Journal of pediatric ophthalmology and strabismus · 2026
Evaluating Large Language Models to Improve Spanish Patient Education on Childhood Glaucoma.
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Tyagi Mallika, Dihan Qais A, Alzein Ahmad F, Salamanca Olga C, Rahal Dania A, Vila Delgado Mariam, Sanvicente Carina T, Khodeiry Mohamed, Elnahry Ayman G, Rolim-de-Moura Christiane, Chang Ta C, Maidana Daniel E, Elhusseiny Abdelrahman M
Аннотация
PURPOSE: To evaluate the effectiveness of ChatGPT-4o (OpenAI) in enhancing the readability and quality of Spanish patient educational materials (PEMs) on childhood glaucoma, and to determine whether they are written above the recommended 6th-grade reading level (per American Medical Association recommendation).
METHODS: This cross-sectional comparative study analyzed 10 original Spanish-language PEMs on "glaucoma infantil." Each was inputted into ChatGPT-4o using a Spanish-language prompt requesting improved readability to a score of 70 or greater on the INFLESZ scale (adaptation of the Flesch-Szigriszt Index for Spanish-language texts), which is equivalent to a 4th- to 6th-grade reading level. Original and revised PEMs were compared using the INFLESZ scale. Additionally, three native Spanish-speaking ophthalmologists assessed each PEM's quality using a published 15-point Likert scale evaluating helpfulness, truthfulness, and harmlessness.
RESULTS: Original PEMs had a mean INFLESZ score of 56.6 ± 4.9 (8th-grade level). ChatGPT-4o significantly improved readability to 69.6 ± 2.3 (4th- to 6th-grade level, P < .001). Revised PEMs had fewer syllables, words, and complex words without a significant difference in sentence count. Quality remained high across both groups (median score = 15, P = .74), and no hallucinations were observed in artificial intelligence-generated text.
CONCLUSIONS: ChatGPT-4o can be used as a supplemental tool by health care professionals to improve the readability of existing Spanish PEMs on childhood glaucoma, without sacrificing the quality, accuracy, or reliability of their content.
METHODS: This cross-sectional comparative study analyzed 10 original Spanish-language PEMs on "glaucoma infantil." Each was inputted into ChatGPT-4o using a Spanish-language prompt requesting improved readability to a score of 70 or greater on the INFLESZ scale (adaptation of the Flesch-Szigriszt Index for Spanish-language texts), which is equivalent to a 4th- to 6th-grade reading level. Original and revised PEMs were compared using the INFLESZ scale. Additionally, three native Spanish-speaking ophthalmologists assessed each PEM's quality using a published 15-point Likert scale evaluating helpfulness, truthfulness, and harmlessness.
RESULTS: Original PEMs had a mean INFLESZ score of 56.6 ± 4.9 (8th-grade level). ChatGPT-4o significantly improved readability to 69.6 ± 2.3 (4th- to 6th-grade level, P < .001). Revised PEMs had fewer syllables, words, and complex words without a significant difference in sentence count. Quality remained high across both groups (median score = 15, P = .74), and no hallucinations were observed in artificial intelligence-generated text.
CONCLUSIONS: ChatGPT-4o can be used as a supplemental tool by health care professionals to improve the readability of existing Spanish PEMs on childhood glaucoma, without sacrificing the quality, accuracy, or reliability of their content.