{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:54:16Z","timestamp":1790189656730,"version":"4.1.0"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T00:00:00Z","timestamp":1770508800000},"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":["Hand (New York, N,Y.)"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Carpal tunnel syndrome (CTS) is a prevalent neuropathy in hand surgery that significantly affects people\u2019s quality of life. Frequently, patients conduct research online before seeking medical care. Large language models (LLMs) like ChatGPT are increasingly used for health information, yet concerns remain regarding the accuracy, readability, and complexity of their responses. Previous studies have assessed older ChatGPT models but have not comprehensively compared newer versions. The purpose of this study is to compare ChatGPT-4-generated, ChatGPT-4o-generated, and ChatGPT-o1-generated answers to common CTS-related patient questions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Six frequently asked CTS questions were queried of each LLM. Responses were independently graded by 2 board-certified hand surgeons using evidence-based guidelines. Lexical diversity was assessed using the Measure of Textual Lexical Diversity, and readability was evaluated using the Flesch-Kincaid Grade Level, Flesch Reading Ease Score, and Simple Measure of Gobbledygook. Analysis of variance or Kruskal-Wallis with post hoc tests were conducted to compare LLMs and questions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All 3 ChatGPT models averaged 93% accuracy with no significant differences between them, though a significant difference in accuracy was observed between questions 3 and 5. Readability scores between models varied significantly, with ChatGPT-4o generating the most readable responses and ChatGPT-o1 producing the most complex answers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>While LLMs had similar accuracy, ChatGPT-4o offered the most patient-friendly content. Furthermore, the readability of all models remains above the recommended level for the general population. Future work should explore whether fine-tuning or advancements in model design can enhance accessibility for a broader audience.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447251415391","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T05:40:32Z","timestamp":1770615632000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Readability, Accuracy, and Lexical Diversity of New ChatGPT Models for Common Carpal Tunnel Syndrome Questions"],"prefix":"10.1177","author":[{"given":"Romir P.","family":"Parmar","sequence":"first","affiliation":[{"name":"University of Arizona College of Medicine\u2014Phoenix, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4751-6282","authenticated-orcid":false,"given":"Sohail R.","family":"Daulat","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center, PA, USA"},{"name":"University of Arizona College of Medicine\u2014Tucson, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4297-1756","authenticated-orcid":false,"given":"Rakshit","family":"Shah","sequence":"additional","affiliation":[{"name":"The University of Arizona, Tucson, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7434-7111","authenticated-orcid":false,"given":"Tyler T.","family":"Brady","sequence":"additional","affiliation":[{"name":"University of Arizona College of Medicine\u2014Phoenix, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Montague","sequence":"additional","affiliation":[{"name":"OrthoArizona, Phoenix, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Roth","sequence":"additional","affiliation":[{"name":"OrthoArizona, Phoenix, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00432-X"},{"issue":"8","key":"e_1_3_3_3_2","first-page":"952","article-title":"Carpalion tunnel syndrome","volume":"83","author":"LeBlanc KE","year":"2011","unstructured":"LeBlanc KE, Cestia W. Carpalion tunnel syndrome. 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Google vs ChatGPT for patient education in hand surgery: a readability and quality comparison. Hand (N Y). 2025.","journal-title":"Hand (N Y)"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsg.2024.03.003"},{"issue":"1","key":"e_1_3_3_21_2","article-title":"ChatGPT-3.5 and -4.0 do not reliably create readable patient education materials for common orthopaedic upper- and lower-extremity conditions","volume":"7","author":"Abdelmalek G","year":"2025","unstructured":"Abdelmalek G, Marder RS, Richards SM, et al. ChatGPT-3.5 and -4.0 do not reliably create readable patient education materials for common orthopaedic upper- and lower-extremity conditions. Arthrosc Sports Med Rehabil. 2025;7(1):101027. doi:\/10.1016\/j.asmr.2024.101027","journal-title":"Arthrosc Sports Med Rehabil"},{"key":"e_1_3_3_22_2","unstructured":"American Society for Surgery of the Hand. Carpal tunnel syndrome. 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