{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:15:47Z","timestamp":1788419747577,"version":"build-2803163510"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Large language models (LLMs) are increasingly used for caregiver-facing health information, but their reliability in Chinese-language pediatric orthopaedics remains uncertain. This study evaluated whether responses to developmental dysplasia of the hip (DDH) questions were clinically accurate, aligned with Chinese guidance, and educationally usable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared ChatGPT-4o and DeepSeek-R1 using 53 Chinese-language DDH questions, including 31 caregiver-oriented frequently asked questions and 22 guideline-derived items. Each model generated one response per question using a standardized single-turn, five-sentence prompt. Six blinded pediatric orthopaedic surgeons rated clinical accuracy and guideline concordance. Paired model comparisons, inter-rater reliability, and exploratory formula-based readability were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      DeepSeek-R1 had higher clinical accuracy than ChatGPT-4o across 31 caregiver-oriented questions (mean question-level score 4.70 [SD 0.15] vs. 3.69 [0.28];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and higher guideline concordance across 22 items (4.44 [0.22] vs. 3.82 [0.33];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Average-rating reliability was good for clinical accuracy (ICC(2,6)\u2009=\u20090.826, 95% bootstrap CI 0.770\u22120.863) and moderate for guideline concordance (ICC(2,6)\u2009=\u20090.519, 95% CI 0.377\u22120.621). Formula-based readability findings were mixed: unadjusted tests indicated lower FKGL, FOG, and SMOG values for ChatGPT-4o, but only FOG and SMOG remained statistically significant after Holm adjustment. Surgery-related observations were exploratory and descriptive.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Under the tested single-query and five-sentence conditions, DeepSeek-R1 achieved higher expert-rated clinical accuracy and Chinese-guideline concordance. The findings describe specific model-platform configurations rather than a permanent model ranking. Professionally reviewed LLM responses may help clinicians reinforce routine DDH education, but individualized diagnostic and treatment guidance, especially for surgery-related questions, should remain clinician-led. Caregivers should use chatbot information only as a supplementary resource.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1919701","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:43:59Z","timestamp":1788417839000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing Chinese-language large language models for caregiver questions about developmental dysplasia of the hip"],"prefix":"10.3389","volume":"14","author":[{"given":"Fangyuan","family":"Wang","sequence":"first","affiliation":[{"name":"Xiangya School of Nursing, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianhong","family":"Li","sequence":"additional","affiliation":[{"name":"Xiangya School of Nursing, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinghui","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaqi","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhui","family":"Xie","sequence":"additional","affiliation":[{"name":"Hospital Administration Office, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e47479","DOI":"10.2196\/47479","article-title":"Reliability of medical information provided by ChatGPT: assessment against clinical guidelines and patient information quality instrument","volume":"25","author":"Walker","year":"2023","journal-title":"J Med Internet Res"},{"key":"B2","doi-asserted-by":"publisher","first-page":"102048","DOI":"10.1016\/j.cpcardiol.2023.102048","article-title":"Large language model-based chatbot as a source of advice on first aid in heart attack","volume":"49","author":"Birkun","year":"2024","journal-title":"Curr Probl Cardiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1007\/s10916-023-02019-x","article-title":"\u201cChatGPT, can you help me save my child's Life?\u201d Diagnostic accuracy and supportive capabilities to lay rescuers by ChatGPT in prehospital basic life support and paediatric advanced life support cases: an in-silico analysis","volume":"47","author":"Bushuven","year":"2023","journal-title":"J Med Syst"},{"key":"B4","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1186\/s12911-024-02824-5","article-title":"Assessing the accuracy and quality of artificial intelligence chatbot-generated responses in making patient-specific drug-therapy and healthcare-related decisions","volume":"24","author":"Shiferaw","year":"2024","journal-title":"BMC Med Inform Decis Mak"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e002080","DOI":"10.1136\/bmjpo-2023-002080","article-title":"Prevalence of developmental dysplasia of the hip (DDH) in infants: a systematic review and meta-analysis","volume":"7","author":"Tao","year":"2023","journal-title":"BMJ Paediatr Open"},{"key":"B6","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1097\/PEP.0000000000000917","article-title":"A survey of parents' and carers' perceptions of parenting a child with developmental dysplasia of the hip","volume":"34","author":"Harry","year":"2022","journal-title":"Pediatr Phys Ther"},{"key":"B7","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1177\/18632521241310318","article-title":"What are patients asking and reading online? 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