Comparative evaluation of traditional versus generative AI patient education material on prehabilitation

BACKGROUND: Effective patient education materials on prehabilitation are essential for optimising patients before surgery. With the growing use of generative artificial intelligence (AI) chatbots in health care communication, it is important to evaluate their suitability compared with established human-generated resources. We aimed to compare patient education materials on prehabilitation, generated by artificial intelligence chatbots (ChatGPT-4o, Gemini 2.5, and DeepSeek V3) with a National Health Service leaflet, assessing factual accuracy, readability, and emotional tone. METHODS: A comparative observational study design was used. All four patient education materials were blinded and evaluated by ten experts using a 10-point Likert-type scale. Readability was assessed using the Flesch Reading Ease and the Flesch-Kincaid Grade Level. Sentiment analysis was done using an online tool. Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) scores were calculated. RESULTS: National Health Service patient education material showed the highest mean ± SD accuracy scores 9.8 ± 0.3 from experts outperforming all artificial intelligence models (p = 0.000). Among artificial intelligence, Gemini scored highest. For readability, ChatGPT and the National Health Service were comparable. Sentiment analysis showed varying tones across all models. Patient Education Materials Assessment Tool for Printable Materials scores showed high understandability across all patient education materials (>75%), but actionability was highest for the National Health Service (93.3%). CONCLUSION: Artificial intelligence chatbots can generate readable and promising patient education materials. Traditional materials remain superior in accuracy and completeness. A hybrid 'human-in-the-loop' approach is recommended for effective patient education.