PubMed ID: 42312647
Author(s): Tyagi M, Dihan QA, Alzein AF, Salamanca OC, Rahal DA, Vila Delgado M, Sanvicente CT, Khodeiry M, Elnahry AG, Rolim-de-Moura C, Chang TC, Maidana DE, Elhusseiny AM. Evaluating Large Language Models to Improve Spanish Patient Education on Childhood Glaucoma. J Pediatr Ophthalmol Strabismus. 2026 Jun 16:1-6. doi: 10.3928/01913913-20260416-02. Epub ahead of print. PMID: 42312647.PMID 42312647
Journal: Journal of Pediatric Ophthalmology and Strabismus
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.