{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:05:54Z","timestamp":1787162754474,"version":"build-2736575974"},"reference-count":54,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002839","name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002839","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/001w7jn25","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017268","name":"Berlin Institute of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100017268","id-type":"DOI","asserted-by":"crossref"}]},{"name":"German Research Society","award":["SFB-1444"],"award-info":[{"award-number":["SFB-1444"]}]},{"name":"German Research Society","award":["P15"],"award-info":[{"award-number":["P15"]}]},{"name":"German Research Society","award":["FOR5177"],"award-info":[{"award-number":["FOR5177"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: ChatGPT is a large language model (LLM) online chatbot developed by OpenAI and launched in November 2022. Early adoption studies have shown high readiness to use this technology for health-related questions and self-diagnosis. However, the quality and clinical adequacy of health-related responses remain incompletely characterized. This study aimed to explore responses generated by ChatGPT-3.5 and ChatGPT-4.0 to common patient questions regarding scoliosis. Methods: Ten scoliosis-related frequently asked questions (FAQs) were selected from a larger pool of over 250 patient-facing questions compiled from 17 publicly available FAQ webpages and informed by a Google Trends analysis. Questions were harmonized, grouped by theme, and then reduced by rule-based expert review to a final set intended to represent common patient concerns. Results: The median ratings of ChatGPT-3.5 and ChatGPT-4.0 responses ranged from satisfactory, requiring minimal (2) to moderate clarification (3). Across the ten matched questions, no statistically detectable difference was found between models in this study setting (W = 8.0, p = 0.59; Cliff\u2019s \u03b4 = \u22120.12 [95% CI \u22120.58, 0.40]); however, given the small question set, unblinded rating process, and poor inter-rater reliability, this should not be interpreted as evidence of equivalence, non-inferiority, or comparable model performance. The results apply only to the 10\u201315 April 2024, online snapshots of ChatGPT-3.5 and ChatGPT-4.0 and should not be generalized to later model iterations. Conclusions: This study should be interpreted as a clinically oriented observational report, intended to inform physician awareness and patient-physician communication rather than validate chatbot accuracy or safety. In this 10\u201315 April 2024, sample, both model outputs frequently required clinician clarification. Given the small FAQ set, low inter-rater reliability, unblinded design, and single-sample outputs, the findings do not establish equivalence or superiority and apply only to the specific 10\u201315 April 2024, model snapshots and evaluated questions.<\/jats:p>","DOI":"10.3390\/jpm16040206","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T08:09:00Z","timestamp":1775549340000},"page":"206","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["An Assessment of GPT-3.5 and GPT-4.0 Responses to Scoliosis FAQs"],"prefix":"10.3390","volume":"16","author":[{"given":"Tu-Lan","family":"Vu-Han","sequence":"first","affiliation":[{"name":"Center for Musculoskeletal Surgery (CMSC), Campus Mitte, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Charit\u00e9platz 1, 13353 Berlin, Germany"},{"name":"Berlin Institute of Health at Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, BIH Biomedical Innovation Academy, Charit\u00e9platz 1, 10117 Berlin, Germany"},{"name":"Explainable AI for Biology, Zuse Institute Berlin, Takustra\u00dfe 7, 14195 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7454-9658","authenticated-orcid":false,"given":"Enik\u00f6","family":"Reg\u00e9nyi","sequence":"additional","affiliation":[{"name":"Explainable AI for Biology, Zuse Institute Berlin, Takustra\u00dfe 7, 14195 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram","family":"Sunkara","sequence":"additional","affiliation":[{"name":"Explainable AI for Biology, Zuse Institute Berlin, Takustra\u00dfe 7, 14195 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7473-6553","authenticated-orcid":false,"given":"Paul","family":"K\u00f6hli","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal Surgery (CMSC), Campus Mitte, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Charit\u00e9platz 1, 13353 Berlin, Germany"},{"name":"Berlin Institute of Health at Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, BIH Biomedical Innovation Academy, Charit\u00e9platz 1, 10117 Berlin, Germany"},{"name":"Department of Orthopaedic Spine Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9224-7363","authenticated-orcid":false,"given":"Friederike","family":"Sch\u00f6mig","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal Surgery (CMSC), Campus Mitte, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Charit\u00e9platz 1, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander P.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Spine Surgery, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8686-0021","authenticated-orcid":false,"given":"Michael","family":"Putzier","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal Surgery (CMSC), Campus Mitte, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Charit\u00e9platz 1, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0885-7370","authenticated-orcid":false,"given":"Matthias","family":"Pumberger","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal Surgery (CMSC), Campus Mitte, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Charit\u00e9platz 1, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilo","family":"Khakzad","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal Surgery (CMSC), Campus Mitte, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Charit\u00e9platz 1, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e45312","DOI":"10.2196\/45312","article-title":"How Does ChatGPT Perform on the Medical Licensing Exams? 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