{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T20:37:11Z","timestamp":1781987831226,"version":"3.54.5"},"reference-count":37,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"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":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The American Medical Association (AMA) recommends patient education materials (PEMs) be written at or below a sixth grade reading level. This study seeks to determine the quality, readability, and content of available alveolar bone grafting (ABG) PEMs and determine if artificial intelligence can improve PEM readability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Review of free online PEMs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Online ABG PEMs were retrieved from different authoring body types (hospital\/academic center, medical society, or private practice).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants<\/jats:title>\n                    <jats:p>None<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Content was assessed by screening PEMs for specific ABG-related topics. Quality was evaluated with the Patient Education Material Assessment Tool (PEMAT), which has measures of understandability and actionability. Open-access readability software (WebFX) determined readability with Flesch Reading Ease, Flesch-Kincaid Grade Level, and Gunning-Fog Index. PEMs were rewritten with ChatGPT, and readability metrics were reassessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Quality, readability, and content of ABG PEMs<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>34 PEMs were analyzed. Regarding quality, the average PEMAT-understandability score was 67.0\u2009\u00b1\u200916.2%, almost at the minimum acceptable score of 70.0% (p\u2009=\u20090.281). The average PEMAT-actionability score was low at 33.0\u2009\u00b1\u200924.1%. Regarding readability, the average Flesch Reading Ease score was 64.6\u2009\u00b1\u200912.8, categorized as \u201cstandard\/plain English.\u201d The average Flesch-Kincaid Grade Level was 8.0\u2009\u00b1\u20092.3, significantly higher than AMA recommendations (p\u2009&lt;\u20090.0001). PEM rewriting with ChatGPT improved Flesch-Kincaid Grade Level to 6.1\u2009\u00b1\u20091.3 (p\u2009&lt;\u20090.0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Available ABG PEMs are above the recommended reading level, yet ChatGPT can improve PEM readability. Future studies should improve areas of ABG PEMs that are most lacking, such as actionability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656241281453","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T09:08:48Z","timestamp":1725959328000},"page":"1873-1880","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Expanding Accessibility in Cleft Care: The Role of Artificial Intelligence in Improving Literacy of Alveolar Bone Grafting Information"],"prefix":"10.1177","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0088-2991","authenticated-orcid":false,"given":"Artur","family":"Manasyan","sequence":"first","affiliation":[{"name":"Children's Hospital Los Angeles"},{"name":"Keck School of Medicine, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasha","family":"Lasky","sequence":"additional","affiliation":[{"name":"Children's Hospital Los Angeles"},{"name":"Keck School of Medicine, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7043-2210","authenticated-orcid":false,"given":"Marah","family":"Jolibois","sequence":"additional","affiliation":[{"name":"Children's Hospital Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9078-7809","authenticated-orcid":false,"given":"Tayla","family":"Moshal","sequence":"additional","affiliation":[{"name":"Children's Hospital Los Angeles"},{"name":"Keck School of Medicine, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7843-583X","authenticated-orcid":false,"given":"Idean","family":"Roohani","sequence":"additional","affiliation":[{"name":"Children's Hospital Los Angeles"},{"name":"Keck School of Medicine, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naikhoba","family":"Munabi","sequence":"additional","affiliation":[{"name":"Children's Hospital Los Angeles"},{"name":"Keck School of Medicine of USC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark M.","family":"Urata","sequence":"additional","affiliation":[{"name":"Children's Hospital Los Angeles"},{"name":"Keck School of Medicine of USC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0030-1420","authenticated-orcid":false,"given":"Jeffrey A.","family":"Hammoudeh","sequence":"additional","affiliation":[{"name":"Children's Hospital Los Angeles"},{"name":"Keck School of Medicine of USC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,9]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656221142098"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1073-8746(96)80014-4"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001665-200311000-00005"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2018.11.019"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(20)32408-1"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2021.01.033"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000753256.29578.6c"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.17219\/acem\/115079"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cnur.2020.02.007"},{"issue":"7","key":"e_1_3_2_11_2","article-title":"Empowering patients: Promoting patient education and health literacy","volume":"14","author":"Bhattad PB","year":"2022","unstructured":"Bhattad PB, Pacifico L. 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