{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:44:37Z","timestamp":1791830677743,"version":"4.3.4"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"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":["Hand (New York, N,Y.)"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The American Medical Association (AMA) recommends patient education materials (PEMs) be written at a sixth-grade level to ensure accessibility. This study aims to compare hand surgery topics from the American Society for Surgery of the Hand (ASSH) website and artificial intelligence (AI)-generated PEMs to evaluate their alignment with the AMA\u2019s recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Ninety-eight hand surgery topics from the ASSH Hand Care \u201cThe Upper Extremity Expert\u201d website were analyzed. Artificial intelligence (AI) platforms (Google Gemini 2.0 Flash and ChatGPT-4) were asked to: (1) create original PEMs based on ASSH website topics; (2) rewrite the ASSH topics at a sixth-grade reading level; and (3) create original PEMs over the ASSH topics at a sixth-grade reading level. Readability was assessed using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The ASSH website and AI-generated PEMs initially exceeded the sixth-grade readability level. Original ASSH PEMs ranged from a readability of 10th to 12th-grade (FRE 57.5 [6.6]; FKGL 9.4 [1.2]). Google Gemini and ChatGPT\u2019s initial PEMs were at the college level (Google Gemini: FRE 49.7 [7.5]; FKGL 9.6 [1.1] vs ChatGPT: FRE 47.4 [9.1]; FKGL 10.4 [1.4]). Artificial intelligence\u2013rewritten ASSH content had improved readability, and AI-generated PEMs at a sixth-grade readability had lower word counts, higher FRE, and lower FKGL than original ASSH PEMs (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Artificial intelligence platforms can be used as a tool to create hand surgery PEMs at the recommended sixth-grade reading level. Future efforts are needed to ensure the accuracy of AI-generated PEMs and accessibility to patients of varying health literacy for informed decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447261478323","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T10:31:47Z","timestamp":1791455507000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Analysis of Readability Levels of Hand Surgery Patient Information on the ASSH Website and Artificial Intelligence"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7401-9542","authenticated-orcid":false,"given":"Neha R.","family":"Momin","sequence":"first","affiliation":[{"name":"The University of Texas Medical Branch, Galveston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5780-6301","authenticated-orcid":false,"given":"Rosevine A.","family":"Azap","sequence":"additional","affiliation":[{"name":"The University of Texas Medical Branch, Galveston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1316-2509","authenticated-orcid":false,"given":"Zainab","family":"Yousaf","sequence":"additional","affiliation":[{"name":"The University of Texas Medical Branch, Galveston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Addi","family":"Moya","sequence":"additional","affiliation":[{"name":"The University of Texas Medical Branch, Galveston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0188-1933","authenticated-orcid":false,"given":"Daniel P.","family":"Donato","sequence":"additional","affiliation":[{"name":"The University of Texas Medical Branch, Galveston, USA"}],"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":"10.1097\/QMH.0000000000000162"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-08527-9"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-2-201107190-00005"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-021-00648-7"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfx293"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.48.3.151"},{"key":"e_1_3_3_8_2","volume-title":"Teaching Patients with Low Literacy Skills","author":"Doak CC","year":"1985","unstructured":"Doak CC, Doak LG, Root JH. 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