{
  "abstract": "Purpose: To evaluate the accuracy and readability of large language model (LLM)-generated patient education materials regarding tympanostomy tube placement.\n\nMethods: Over a two-month period, ChatGPT 4o, Gemini 2.5 Flash, and Google Search AI were prompted daily using long-form and layered prompt formats covering typical concerns regarding tympanostomy. Responses were scored on a 12-point rubric adapted from the AAO-HNS Clinical Practice Guidelines (CPG), assessing diagnostic accuracy, procedural clarity, and postoperative care. Readability was evaluated using Flesch Reading Ease and Flesch-Kincaid Grade Level. For each model and prompt type, average scores and variability were analyzed with 95% confidence intervals. Between-model differences were tested with Welch’s t-tests and Cohen’s d; temporal trends were analyzed via linear regression.\n\nResults: For long-form outputs, Google Search AI and Gemini 2.5 Flash demonstrated the highest mean CPG adherence (96.4% and 96.6%, respectively), both significantly exceeding ChatGPT 4o (84.3%; both P < .001; Cohen’s d ≈ 2.05). For layered prompt sessions, Google Search AI again demonstrated the highest adherence (91.7%), followed by Gemini 2.5 Flash (88.1%) and ChatGPT 4o (76.2%). Guideline adherence was temporally stable across all models (P > .05 for most). All outputs exceeded the recommended sixth-grade reading threshold (mean FKGL, 9.4 for long-form; 10.6 for layered), with no statistically significant readability differences between prompt strategies.\n\nConclusions: Google Search AI demonstrated the highest guideline concordance, though all models produced material too complex for typical patient comprehension. Structured prompting enhances clinical accuracy, but readability remains a key barrier to accessibility.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Otolaryngology-Head and Neck Surgery, Hackensack University Medical Center, Hackensack, NJ 07662 USA",
    "Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, NJ 07103 USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Shreeya Bahethi"
    },
    {
      "affs": [
        1
      ],
      "name": "Hetal Lad"
    },
    {
      "affs": [
        1
      ],
      "name": "Shrey Shah"
    },
    {
      "affs": [
        1
      ],
      "name": "Sudeepti Vedula"
    },
    {
      "affs": [
        1
      ],
      "name": "Brian Manzi",
      "orcid": "0000-0002-8917-9654"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7pz8d8a5vct7a.bib",
  "cited_by": 0,
  "doi": "10.1007/s00405-026-10612-2",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13748056/",
  "id": "7pz8d8a5vct7a",
  "issns": [
    "0937-4477",
    "1434-4726"
  ],
  "landing_url": "https://doi.org/10.1007/s00405-026-10612-2",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Miscellaneous"
    ],
    [
      "openalex",
      "2718|Artificial Intelligence in Healthcare and Education"
    ]
  ],
  "openalex": "W7213310123",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s00405-026-10612-2.pdf",
  "pmcid": "PMC13748056",
  "pmid": "42747529",
  "published": "2026-09-16",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7pz8d8a5vct7a.ris",
  "sources": [
    {
      "first_seen": "2026-11-13T12:25:38Z",
      "native_id": "PMC13748056",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s00405-026-10612-2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2718|Artificial Intelligence in Healthcare and Education",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Large language models for tympanostomy patient education: readability and guideline adherence",
  "title_text": "Large language models for tympanostomy patient education: readability and guideline adherence",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T12:25:38Z",
  "url": "https://research.draconitic.com/paper/7pz8d8a5vct7a",
  "venue": "European Archives of Oto-Rhino-Laryngology",
  "versions": []
}