Restricted accessResearch articleFirst published online 2026-1
Improving Accessibility to Facial Plastic and Reconstructive Surgery Patient Resources Using Artificial Intelligence: A Pilot Study in Patient Education Materials
The applications of artificial intelligence (AI) are evolving, offering new opportunities to enhance patient care.
Objective:
To determine whether the use of AI platforms for translating patient education materials (PEMs) improves their readability for patients seeking information on facial plastic and reconstructive surgery (FPRS) procedures.
Methods:
Text from 25 PEMs on topics such as rhytidectomy, rhinoplasty, and blepharoplasty was extracted. ChatGPT 4.o, ChatGPT 3.5, Microsoft Copilot, and Google Gemini were prompted to translate AAFPRS PEMs to the 6th-grade reading level, the accepted readability standard for PEMs. Readability was determined using Flesch Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), and Flesch Kincaid Reading Ease (FKRE). Statistical analysis was performed.
Results:
A total of 125 PEMs were reviewed. Original PEMs had a mean FKGL, GFI, and FKRE of 10.7, 13.48, and 50.8 respectively, which exceed the recommended level. The translated AI-generated PEMs had a mean FKGL, GFI, and FKRE of 8.41, 10.62, and 64.43 respectively, representing an improvement in readability (p < 0.001).
Conclusion:
With physician supervision, AI platforms can improve the readability of PEMs for common FPRS procedures. This strategy may increase the accessibility of educational resources for diverse patient populations.
Get full access to this article
View all access options for this article.
References
1.
TrutnerZD, FurloughK, MartinezA, et al.Is health literacy associated with surgical outcomes? A systematic review. J Surg Res. 2023; 291:720–733; doi: 10.1016/j.jss.2023.06.044
2.
MegwaluUC, BernsteinIA. Chapter 9 - The impact of health literacy on patient care in otolaryngology. In: (BoweSN, FaucettEA, eds). Healthcare Disparities in Otolaryngology. Elsevier; 2024:151–166. doi:10.1016/B978-0-443-10714-6.00013-4
3.
TopanH, MucukS, YontarY. The effect of patient education prior to rhinoplasty surgery on anxiety, pain, and satisfaction levels. J Perianesth Nurs. 2022; 37(3):374–379; doi: 10.1016/j.jopan.2021.07.001
4.
DriessensH, van WijkL, BuisCI, et al.Low health literacy is associated with worse postoperative outcomes following hepato-pancreato-biliary cancer surgery. HPB (Oxford). 2022; 24(11):1869–1877; doi: 10.1016/j.hpb.2022.07.006
5.
TheissLM, WoodT, McLeodMC, et al.The association of health literacy and postoperative complications after colorectal surgery: A cohort study. Am J Surg. 2022; 223(6):1047–1052; doi: 10.1016/j.amjsurg.2021.10.024
6.
ScarpatoKR, KappaSF, GogginsKM, et al.The impact of health literacy on surgical outcomes following radical cystectomy. J Health Commun. 2016; 21(sup2):99–104; doi: 10.1080/10810730.2016.1193916
7.
BakerS, MaloneE, GrahamL, et al.Patient-reported health literacy scores are associated with readmissions following surgery. Am J Surg. 2020; 220(5):1138–1144; doi: 10.1016/j.amjsurg.2020.06.071
8.
MurdockN, MissnerA, MehtaV. Health literacy in oculofacial plastic surgery: A literature review. Cureus. 2023; 15(7):e41518; doi: 10.7759/cureus.41518
9.
PakhchanianH, YuanM, RaikerR, et al.Readability analysis of the american society of ophthalmic plastic & reconstructive surgery patient educational brochures. Semin Ophthalmol. 2022; 37(1):77–82; doi: 10.1080/08820538.2021.1919721
10.
CorderoJ, FredianiT, CarreAL, et al.Complexity of online facial feminization surgery material exceeds patient health literacy. J Craniofac Surg. 2022; 33(8):e818–e820; doi: 10.1097/SCS.0000000000008726
11.
AlperDP, AlmeidaMN, De BaunHM, et al.Quality and readability of accessible facial feminization literature: Where can we improve? Ann Plast Surg. 2023; 90(6):533–537; doi: 10.1097/SAP.0000000000003569
12.
MisraP, AgarwalN, KasabwalaK, et al.Readability analysis of healthcare-oriented education resources from the American Academy of Facial Plastic and Reconstructive Surgery. Laryngoscope. 2013; 123(1):90–96; doi: 10.1002/lary.23574
13.
BadarudeenS, SabharwalS. Assessing readability of patient education materials: Current role in orthopaedics. Clin Orthop Relat Res. 2010; 468(10):2572–2580; doi: 10.1007/s11999-010-1380-y
14.
Institute of Medicine (US) Committee on Health Literacy. Health Literacy: A Prescription to End Confusion. (Nielsen-BohlmanL, PanzerAM, KindigDA, eds.). National Academies Press (US); 2004. http://www.ncbi.nlm.nih.gov/books/NBK216032/
15.
WeissBD, BlanchardJS, McGeeDL, et al.Illiteracy among Medicaid recipients and its relationship to health care costs. J Health Care Poor Underserved. 1994; 5(2):99–111; doi: 10.1353/hpu.2010.0272
16.
AyoubM, BalloutAA, ZayekRA, et al.Mind + Machine: ChatGPT as a basic clinical decisions support tool. Cureus. 2023; 15(8):e43690; doi: 10.7759/cureus.43690
17.
LechienJR, RameauA. Applications of ChatGPT in otolaryngology-head neck surgery: A state of the art review. Otolaryngol Head Neck Surg. 2024; 171(3):667–677; doi: 10.1002/ohn.807
18.
OlivaAD, PasickLJ, HofferME, et al.Improving readability and comprehension levels of otolaryngology patient education materials using ChatGPT. Am J Otolaryngol. 2024; 45(6):104502; doi: 10.1016/j.amjoto.2024.104502
19.
VallurupalliM, ShahND, VyasRM. Validation of ChatGPT 3.5 as a tool to optimize readability of patient-facing craniofacial education materials. Plast Reconstr Surg Glob Open. 2024; 12(2):e5575; doi: 10.1097/GOX.0000000000005575
20.
SwisherAR, WuAW, LiuGC, et al.Enhancing health literacy: Evaluating the readability of patient handouts revised by ChatGPT’s large language model. Otolaryngol Head Neck Surg. 2024; 171(6):1751–1757; doi: 10.1002/ohn.927
21.
MohanS, SouzaS, FakurnejadS, et al.Utility of an artificial intelligence language model for post-operative patient instructions following facial trauma. Craniomaxillofac Trauma Reconstr. 2024; 17(4):291–294; doi: 10.1177/19433875231222803
22.
ShamilE, KoTK, FanKS, et al.Assessing the quality and readability of online patient information: ENT UK patient information e-leaflets versus responses by a generative Artificial Intelligence. Facial Plast Surg. 2024; doi: 10.1055/a-2413-3675
23.
Solutions TK ISG, Reconstructiv AA of FP&. American Academy of Facial Plastic and Reconstructive Surgery. American Academy of Facial Plastic and Reconstructive Surgery. Available from: https://www.aafprs.org/ [Last accessed: November14, 2024].
KaundinyaT, El-BehaediS, ChoiJN. Readability of online patient education materials for graft-versus-host disease. J Cancer Educ. 2023; 38(4):1363–1366; doi: 10.1007/s13187-023-02271-2
26.
FriedmanDB, Hoffman-GoetzL. A systematic review of readability and comprehension instruments used for print and web-based cancer information. Health Educ Behav Off Publ Soc Public Health Educ. 2006; 33(3):352–373; doi: 10.1177/1090198105277329
27.
MichelC, DijanicC, AbdelmalekG, et al.Readability assessment of patient educational materials for pediatric spinal conditions from top academic orthopedic institutions. J Child Orthop. 2023; 17(3):284–290; doi: 10.1177/18632521231156435
28.
CherlaDV, SanghviS, ChoudhryOJ, et al.Readability assessment of Internet-based patient education materials related to endoscopic sinus surgery. Laryngoscope. 2012; 122(8):1649–1654; doi: 10.1002/lary.23309
29.
KellyNEW, MurrayKE, McCarthyC, et al.An objective analysis of quality and readability of online information on COVID-19. Health Technol (Berl). 2021; 11(5):1093–1099; doi: 10.1007/s12553-021-00574-2
30.
WuMP, MillerLE, MeyerCD, et al.Online searches related to total laryngectomy. Laryngoscope. 2023; 133(11):2971–2976; doi: 10.1002/lary.30643
31.
WeissBD. Health Literacy. 2003.
32.
KianianR, SunD, CrowellEL, et al.The use of large language models to generate education materials about uveitis. Ophthalmol Retina. 2024; 8(2):195–201; doi: 10.1016/j.oret.2023.09.008
33.
FazilatAZ, BerryCE, ChurukianA, et al.AI-based cleft lip and palate surgical information is preferred by both plastic surgeons and patients in a blind comparison. Cleft Palate Craniofac J. 2024:10556656241266368; doi: 10.1177/10556656241266368
34.
ShaariAL, PatilDP, MohammedS, et al.Utility of generative artificial intelligence for patient care counseling for mandibular fractures. J Craniofac Surg. 2024; doi: 10.1097/SCS.0000000000010832
35.
MeyerMKR, KandathilCK, DavisSJ, et al.Evaluation of rhinoplasty information from ChatGPT, Gemini, and Claude for readability and accuracy. Aesthetic Plast Surg. 2024; doi: 10.1007/s00266-024-04343-0
36.
GargN, CampbellDJ, YangA, et al.Chatbots as patient education resources for aesthetic facial plastic surgery: Evaluation of ChatGPT and google bard responses. Facial Plast Surg Aesthet Med. 2024; 26(6):665–673; doi: 10.1089/fpsam.2023.0368
37.
MoonsP, Van BulckL. Using ChatGPT and google bard to improve the readability of written patient information: A proof of concept. Eur J Cardiovasc Nurs. 2024; 23(2):122–126; doi: 10.1093/eurjcn/zvad087
38.
ShaariAL, BhallaS, XuA, et al.Comparative analysis of artificial intelligence platforms in generating post-operative instructions for rhinologic surgery. Indian J Otolaryngol Head Neck Surg. 2025; 77(1):601–603; doi: 10.1007/s12070-024-05161-1
DavidsonKW, MangioneCM, BarryMJ, et al.; US Preventive Services Task Force. Collaboration and Shared decision-making between patients and clinicians in preventive health care decisions and US preventive services task force recommendations. JAMA. 2022; 327(12):1171–1176; doi: 10.1001/jama.2022.3267
41.
President’s Commission. Making Health Care Decisions: The Ethical and Legal Implications of Informed Consent in the Patient-Practitioner Relationship. 1982.
42.
DoakCC, DoakLG, FriedellGH, et al.Improving comprehension for cancer patients with low literacy skills: Strategies for clinicians. CA Cancer J Clin. 1998; 48(3):151–162; doi: 10.3322/canjclin.48.3.151
43.
RossettiniG, RodeghieroL, CorradiF, et al.Comparative accuracy of ChatGPT-4, Microsoft copilot and google Gemini in the Italian entrance test for healthcare sciences degrees: A cross-sectional study. BMC Med Educ. 2024; 24(1):694; doi: 10.1186/s12909-024-05630-9
44.
EnginCD, KaratasE, OzturkT. Exploring the role of ChatGPT-4, BingAI, and Gemini as virtual consultants to educate families about retinopathy of prematurity. Children (Basel). 2024; 11(6):750; doi: 10.3390/children11060750
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
