{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:22:51Z","timestamp":1791249771598,"version":"4.1.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetes-related foot disease requires timely recognition of neuropathic risk, ulceration, infection, ischemia, offloading needs, and recurrence risk. Publicly accessible large language models (LLMs) may provide patient-facing information, but reproducible prompt construction for benchmarking such outputs remains insufficiently characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to develop and apply a domain- and source-balanced prompt framework for benchmarking patient-facing diabetic foot information generated by publicly accessible LLMs under default single-turn public-interface conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 24-item benchmark prompt set was generated using a domain- and source-balanced framework incorporating public-query sources and guideline-derived decision-critical content. Six clinical domains were crossed with four source categories: Google Trends, Baidu Zhidao, a PubMed-indexed Chinese diabetic foot guideline, and PubMed-indexed international diabetic foot guidelines. Each prompt was submitted once to GPT-5.5 Thinking, DeepSeek-V4, Gemini 3.1 Pro, Grok 4.3, and Qwen3.6-Max-Preview, yielding 120 responses. Response quality was assessed using DISCERN, EQIP, and GQS; visible transparency-related features were evaluated using JAMA benchmark criteria; readability was assessed using six formulas; and an exploratory potential clinical-risk flag (PCF) screened for overt short-term harm signals. Formal claim-level factual-accuracy review, guideline-concordance adjudication, and hallucination-frequency analysis were not performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant metric-specific differences were observed across models. Grok 4.3 recorded the highest observed mean DISCERN, EQIP, GQS, and JAMA-based visible transparency-related scores, whereas DeepSeek-V4 showed the lowest observed mean scores for several readability-grade metrics and the highest mean FRES. Visible transparency-related scores remained low across models. No response was rated as PCF 1 or PCF 2. No response met all predefined readability targets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The proposed prompt framework provides a structured basis for public-interface LLM benchmarking in diabetic foot education. Default responses showed metric-specific variation, limited visible transparency, and inadequate readability, and should not be relied upon independently for high-risk diabetic foot decision-making without clinician oversight.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1895366","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T04:20:29Z","timestamp":1784607629000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Patient-facing diabetic foot information from large language models: a domain- and source-balanced prompt framework for public-interface benchmarking"],"prefix":"10.3389","volume":"17","author":[{"given":"Yang","family":"Wen","sequence":"first","affiliation":[{"name":"Department of Lower Extremity and Orthopedic Surgery, Suining Central Hospital","place":["Suining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Medical Department, Suining Central Hospital","place":["Suining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaping","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Lower Extremity and Orthopedic Surgery, Suining Central Hospital","place":["Suining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Lower Extremity and Orthopedic Surgery, Suining Central Hospital","place":["Suining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Lower Extremity and Orthopedic Surgery, Suining Central Hospital","place":["Suining, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2337\/dci22-0043","article-title":"Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers","volume":"46","author":"McDermott","year":"2023","journal-title":"Diabetes Care"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3657","article-title":"Practical guidelines on the prevention and management of diabetes-related foot disease (IWGDF 2023 update)","volume":"40","author":"Schaper","year":"2024","journal-title":"Diabetes Metab Res Rev"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad527","article-title":"IWGDF\/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections (IWGDF\/IDSA 2023)","volume":"40","author":"Senneville","year":"2024","journal-title":"Diabetes Metab Res Rev"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3651","article-title":"Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update)","volume":"40","author":"Bus","year":"2024","journal-title":"Diabetes Metab Res Rev"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/burnst\/tkaf064","article-title":"Practical guidelines for the prevention and management of diabetic foot disease in China","volume":"13","author":"Luo","year":"2025","journal-title":"Burns Trauma"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13694","article-title":"Associations of health literacy with diabetic foot outcomes: a systematic review and meta-analysis","volume":"35","author":"Chen","year":"2018","journal-title":"Diabetes Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/s13047-023-00644-w","article-title":"Health literacy predicts incident foot ulcers after 4 years - 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