{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T14:46:09Z","timestamp":1791729969873,"version":"4.3.4"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"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":["Journal of Back and Musculoskeletal Rehabilitation"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>AI-based chatbots are increasingly used for health information, while cross-linguistic studies suggest that response performance may vary by language. Given the high prevalence of carpal tunnel syndrome (CTS), this study evaluated the reliability, quality, patient education suitability, and readability of AI-generated responses to CTS questions in English and Turkish.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      Seventeen patient-centered CTS questions were directed to ChatGPT\n                      <jats:sup>\u00ae<\/jats:sup>\n                      (GPT-5 Mini), Gemini\n                      <jats:sup>\u00ae<\/jats:sup>\n                      3 Flash, and Claude\n                      <jats:sup>\u00ae<\/jats:sup>\n                      4.5 Sonnet, using zero-shot prompting across 102 independent sessions in English and Turkish. Responses were evaluated for reliability, quality, and patient education using mDISCERN (MD), Global Quality Score (GQS), and the Patient Education Materials Assessment Tool (PEMAT). Readability was assessed via Flesch Reading Ease (English) and Ate\u015fman Index (Turkish). Friedman and Wilcoxon tests with Bonferroni correction were applied.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant inter-model differences were observed in English across all metrics (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05), with Gemini achieving higher MD and PEMAT scores than ChatGPT and Claude (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Cross-language differences were observed in mDISCERN scores, while Gemini showing a significant difference in favor of English (r\u2009=\u20090.93;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). None of the models met recommended readability levels in either language.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AI-generated CTS information varied by model and language. Differences in MD scores should be interpreted cautiously because this instrument partly reflects the provision of references and does not directly assess factual clinical accuracy. None of the evaluated models achieved recommended readability levels for patient education. These findings support the use of AIs as supplementary rather than standalone sources of CTS-related patient information.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10538127261492778","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:40:04Z","timestamp":1791463204000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reliability, quality, and readability of large language models in carpal tunnel syndrome: A comparative cross-linguistic, cross-sectional observational study"],"prefix":"10.1177","author":[{"given":"Bilgehan Kolutek","family":"Ay","sequence":"first","affiliation":[{"name":"S\u00fct\u00e7\u00fc \u0130mam University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cem Zafer","family":"Y\u0131ld\u0131r","sequence":"additional","affiliation":[{"name":"S\u00fct\u00e7\u00fc \u0130mam University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2025.1644041"},{"key":"e_1_3_3_3_2","first-page":"138912","article-title":"Artificial intelligence in healthcare: trends, opportunities, and challenges","volume":"6","author":"Fairhurst K.","year":"2024","unstructured":"Fairhurst K. Artificial intelligence in healthcare: trends, opportunities, and challenges. Front Digit Health 2024; 6: 138912.","journal-title":"Front Digit Health"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-025-56989-2"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/info16060489"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000039305"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2014.05.027"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/10410236.2024.2309810"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9121740"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_3_3_11_2","unstructured":"OpenAI. ChatGPT (GPT-5 Mini) [Internet]. San Francisco CA USA: OpenAI; 2026 [Accessed 2026 Jan 6]. Available from: https:\/\/chat.openai.com\/."},{"key":"e_1_3_3_12_2","unstructured":"Google. Gemini 3 Flash [Internet]. Mountain View CA USA: Google; 2026 [Accessed 2026 Jan 6]. Available from: https:\/\/gemini.google.com\/."},{"key":"e_1_3_3_13_2","unstructured":"Anthropic. Claude 4.5 Sonnet [Internet]. San Francisco CA USA: Anthropic; 2026 [Accessed 2026 Jan 6]. Available from: https:\/\/claude.ai\/."},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.53.2.105"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.111114"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01325.x"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.5152\/FNJN.2023.22196"},{"key":"e_1_3_3_18_2","first-page":"71","article-title":"T\u00fcrk\u00e7ede okunabilirli\u011fin \u00f6l\u00e7\u00fclmesi (in Turkish)","volume":"58","author":"Ate\u015fman E.","year":"1997","unstructured":"Ate\u015fman E. T\u00fcrk\u00e7ede okunabilirli\u011fin \u00f6l\u00e7\u00fclmesi (in Turkish). Ankara \u00dcniversitesi T\u00f6mer Dil Dergisi 1997; 58: 71\u201374.","journal-title":"Ankara \u00dcniversitesi T\u00f6mer Dil Dergisi"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1037\/h0057532"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2016.02.012"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.2196\/68560"},{"key":"e_1_3_3_22_2","article-title":"Quality of ChatGPT responses to frequently asked questions in carpal tunnel release surgery","volume":"12","author":"Amen TB","year":"2024","unstructured":"Amen TB, Torabian KA, Subramanian T, et al. Quality of ChatGPT responses to frequently asked questions in carpal tunnel release surgery. 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Language discrepancies in the performance of generative artificial intelligence models: an examination of infectious disease queries in English and Arabic. British Medical Council Infectious Diseases 2024; 24: 799.","journal-title":"British Medical Council Infectious Diseases"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-010-1380-y"},{"key":"e_1_3_3_33_2","volume-title":"Health literacy and patient safety: Help patients understand. manual for clinicians. 2nd ed","author":"Weiss BD.","year":"2007","unstructured":"Weiss BD. Health literacy and patient safety: Help patients understand. manual for clinicians. 2nd ed. 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