{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:22:53Z","timestamp":1791249773100,"version":"4.1.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background\/objectives<\/jats:title>\n                    <jats:p>Patients increasingly use large language model (LLM) interfaces for health information, but their safety and quality for public questions about interstitial cystitis\/bladder pain syndrome (IC\/BPS) remain uncertain. This study evaluated the safety, accuracy, empathic communication, information quality, reliability, and readability of five publicly accessible LLM interfaces.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this CHART-guided cross-sectional comparative study, 58 public-facing IC\/BPS questions were submitted once, in English, to ChatGPT, Gemini, Microsoft Copilot, DeepSeek, and Doubao using a standardized single-turn, zero-shot protocol. Three blinded senior urologists independently assessed safety, accuracy, empathic communication, DISCERN, EQIP, JAMA benchmark criteria, and Global Quality Score. Six readability indices were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Inter-rater agreement was significant for all manually assessed metrics. Fleiss\u2019 kappa for safety was 0.822, and ICC(2,1) values for other rater-assessed metrics ranged from 0.761 to 0.848. Unsafe responses occurred in all interfaces, ranging from 5.2% for ChatGPT to 8.6% for DeepSeek and Doubao, without a significant between-interface difference (Cochran\n                      <jats:italic>Q<\/jats:italic>\n                      \u202f=\u202f1.000,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.910). Accuracy and empathic communication differed significantly across interfaces (both\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). ChatGPT had the highest median accuracy score, whereas DeepSeek had the highest empathic communication score. Information-quality and reliability scores also differed significantly (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001); ChatGPT achieved higher DISCERN, EQIP, and GQS scores, while Gemini achieved higher JAMA scores. Readability differed significantly across interfaces, but none met predefined patient-facing readability benchmarks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Publicly accessible LLM interfaces showed domain-specific differences when answering IC\/BPS-related public questions. Unsafe responses were uncommon but present in all interfaces, and no interface consistently outperformed the others. LLM interfaces may support general IC\/BPS education and question preparation but should not replace clinician-led evaluation or individualized medical advice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1942399","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T05:31:18Z","timestamp":1787549478000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Safety, accuracy, empathic communication, information quality, and readability of five large language model interfaces answering public questions about interstitial cystitis\/bladder pain syndrome"],"prefix":"10.3389","volume":"14","author":[{"given":"Jiangtao","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Urology, Kaifeng 155 Hospital, China RongTong Medical Healthcare Group Co., Ltd.","place":["Kaifeng, China"]},{"name":"Kaifeng Minimally Invasive Diagnosis and Treatment Engineering Technology Research Center for Prostate Hyperplasia","place":["Kaifeng, China"]},{"name":"Henan Province Prostate Disease Precision Diagnosis and Treatment Engineering Research Center of Traditional Chinese and Western Medicine","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenhua","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Urology, Maanshan 86 Hospital, China RongTong Medical Healthcare Group Co., Ltd.","place":["Maanshan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Kaifeng 155 Hospital, China RongTong Medical Healthcare Group Co., Ltd.","place":["Kaifeng, China"]},{"name":"Kaifeng Minimally Invasive Diagnosis and Treatment Engineering Technology Research Center for Prostate Hyperplasia","place":["Kaifeng, China"]},{"name":"Henan Province Prostate Disease Precision Diagnosis and Treatment Engineering Research Center of Traditional Chinese and Western Medicine","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Kaifeng 155 Hospital, China RongTong Medical Healthcare Group Co., Ltd.","place":["Kaifeng, China"]},{"name":"Kaifeng Minimally Invasive Diagnosis and Treatment Engineering Technology Research Center for Prostate Hyperplasia","place":["Kaifeng, China"]},{"name":"Henan Province Prostate Disease Precision Diagnosis and Treatment Engineering Research Center of Traditional Chinese and Western Medicine","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Urology, Kaifeng 155 Hospital, China RongTong Medical Healthcare Group Co., Ltd.","place":["Kaifeng, China"]},{"name":"Kaifeng Minimally Invasive Diagnosis and Treatment Engineering Technology Research Center for Prostate Hyperplasia","place":["Kaifeng, China"]},{"name":"Henan Province Prostate Disease Precision Diagnosis and Treatment Engineering Research Center of Traditional Chinese and Western Medicine","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Maanshan 86 Hospital, China RongTong Medical Healthcare Group Co., Ltd.","place":["Maanshan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Urology, Kaifeng 155 Hospital, China RongTong Medical Healthcare Group Co., Ltd.","place":["Kaifeng, China"]},{"name":"Kaifeng Minimally Invasive Diagnosis and Treatment Engineering Technology Research Center for Prostate Hyperplasia","place":["Kaifeng, China"]},{"name":"Henan Province Prostate Disease Precision Diagnosis and Treatment Engineering Research Center of Traditional Chinese and Western Medicine","place":["Kaifeng, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1097\/JU.0000000000002756","article-title":"Diagnosis and treatment of interstitial cystitis\/bladder pain syndrome","volume":"208","author":"Clemens","year":"2022","journal-title":"J Urol"},{"key":"ref2","year":""},{"key":"ref3","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1097\/JU.0000000000003820","article-title":"Urologic chronic pelvic pain syndrome flares: a comprehensive, systematic review and Meta-analysis of the peer-reviewed flare literature","volume":"211","author":"Barker","year":"2024","journal-title":"J Urol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1002\/nau.23421","article-title":"Psychosocial 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