{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:09:51Z","timestamp":1790802591631,"version":"4.1.0"},"reference-count":96,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T00:00:00Z","timestamp":1764979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Large language models (LLMs) show promise for patient education, yet their safety and efficacy for chronic diseases requiring lifelong management remain unclear. This study presents the first comprehensive comparative evaluation of three leading LLMs for celiac disease patient education. Methods: We conducted a cross-sectional evaluation comparing ChatGPT-4, Claude 3.7, and Gemini 2.0 using six blinded clinical specialists (four gastroenterologists and two dietitians). Twenty questions spanning four domains (general understanding, symptoms\/diagnosis, diet\/nutrition, lifestyle management) were evaluated for scientific accuracy, clarity (5-point Likert scales), misinformation presence, and readability using validated computational metrics (Flesch Reading Ease, Flesch-Kincaid Grade Level, SMOG index). Results: Gemini 2.0 demonstrated superior performance across multiple dimensions. Gemini 2.0 achieved the highest scientific accuracy ratings (median 4.5 [IQR: 4.5\u20135.0] vs. 4.0 [IQR: 4.0\u20134.5] for both competitors, p = 0.015) and clarity scores (median 5.0 [IQR: 4.5\u20135.0] vs. 4.0 [IQR: 4.0\u20134.5], p = 0.011). While Gemini 2.0 showed numerically lower misinformation rates (13.3% vs. 23.3% for ChatGPT\u20134 and 24.2% for Claude 3.7), differences were not statistically significant (p = 0.778). Gemini 2.0 achieved significantly superior readability, requiring approximately 2\u20133 fewer years of education for comprehension (median Flesch-Kincaid Grade Level 9.8 [IQR: 8.8\u201310.3] vs. 12.5 for both competitors, p &lt; 0.001). However, all models exceeded recommended 6th\u20138th grade health literacy targets. Conclusions: While Gemini 2.0 demonstrated statistically significant advantages in accuracy, clarity, and readability, misinformation rates of 13.3\u201324.2% across all models represent concerning risk levels for direct patient applications. AI offers valuable educational support but requires healthcare provider supervision until misinformation rates improve.<\/jats:p>","DOI":"10.3390\/nu17243828","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T09:17:36Z","timestamp":1765185456000},"page":"3828","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy of Large Language Models in Providing Evidence-Based Patient Education for Celiac Disease: A Comparative Analysis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9816-4171","authenticated-orcid":false,"given":"Luisa","family":"Bertin","sequence":"first","affiliation":[{"name":"Department of Surgery, Oncology, Gastroenterology, University of Padua, 35128 Padua, Italy"},{"name":"Gastroenterology Unit, Azienda Ospedale-Universit\u00e0 Padova, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9217-8241","authenticated-orcid":false,"given":"Federica","family":"Branchi","sequence":"additional","affiliation":[{"name":"Medizinische Klinik F\u00fcr Gastroenterologie, Infektiologie und Rheumatologie, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, 12203 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7426-1145","authenticated-orcid":false,"given":"Carolina","family":"Ciacci","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne R.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, Celiac Disease Center, Columbia University Medical Center, Columbia University, New York, NY 10032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Sanders","sequence":"additional","affiliation":[{"name":"Gastroenterology and Liver Unit, Royal Hallamshire Hospital, Sheffield S5 7AU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Trott","sequence":"additional","affiliation":[{"name":"Gastroenterology and Liver Unit, Royal Hallamshire Hospital, Sheffield S5 7AU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1133-1502","authenticated-orcid":false,"given":"Fabiana","family":"Zingone","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology, Gastroenterology, University of Padua, 35128 Padua, Italy"},{"name":"Gastroenterology Unit, Azienda Ospedale-Universit\u00e0 Padova, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Reddy, K., and Paulus, Y.M. 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