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.
Keywords
AI - ChatGPT - LLMs - DFU - ALT - microsurgery
