{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:03:45Z","timestamp":1789625025386,"version":"build-2803163510"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"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. Reprod. Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bacterial vaginosis (BV) concerns involve intimate symptoms, stigma, diagnostic uncertainty, medication use, pregnancy, sexual health, and self-care. Publicly accessible generative artificial intelligence chatbots offer immediate and potentially non-judgmental information, but the quality and safety of specific responses remain uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare five publicly accessible generative AI chatbot interfaces using standardized, researcher-developed patient-oriented questions about BV. In this study, patient-oriented denotes consumer-facing wording and does not imply direct patient derivation or validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty-one standardized English-language questions were submitted once to ChatGPT, Gemini, Microsoft Copilot, DeepSeek, and Doubao in separate single-turn sessions, yielding 305 responses. Five senior obstetrician-gynecologists independently evaluated safety, accuracy, study-specific guideline-anchored concordance, and empathy using a question-specific reference framework. Independent ratings were locked before adjudication and were used to estimate inter-rater agreement. Consensus scores were used for primary comparisons, and a sensitivity analysis used the median of the five locked ratings. Readability was assessed separately using six formula-based indices. Paired comparisons used Cochran's Q, Friedman, McNemar, and Wilcoxon signed-rank tests with Benjamini-Hochberg adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-one responses (10.2%) were classified as unsafe or potentially unsafe. Observed interface-specific rates ranged from 6.6% (95% CI, 2.6%\u201315.7%) to 14.8% (95% CI, 8.0%\u201325.7%), while the matched binary comparison did not detect an overall difference (Cochran's Q\u2009=\u20092.596, df\u2009=\u20094,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.627). Under the documented query conditions, differences were detected in accuracy (Kendall's W\u2009=\u20090.686), study-specific guideline-anchored concordance (W\u2009=\u20090.243), empathy (W\u2009=\u20090.322), and all six readability indices (W range, 0.482\u20130.679; all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The sensitivity analysis produced the same inferential conclusions. Unsafe content occurred in every interface and was concentrated in recurrent-BV, sexual-health, medication, and self-care scenarios.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This exploratory study characterizes a recorded sample of specific chatbot responses, not stable or repeatable performance characteristics. Clinically relevant risks were observed in every interface, and the non-significant safety comparison should not be interpreted as equivalence. Because each researcher-developed prompt was submitted once and the interfaces were queried on different dates in a fixed order, the findings do not establish a stable ranking of underlying model capability, clinical effectiveness, or suitability for unsupervised care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frph.2026.1967818","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:32:11Z","timestamp":1789623131000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A comparative cross-sectional evaluation of generative AI chatbots for patient-oriented bacterial vaginosis health advice: safety, accuracy, guideline concordance, empathy, and readability"],"prefix":"10.3389","volume":"8","author":[{"given":"Ling","family":"Miao","sequence":"first","affiliation":[{"name":"Department of Gynecology, Nanquan Branch, Xuelang Subdistrict Community Health Service Center","place":["Wuxi, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University","place":["Wuxi, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaole","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Mudanjiang Second People's Hospital","place":["Mudanjiang, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengfeng","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University","place":["Wuxi, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University","place":["Wuxi, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.rr7004a1","article-title":"Sexually transmitted infections treatment guidelines, 2021","volume":"70","author":"Workowski","year":"2021","journal-title":"MMWR Recomm Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/j.mayocp.2021.09.022","article-title":"Evaluation and management of vaginitis","volume":"97","author":"Marnach","year":"2022","journal-title":"Mayo Clin Proc"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1100029","DOI":"10.3389\/frph.2023.1100029","article-title":"Bacterial vaginosis: a review of approaches to treatment and prevention","volume":"5","author":"Abbe","year":"2023","journal-title":"Front Reprod Health"},{"key":"B4","doi-asserted-by":"publisher","first-page":"S144","DOI":"10.1093\/cid\/ciac021","article-title":"Diagnosis and management of bacterial vaginosis: summary of evidence and practical considerations","volume":"74","author":"Muzny","year":"2022","journal-title":"Clin Infect Dis"},{"key":"B5","doi-asserted-by":"publisher","first-page":"978","DOI":"10.3390\/antibiotics10080978","article-title":"Comparative effectiveness of treatments for bacterial vaginosis: a network meta-analysis","volume":"10","author":"Munoz-Barreno","year":"2021","journal-title":"Antibiotics (Basel)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"938838","DOI":"10.3389\/fnut.2022.938838","article-title":"Probiotics, a promising therapy to reduce the recurrence of bacterial vaginosis in women? 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