A multimetric health literacy analysis of phalloplasty techniques: Comparing artificial intelligence and online resources

Background: This study aims to compare the informational quality of online and artificial intelligence (AI) - sources on different phalloplasty donor sites to assess reliability and accessibility. Methods: A deidentified Google search was conducted using search phrases for forearm, thigh, back, and abdomen phalloplasty. The first ten websites for each donor site were included. The same search phrases were entered into three AI platforms: ChatGPT-4o mini, Google Gemini, and MetaAI. The Simple Measure of Gobbledygook (SMOG), Patient Education and Materials Assessment Tool (PEMAT), and the DISCERN tool to evaluate readability, understandability and actionability, and quality, respectively. Results: Website readability was higher than AI platforms, though not statistically significant (p=0.10). All means exceeded the eighth-grade reading level, with AI outperforming websites in understandability and actionability (p<0.0001 and p=0.006). While websites were deemed understandable, they lacked actionable content. AI scores averaged 51.9, categorized as "good quality," whereas websites averaged 46.9, classified as "fair quality" (p=0.001). No significant differences across donor sites were found (p=0.82). Conclusions: Improving the quality of online health resources for phalloplasty donor sites is essential in enabling patients to make informed surgical decisions. The emergence of AI as an educational tool enhances the understandability and quality of online phalloplasty materials, but its overall value warrants further evaluation.