{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:49:02Z","timestamp":1791557342013,"version":"4.3.4"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Phlebology"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Effective patient communication is critical in acute deep vein thrombosis (DVT) management. This study evaluated and compared the intelligibility and clinical appropriateness of patient-directed explanations for acute DVT generated by vascular surgeons versus a diverse panel of large language models (LLMs), using a balanced, unit-matched design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this observational, cross-sectional study, 11 board-certified vascular surgeons and 11 distinct, independently developed LLMs each produced one response to a standardized acute DVT vignette in Spanish. Responses were blinded and scored using an 8-item clinical appropriateness grid (two independent graders, consensus) and five validated Spanish readability indices. Central tendency was assessed with Mann-Whitney U tests; dispersion was assessed descriptively (coefficient of variation, range) and, exploratorily, with Brown-Forsythe tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Clinical appropriateness did not differ significantly between groups (median 7\/8 in both;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.258), dispersion was descriptively far smaller for LLMs (SD 0.40 vs 1.92; coefficient of variation 5.9% vs 32.5%). LLM responses were more readable on three of four content-complexity indices (Fern\u00e1ndez-Huerta, Guti\u00e9rrez de Polini, Szigriszt-Pazos; all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.02) and required a numerically lower educational grade level (Crawford 5.4 vs 6.1;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.075). Readability dispersion was descriptively far lower for LLMs (Fern\u00e1ndez-Huerta range 31 vs 200 points; coefficient of variation 15% vs 181%), driven in the surgeon cohort by a single response that fell far outside the interpretable range; formal variance tests did not reach significance at this sample size. LLM responses were longer (median 903 vs 354 words;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.003) and took longer to read (4.5 vs 1.8\u00a0min;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). Neither group addressed screening for silent pulmonary embolism. Free-versus-premium comparisons were model-specific rather than uniform.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current-generation LLMs matched board-certified surgeons in clinical completeness and produced more readable, descriptively far more consistent patient-facing explanations, without the communication failures observed in a minority of human responses. Both cohorts share an important, guideline-adjacent counseling gap.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02683555261494674","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:16:47Z","timestamp":1790885807000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Artificial intelligence and vascular surgeons in patient communication: A comparative analysis of intelligibility and clinical appropriateness in acute deep vein thrombosis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9456-8366","authenticated-orcid":false,"given":"Oliver Antonio","family":"G\u00f3mez Guti\u00e9rrez","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Tecnol\u00f3gico de Monterrey Escuela de Medicina y Ciencias de la Salud"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1795-3313","authenticated-orcid":false,"given":"Oscar A.","family":"De la Torre","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Tecnol\u00f3gico de Monterrey Escuela de Medicina y Ciencias de la Salud"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Cassagne","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Tecnol\u00f3gico de Monterrey Escuela de Medicina y Ciencias de la Salud"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Flores-Ordu\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Tecnol\u00f3gico de Monterrey Escuela de Medicina y Ciencias de la Salud"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Leon","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Tucson Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8548-6833","authenticated-orcid":false,"given":"Mario Alejandro","family":"Fabiani","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Tecnol\u00f3gico de Monterrey Escuela de Medicina y Ciencias de la Salud"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61904-1"},{"key":"e_1_3_9_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000130"},{"key":"e_1_3_9_4_2","doi-asserted-by":"publisher","unstructured":"Nicolaides A Kakkos S Baekgaard N et al. 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