Accuracy and Readability of ChatGPT Responses to Patient-Centric Strabismus Questions

Purpose: To assess the medical accuracy and readability of responses provided by ChatGPT (OpenAI), the most widely used artificial intelligence-powered chatbot, regarding questions about strabismus. Methods:Thirty-four questions were input into ChatGPT 3.5 (free version) and 4.0 (paid version) at three time intervals (day 0, 1 week, and 1 month) in two distinct geographic locations (California and Florida) in March 2024. Two pediatric ophthalmologists rated responses as "acceptable," "accurate but missing key information or minor inaccuracies," or "inaccurate and potentially harmful." The online tool, Readable, measured the Flesch-Kincaid Grade Level and Flesch Reading Ease Score to assess readability. Results: Overall, 64% of responses by ChatGPT were "acceptable;" but the proportion of "acceptable" responses differed by version (47% for ChatGPT 3.5 vs 53% for 4.0, P < .05) and state (77% of California vs 51% of Florida, P < .001). Responses in Florida were more likely to be "inaccurate and potentially harmful"compared to those in California (6.9% vs. 1.5%, P < .001). Over 1 month, the overall percentage of "acceptable" responses increased (60% at day 0, 64% at 1 week, and 67% at 1 month, P > .05), whereas "inaccurate and potentially harmful" responses decreased (5% at day 0, 5% at 1 week, and 3% at 1 month, P > .05). On average, responses scored a Flesch-Kincaid Grade Level score of 15, equating to a higher than high school grade reading level. Conclusions: Although most of ChatGPT's responses to strabismus questions were clinically acceptable, there were variations in responses across time and geographic regions. The average reading level exceeded a high school level and demonstrated low readability. Although ChatGPT demonstrates potential as a supplementary resource for parents and patients with strabismus, improving the accuracy and readability of free versions of ChatGPT may increase its utility.