{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:59:04Z","timestamp":1786737544167,"version":"build-2736575974"},"reference-count":33,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Peer-reviewed medical literature consistently violates established health literacy readability targets, creating a gap that effectively excludes patients and caregivers from accessing evidence-based information.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate whether a large language model (LLM) can generate plain-language summaries of pediatric strabismus literature while preserving clinical fidelity and meeting established health literacy readability targets.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This cross-sectional study analyzed 85 open access, peer-reviewed pediatric strabismus articles published between 2022 and 2025, stratified by strabismus subtype, surgical relevance, and publication type. Full-text articles were processed using DeepSeek-V3 (DeepSeek) via a structured prompt, which instructed the model to provide a simplified summary meeting the following requirements for each article: a seventh-grade or lower reading level, a maximum length of 800 words, and strict preservation of medically significant data. Primary outcomes were readability scores measured by the Flesch-Kincaid Grade Level (FKGL) and Simple Measure of Gobbledygook (SMOG) indices. Secondary outcomes included clinical fidelity, which was independently assessed by 2 fellowship-trained pediatric strabismus specialists.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Baseline articles demonstrated a mean FKGL score of 15.79 (SD 1.53) and a mean SMOG score of 14.41 (SD 1.09). Following LLM simplification, the mean FKGL score significantly decreased from 15.79 (SD 1.53) to 7.84 (SD 1.30), representing a mean difference of 7.95 (95% CI 7.52-8.38;\n P<\/jats:italic>\n <.001). Similarly, the mean SMOG score decreased from 14.41 (SD 1.09) to 7.68 (SD 0.94), representing a mean difference of 6.73 (95% CI 6.42-7.04;\n P<\/jats:italic>\n <.001). Postsimplification readability did not differ significantly by strabismus subtype or surgical relevance (all adjusted\n P<\/jats:italic>\n >.05). However, case reports retained slightly higher FKGL scores (mean 8.35, SD 0.89) compared to reviews (mean 7.89, SD 1.37) and original research (mean 7.48, SD 1.40) (adjusted\n P<\/jats:italic>\n =.003). Out of the 85 summaries, clinical fidelity was rated good in 81 (95.29%), moderate in 4 (4.71%; these were exclusively summaries of review articles), and poor in 0 (0%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n DeepSeek-V3 effectively reduced the reading level of complex pediatric strabismus literature by approximately 8 grade levels, achieving National Institutes of Health\u2013recommended eighth-grade or lower targets without compromising clinical accuracy. When integrated with clinician oversight, LLM-generated summaries offer a scalable, equitable tool to enhance health literacy and support shared decision-making for patients and caregivers.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/91572","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T18:55:45Z","timestamp":1786733745000},"page":"e91572-e91572","source":"Crossref","is-referenced-by-count":0,"title":["Large Language Model Simplification of Open Access Pediatric Strabismus Literature: Cross-Sectional Validation of Readability and Clinical Fidelity"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3375-535X","authenticated-orcid":false,"given":"Mingming","family":"Jiang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5007-5485","authenticated-orcid":false,"given":"Mingming","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7309-2191","authenticated-orcid":false,"given":"Xiaomei","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5277-8602","authenticated-orcid":false,"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"issue":"6","key":"R1","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1542\/pir.2018-0027","article-title":"Health literacy: implications for child health","volume":"40","author":"Morrison","journal-title":"Pediatr Rev"},{"key":"R2","unstructured":"Weiss BD . 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