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Development and Validation of a Large Language Model-Powered Chatbot for Neurosurgery: Mixed Methods Study on Enhancing Perioperative Patient Education

Ho CM, Guan S, Mok PK, Lam CH, Ho WY, Mak CH, Qin H, Wong AKC et al.

Journal of medical Internet research, 2025

Abstract

BACKGROUND: Perioperative education is crucial for optimizing outcomes in neuroendovascular procedures, where inadequate understanding can heighten patient anxiety and hinder care plan adherence. Current education models, reliant on traditional consultations and printed materials, often lack scalability and personalization. Artificial intelligence (AI)-powered chatbots have demonstrated efficacy in various health care contexts; however, their role in neuroendovascular perioperative support remains underexplored. Given the complexity of neuroendovascular procedures and the need for continuous, tailored patient education, AI chatbots have the potential to offer tailored perioperative guidance to improve patient education in this specialty.

OBJECTIVE: We aimed to develop, validate, and assess NeuroBot, an AI-driven system that uses large language models (LLMs) with retrieval-augmented generation to deliver timely, accurate, and evidence-based responses to patient inquiries in neurosurgery, ultimately improving the effectiveness of patient education.

METHODS: A mixed methods approach was used, consisting of 3 phases. In the first phase, internal validation, we compared the performance of Assistants API, ChatGPT, and Qwen by evaluating their responses to 306 bilingual neuroendovascular-related questions. The accuracy, relevance, and completeness of the responses were evaluated using a Likert scale; statistical analyses included ANOVA and paired t tests. In the second phase,…

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