{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T10:03:23Z","timestamp":1789380203911,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Large language models (LLMs) are increasingly used for patient education, but their output quality across health literacy levels is unknown. This cross\u2010sectional study compared ChatGPT\u20104o, ChatGPT\u20105, DeepSeek\u2010V3.1, and DeepSeek\u2010R2 in generating osteoporosis education materials tailored to low, moderate, and high health literacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six clinical domains were posed to each LLM, with prompts adapted for three literacy tiers per model (18 outputs per model). Outputs were aggregated into 12 composite texts (4 models \u00d7 3 tiers). Three blinded clinicians assessed information quality using DISCERN (0\u201380) and readability using Flesch\u2010Kincaid (FKGL, lower = easier).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean DISCERN scores ranged 36\u201352\/80 (\u201cfair\u201d); no output reached \u201cexcellent\u201d (&gt;\u200970\/80). DeepSeek\u2010V3.1 provided the highest treatment detail for high literacy and best low\u2010literacy readability (FKGL 3.99). ChatGPT\u20105 performed most consistently across tiers. Median readability ranged from grade 4.8 to 10.2. All outputs lacked citations, publication dates, quantitative risk data, and uncertainty statements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LLMs can rapidly generate readable osteoporosis education, but current outputs require supplementation with references, risk statistics, and updated transparency before clinical use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72706","type":"journal-article","created":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T03:27:05Z","timestamp":1783222025000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing Readability and DISCERN Quality of Osteoporosis Education Materials Generated by ChatGPT and Deepseek for Diverse Health Literacy Levels: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1187-8631","authenticated-orcid":false,"given":"Junfang","family":"Miao","sequence":"first","affiliation":[{"name":"Cardiovascular Department II The First People's Hospital of Baiyin Baiyin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3473-0300","authenticated-orcid":false,"given":"Guanghu","family":"Sun","sequence":"additional","affiliation":[{"name":"Xiaotieshan Mine Baiyin Nonferrous Group Co. Ltd Baiyin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8729-9365","authenticated-orcid":false,"given":"Yichao","family":"Wang","sequence":"additional","affiliation":[{"name":"Baiyin Colored Blue Bird Digital Technology Co. Ltd Baiyin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4293-2646","authenticated-orcid":false,"given":"Fangying","family":"Li","sequence":"additional","affiliation":[{"name":"Breast Section The First People's Hospital of Baiyin Baiyin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangli","family":"Li","sequence":"additional","affiliation":[{"name":"Nursing Department The First People's Hospital of Baiyin Baiyin China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2024.1416739"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-022-06657-8"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.3757"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114525000790"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-020-03217-1"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-021-06226-5"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/fmch-2020-000351"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.3928\/24748307-20200731-01"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12395"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.2196\/22769"},{"key":"e_1_2_13_12_1","unstructured":"M. L.Olson N.Ratzlaff M.Hinck et al. 2025. \"Semantic Specialization in MoE Appears With Scale: A Study of DeepSeek R1 Expert Specialization.\" arXiv."},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-025-01533-4"},{"key":"e_1_2_13_14_1","first-page":"1812","article-title":"ChatGPT and the Future of Digital Health: A Study on Healthcare Workers' Perceptions and Expectations","volume":"11","author":"Temsah M. H.","year":"2023","journal-title":"Healthcare (Basel, Switzerland)"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02640361"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.53.2.105"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.4103\/1357-6283.210517"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/1357-6283.210517"},{"key":"e_1_2_13_19_1","unstructured":"Y.Han A.Ceross andJ. H.Bergmann 2024. \u201cThe Use of Readability Metrics in Legal Text: A Systematic Literature Review.\u201d arXiv."},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2025.110289"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2025.110711"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-020-05800-7"},{"key":"e_1_2_13_23_1","article-title":"A Critical Assessment of the Quality and Readability of Information on Gastric Cancer Available on the Internet for Patients","volume":"16","author":"Burke E.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1400749"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.2196\/40733"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2024.105657"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.72706","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.72706","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.72706","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T09:11:29Z","timestamp":1789377089000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.72706"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/hsr2.72706"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.72706","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-01-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72706"}}