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TRUVACE RECORD VERSION
record: TRV-2026-1734
version: 1
kind: certified
reason: Certified into the record
timestamp: 2026-10-17T22:01:08.873290Z
status: published
lens: trace
sector: health
headline: Comparative Analysis of Readability Levels of Hand Surgery Patient Information on the ASSH Website and Artificial Intelligence
dek: Background The American Medical Association (AMA) recommends patient education materials (PEMs) be written at a sixth-grade level to ensure accessibility. This study aims to compare hand surgery topics from the American Society for Surgery of the Hand (ASSH) website and artificial intelligence (AI)-generated PEMs to evaluate their alignment with the AMA's recommendations. Methods Ninety-eight hand surgery topics from the ASSH Hand Care "The Upper Extremity Expert" website were analyzed. Artificial intelligence (…
gain_title: When asked to target a sixth-grade level, Gemini 2.0 Flash and ChatGPT-4 produced hand surgery patient materials that were easier to read and shorter than the original ASSH website content.
problem_title: Default AI-generated patient materials and the existing ASSH materials were written above the recommended sixth-grade level, with AI's initial output at college level, which limits accessibility for patients.
trace_subject: Readability of hand surgery patient education materials from the ASSH website versus AI-generated versions
gain_reading: When asked to target a sixth-grade level, Gemini 2.0 Flash and ChatGPT-4 produced hand surgery patient materials that were easier to read and shorter than the original ASSH website content.
gain_evidence: AI-generated PEMs at a sixth-grade readability had lower word counts, higher FRE, and lower FKGL than original ASSH PEMs | Artificial intelligence platforms can be used as a tool to create hand surgery PEMs at the recommended sixth-grade reading level
problem_reading: Default AI-generated patient materials and the existing ASSH materials were written above the recommended sixth-grade level, with AI's initial output at college level, which limits accessibility for patients.
problem_evidence: The ASSH website and AI-generated PEMs initially exceeded the sixth-grade readability level | Google Gemini and ChatGPT's initial PEMs were at the college level
quick_read: Researchers analyzed 98 hand surgery topics from the American Society for Surgery of the Hand patient website and compared them with materials generated by Google Gemini 2.0 Flash and ChatGPT-4. The AI tools were asked to write new materials, rewrite the ASSH topics at a sixth-grade level, and write new materials at that level, with readability scored using Flesch measures.

The findings matter because patient materials that are too hard to read can undermine informed decision-making, and the American Medical Association recommends a sixth-grade level. The study shows AI can lower reading difficulty when prompted, but the authors say the accuracy of AI-written content and its fit for patients with varying health literacy still need to be established.
limitation: The study measured readability only, and the authors state that the accuracy of AI-generated patient materials and their accessibility to patients with varying health literacy still need to be ensured.
tag: Dual reading
key_points: The original ASSH materials ranged from 10th to 12th-grade readability, with a mean FKGL of 9.4. | Without a reading-level instruction, Gemini and ChatGPT outputs were at college level, with mean FKGL scores of 9.6 and 10.4. | AI-rewritten ASSH content showed improved readability compared with the originals. | AI materials created at a sixth-grade target had fewer words and better Flesch scores than the ASSH originals. | The authors call for future work on the accuracy of AI-generated materials and on accessibility for patients with varying health literacy.
rundown: The study used the ASSH Hand Care website, called The Upper Extremity Expert, as its baseline. Its 98 topics were scored with Flesch Reading Ease and Flesch-Kincaid Grade Level, and the original materials averaged an FRE of 57.5 and an FKGL of 9.4.

Three prompt conditions were tested on both AI platforms: creating original materials from ASSH topics, rewriting ASSH topics at a sixth-grade level, and creating original materials at a sixth-grade level. Initial Gemini output averaged an FRE of 49.7 and an FKGL of 9.6, while ChatGPT averaged an FRE of 47.4 and an FKGL of 10.4.

The authors conclude that AI can serve as a tool for producing hand surgery patient materials at the recommended level, while stressing that the accuracy of such materials must be ensured.
sources:
- peer_reviewed | HAND | https://doi.org/10.1177/15589447261478323 | 2026-10-08
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