resources

Research Type: Level 5 - Case report, Expert opinion, Personal observation Introduction/Purpose: ChatGPT, an AI-powered chatbot, utilizes natural language generation to provide human-like responses across various topics, including medicine. It continuously learns and improves through advanced algorithms. ChatGPT offers up-to-date information on diseases, symptoms, and treatments in healthcare. Its latest iterations, GPT-3.5 and GPT-4.0, enhance accuracy and performance. This study evaluates ChatGPT’s patient education capabilities by comparing GPT-3.5 and GPT-4.0 in explaining fifteen foot and ankle orthopedic conditions. Additionally, Foot and Ankle Orthopedic Surgeons assess the accuracy of the provided information. Methods: Fifteen foot and ankle orthopedic conditions were presented to ChatGPT (GPT-3.5 and GPT-4.0) using the standardized prompt: “I have been diagnosed with [condition]. Can you tell me more about it?” The generated responses were compared to publicly available information from the American Orthopaedic Foot & Ankle Society (AOFAS) Foot Care MD patient information sheets within the same time frame. Each inquiry was conducted in a separate chat session to prevent ChatGPT from referencing prior responses. To evaluate the accuracy of ChatGPT’s information, two fellowship-trained foot and ankle orthopedic surgeons (A.B. and G.I.P.) independently reviewed the outputs. They categorized their accuracy into four tiers: < 50%, 50–74%, 75–99%, or 100% accurate, with each category reflecting an estimated level of correctness. Results: Compared to the AOFAS FootCare MD website, ChatGPT-4.0 provided a more comprehensive description of symptoms, whereas ChatGPT-3.5 included more risk factors. In contrast, AOFAS offered more detailed treatment options. Regarding accuracy, the majority of conditions evaluated using ChatGPT-3.5 (12 of 15) and ChatGPT-4.0 (13 of 15) were rated as primarily accurate (75%–99%) by both reviewers. Notably, both surgeons consistently classified one condition generated by ChatGPT-3.5 as mostly inaccurate ( < 50% accuracy). Interobserver agreement for accuracy ratings was poor, with a Cohen’s kappa coefficient of -0.02, indicating a lack of consistency between reviewers. Conclusion: ChatGPT (GPT-3.5 and GPT-4.0) demonstrates a relatively high degree of accuracy in generating patient education materials for foot and ankle orthopedic conditions. However, its ability to provide detailed, condition-specific information remains limited. Specialty organizations, such as the American Orthopaedic Foot & Ankle Society (AOFAS), are the most accurate and reliable sources for comprehensive musculoskeletal information related to foot and ankle pathology.