Evaluating and Validating Large Language Models for Health Education on Developmental Dysplasia of the Hip: 2-Phase Study With Expert Ratings and a Pilot Randomized Controlled Trial

BACKGROUND: Developmental dysplasia of the hip (DDH) is a common pediatric orthopedic disease, and health education is vital to disease management and rehabilitation. The emergence of large language models (LLMs) has provided new opportunities for health education. However, the effectiveness and applicability of LLMs in education with DDH have not been systematically evaluated. OBJECTIVE: This study conducted an integrated 2-phase evaluation to assess the quality and educational effectiveness of LLM-generated educational materials. METHODS: This study comprised 2 phases. Based on Bloom's taxonomy, a 16-item DDH question bank was created through literature analysis and collaboration. Four LLMs (ChatGPT-4 [OpenAI], DeepSeek-V3, Gemini 2.0 Flash [Google], and Copilot [Microsoft Corp]) were questioned using standardized prompts. All responses were independently evaluated by 5 pediatric orthopedic experts using 5-point Likert measures of accuracy, fluency, and richness, the scales of Patient Education Materials Assessment Tool for Printable Materials, and DISCERN. The readability was measured by a formula. The data were examined using Kruskal-Wallis tests, ANOVA, and post hoc comparisons. In phase 2, an assessor-blinded, 2-arm pilot randomized controlled trial was conducted. A total of 127 caregivers were randomized into an LLM-assisted education group or a web search control group. The intervention included structured LLM training, supervised practice, and 2 weeks of reinforcement training. Measured at baseline, postintervention, and 2 weeks following, the outcomes were eHealth literacy (primary), DDH knowledge, health risk perception, perceived usefulness, information self-efficacy, and health information-seeking behavior. Cohen d effect sizes and linear mixed-effects models were used in an intention-to-treat manner. RESULTS: There were significant differences between the 4 LLMs concerning accuracy, richness, fluency, Patient Education Materials Assessment Tool for Printable Materials Understandability, and DISCERN (P