Evaluation of large language models in generating and optimizing educational materials for neonatal home oxygen therapy.

Background: Neonatal Home Oxygen Therapy (NHOT) is a critical treatment for premature infants with Bronchopulmonary Dysplasia (BPD). However, existing health education materials are generally difficult to read, particularly for grandparent caregivers with lower educational backgrounds. This study aimed to systematically evaluate the capacity of six major Large Language Models (LLMs) to generate and optimize NHOT health education materials. Methods: Six LLMs were included: ChatGPT-5.1, Claude 4.5 Sonnet, Gemini 2.5 Pro, Grok-4.1, Qwen-3-Max, and DeepSeek-V3.2. Each model generated 20 texts under three prompting strategies-baseline (Prompt A), simplification (Prompt B), and rewriting (Prompt C)-yielding 360 texts in total. Twenty WeChat public health articles served as the human-authored baseline. Subjective evaluation employed C-DISCERN, C-PEMAT (understandability and actionability), and a medical accuracy Likert scale, supplemented by objective linguistic analysis using the Alpha Readability Chinese (ARC) tool. Results: All models demonstrated superior medical accuracy compared to the human baseline (Likert median 1.0, against 2.0 for the original articles). Under baseline conditions, Qwen achieved the highest content quality (C-DISCERN median 57.0), while Claude attained perfect actionability scores. The simplification prompt (Prompt B) significantly reduced C-DISCERN scores across all models (all Conclusion: LLMs demonstrate significant potential for optimizing existing health education materials, performing more reliably in rewriting mode than in