Evidence map›Paper›PMID 40627825›Full record

Observational studyJMIR cardio2025

Improving the Readability of Institutional Heart Failure-Related Patient Education Materials Using GPT-4: Observational Study.

Ryan C King, Jamil S Samaan, Joseph Haquang, Vishnu Bharani, Samuel Margolis, Nitin Srinivasan, Yuxin Peng, Yee Hui Yeo, Roxana Ghashghaei

Abstract readObservational Study
In one paragraph

Observational study in JMIR cardio, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Review
  2. Article
  3. ChatGPT and Gemini in warfarin counseling.Croatian medical journal · 2026
    Article
  4. Article
  5. Article
  6. Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ryan C KingDepartment of Medicine, Division of Cardiology, University of California, Irvine Medical Center, 101 The City Dr S, Orange, CA, 92868, United States, 1 714-456-7890.ORCID http://orcid.org/0000-0003-3479-0365
Jamil S SamaanDepartment of Medicine, Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, United States.ORCID http://orcid.org/0000-0002-6191-2631
Joseph HaquangDepartment of Medicine, Division of Cardiology, University of California, Irvine Medical Center, 101 The City Dr S, Orange, CA, 92868, United States, 1 714-456-7890.ORCID http://orcid.org/0009-0002-2871-0242
Vishnu BharaniDepartment of Medicine, Division of Cardiology, University of California, Irvine Medical Center, 101 The City Dr S, Orange, CA, 92868, United States, 1 714-456-7890.ORCID http://orcid.org/0000-0002-2377-4952
Samuel MargolisDavid Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.ORCID http://orcid.org/0009-0003-0374-2739
Nitin SrinivasanKeck School of Medicine, University of Southern California, Los Angeles, CA, United States.ORCID http://orcid.org/0000-0001-7906-846X
Yuxin PengSchool of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, China.ORCID http://orcid.org/0009-0008-2737-5394
Yee Hui YeoDepartment of Medicine, Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, United States.ORCID http://orcid.org/0000-0002-2703-5954
Roxana GhashghaeiDepartment of Medicine, Division of Cardiology, University of California, Irvine Medical Center, 101 The City Dr S, Orange, CA, 92868, United States, 1 714-456-7890.ORCID http://orcid.org/0000-0002-2588-2631

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Heart failure management involves comprehensive lifestyle modifications such as daily weights, fluid and sodium restriction, and blood pressure monitoring, placing additional responsibility on patients and caregivers, with successful adherence often requiring extensive counseling and understandable patient education materials (PEMs). Prior research has shown PEMs related to cardiovascular disease often exceed the American Medical Association's fifth- to sixth-grade recommended reading level. The large language model (LLM) ChatGPT may be a useful tool for improving PEM readability. Objective: We aim to assess the readability of heart failure-related PEMs from prominent cardiology institutions and evaluate GPT-4's ability to improve these metrics while maintaining accuracy and comprehensiveness. Methods: A total of 143 heart failure-related PEMs were collected from the websites of the top 10 institutions listed on the 2022-2023 US News & World Report for "Best Hospitals for Cardiology, Heart & Vascular Surgery." PEMs were individually entered into GPT-4 (version updated July 20, 2023), preceded by the prompt, "Please explain the following in simpler terms." Readability was assessed using the Flesch Reading Ease score, Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index, Coleman-Liau Index, Simple Measure of Gobbledygook Index, and Automated Readability Index. The accuracy and comprehensiveness of revised GPT-4 PEMs were assessed by a board-certified cardiologist. Results: For 143 institutional heart failure-related PEMs analyzed, the median FKGL was 10.3 (IQR 7.9-13.1; high school sophomore) compared to 7.3 (IQR 6.1-8.5; seventh grade) for GPT-4's revised PEMs (P<.001). Of the 143 institutional PEMs, there were 13 (9.1%) below the sixth-grade reading level, which improved to 33 (23.1%) after revision by GPT-4 (P<.001). No revised GPT-4 PEMs were graded as less accurate or less comprehensive compared to institutional PEMs. A total of 33 (23.1%) GPT-4 PEMs were graded as more comprehensive. Conclusions: GPT-4 significantly improved the readability of institutional heart failure-related PEMs. The model may be a promising adjunct resource in addition to care provided by a licensed health care professional for patients living with heart failure. Further rigorous testing and validation is needed to investigate its safety, efficacy, and impact on patient health literacy.

Indexed as

ComprehensionHealth LiteracyHeart FailurePatient Education as TopicHumansartificial intelligenceChatGPTGPT-4health literacyheart failurelarge language modelspatient educationreadability

Identifiers

PMID40627825
PMCPMC12263092

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.