Exploring Patient Perspectives, Engagement, and Output Quality in Doctor-Supervised Use of Artificial Intelligence During Informed Consent Consultation With ChatGPT and Retrieval Augmented Generation (RAG): Quantitative Exploratory Study
Abstract
BACKGROUND: Comprehensive preoperative education is essential for optimizing outcomes and ensuring informed consent in patients undergoing total hip arthroplasty (THA). Emerging artificial intelligence (AI) tools, such as ChatGPT, offer scalable support for patient education, but their clinical application requires rigorous evaluation to ensure accuracy, safety, and trust.
OBJECTIVE: This study assessed patients' preferences and satisfaction with AI-assisted informed consent in THA, comparing traditional physician consultations to those supported by native ChatGPT and a customized version enhanced with retrieval-augmented generation (RAG). It also examined how state anxiety and general attitudes toward AI affect preferences for AI-supported consent and whether RAG integration improves ChatGPT response quality.
METHODS: A total of 36 patients scheduled for elective THA were assigned to one of three groups (12 each): (1) standard physician-only consultations (control), (2) physician-assisted consultations supported by native ChatGPT, and (3) supported by ChatGPT enhanced through RAG. Data collection involved standardized Likert scale questionnaires assessing patient satisfaction with the consent process, perceived informedness, anxiety levels, and attitudes toward AI. The ChatGPT responses were independently evaluated by physicians for relevance, accuracy, clarity, completeness, adherence to evidence-based guidelines, and appropriate length. Instances of hallucinations,…
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