{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:32:32Z","timestamp":1792510352086,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"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":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients increasingly consult artificial intelligence (AI) chatbots for health information, yet the reliability and accessibility of AI\u2010generated content for complex conditions like dysphagia remain unvalidated. We conducted the first head\u2010to\u2010head comparison of leading large language models for dysphagia patient education, evaluated by an international expert panel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Forty\u2010six validated questions across four clinical domains were submitted to ChatGPT\u20104.0 (OpenAI) and Claude 3.7 (Anthropic) in March 2025. Ten blinded experts from six countries rated responses for scientific accuracy (5\u2010point Likert), clarity (5\u2010point Likert), and misinformation (binary). Readability was assessed using Flesch Reading Ease, Flesch\u2013Kincaid Grade Level, and SMOG Index. Between\u2010model comparisons used Wilcoxon signed\u2010rank tests with Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      effect sizes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      No significant differences emerged for scientific accuracy (ChatGPT: 3.87\u2009\u00b1\u20090.36 vs. Claude: 3.93\u2009\u00b1\u20090.35;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.26;\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.16), clarity (4.12\u2009\u00b1\u20090.34 vs. 4.15\u2009\u00b1\u20090.27;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.67;\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.11), or mean misinformation rates (both 2.15;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.96). Strong inter\u2010model correlation existed for accuracy (rs\u2009=\u20090.678;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Critically, both models produced content far exceeding recommended readability levels: SMOG indices of 14.95\u2009\u00b1\u20092.40\u2009years (ChatGPT) and 17.37\u2009\u00b1\u20092.67\u2009years (Claude) required extensive education (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001;\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.95) versus the recommended 6\u20137\u2009years. Categorical analysis showed Claude generated three times more misinformation\u2010free responses (19.6% vs. 6.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.077).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Inferences<\/jats:title>\n                    <jats:p>Leading AI chatbots demonstrate equivalent, acceptable accuracy for dysphagia information but produce content inaccessible to most patients due to excessive complexity. The strong inter\u2010model correlation suggests shared limitations in medical training data. Before clinical implementation, AI\u2010generated patient education requires mandatory readability optimization to address the substantial health literacy gap identified in this study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70344","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T05:52:51Z","timestamp":1778478771000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Artificial Intelligence Chatbots for Dysphagia Patient Education: A Multi\u2010Center International Expert Evaluation"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9816-4171","authenticated-orcid":false,"given":"Luisa","family":"Bertin","sequence":"first","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology University of Padua  Padua Italy"},{"name":"Gastroenterology Unit, Azienda Ospedale\u2010Universit\u00e0 Padova  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afrin K.","family":"Rahman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Clarke","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Mari","sequence":"additional","affiliation":[{"name":"Gastroenterology Institute, Nazareth EMMS Hospital  Nazareth Israel"},{"name":"Faculty of Medicine Bar\u2010Ilan University  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6802-2121","authenticated-orcid":false,"given":"Frank","family":"Zerbib","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology CHU de Bordeaux and Universit\u00e9 de Bordeaux, INSERM CIC  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Prakash","family":"Gyawali","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Carri\u00f3n","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), Instituto de Salud Carlos III  Madrid Spain"},{"name":"Gastrointestinal Motility Unit, Hospital de Matar\u00f3  Matar\u00f3 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0845-0845","authenticated-orcid":false,"given":"J\u00e9r\u00f4me R.","family":"Lechien","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Elsan Polyclinique de Poitiers  Poitiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7798-7638","authenticated-orcid":false,"given":"Sabine","family":"Roman","sequence":"additional","affiliation":[{"name":"Digestive Physiology Hospices Civils de Lyon and Lyon 1 University  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Marabotto","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Internal Medicine University of Genoa  Genoa Italy"},{"name":"IRCCS AOM Policlinico San Martino  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram","family":"Dickman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Rabin Medical Center, Petah Tikva, and Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Savarino","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Internal Medicine University of Genoa  Genoa Italy"},{"name":"IRCCS AOM Policlinico San Martino  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo Vincenzo","family":"Savarino","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology University of Padua  Padua Italy"},{"name":"Gastroenterology Unit, Azienda Ospedale\u2010Universit\u00e0 Padova  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2015.49"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.70062"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010017\u20109844\u20109"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S107750"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010018\u20103376\u20103"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11060887"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010023\u201002448\u20108"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.16607"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13111950"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2023.0089"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.2196\/47479"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu17243828"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.1838"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010155\u20102\u2010201107190\u201000005"},{"key":"e_1_2_11_16_1","unstructured":"\u201cThe Health Literacy of America's Adults: Results From the 2003 National Assessment of Adult Literacy \u201d2003."},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2012.05.009"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.04.033"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201021689\u2010w"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.10728"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000002668"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.57879"},{"key":"e_1_2_11_23_1","unstructured":"\u201cTi Presentiamo ChatGPT Salute \u201d2026 https:\/\/openai.com\/it\u2010IT\/index\/introducing\u2010chatgpt\u2010health\/."},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmed\u20102025\u2010001632"}],"container-title":["Neurogastroenterology &amp; 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