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TRUVACE RECORD VERSION
record: TRV-2026-2868
version: 1
kind: certified
reason: Certified into the record
timestamp: 2026-11-12T18:02:53.298796Z
status: published
lens: g_space
sector: health
headline: Prompt-dependent readability and accuracy of Generative Pre-trained Transformer-5 thinking responses to breast imaging questions derived from European Society of Breast Imaging patient recommendations
dek: Purpose: Although professional societies provide standardized resources, the reliability of online health content remains inconsistent, particularly as large language models (LLMs) become a growing source of patient information. Therefore, the primary objective of this study was to determine whether patient-focused prompt optimization improves the readability of Generative Pre-trained Transformer-5 (GPT-5) Thinking responses compared with standard prompting while evaluating potential changes in expert-rated fact…
gain_title: In a study of 48 European Society of Breast Imaging questions, a patient-focused prompt made GPT-5 Thinking answers significantly easier to read on all four readability indices (P < 0.001), while radiologist-rated accuracy stayed at 4.52 versus 4.54 out of 5.
problem_title: (none)
trace_subject: (none)
gain_reading: In a study of 48 European Society of Breast Imaging questions, a patient-focused prompt made GPT-5 Thinking answers significantly easier to read on all four readability indices (P < 0.001), while radiologist-rated accuracy stayed at 4.52 versus 4.54 out of 5.
gain_evidence: Prompt 2 produced significantly lower readability levels than Prompt 1 across all indices (P < 0.001). | The mean accuracy scores remained high and comparable between prompts for all questions (4.54 ± 0.63 vs. 4.52 ± 0.59, P = 0.75).
problem_reading: (none)
problem_evidence: (none)
quick_read: Researchers asked GPT-5 Thinking 48 questions drawn from European Society of Breast Imaging patient materials, 15 FAQs and 33 special information note questions, under a standard prompt and a patient-focused prompt, producing 96 responses. The patient-focused prompt gave significantly lower reading levels on every readability index (P < 0.001).

Answer length did not explain the change: word count (P = 0.12) and sentence count (P = 0.63) did not differ significantly between prompts. Two radiologists scored accuracy on a 5-point scale, giving mean scores of 4.54 for the standard prompt and 4.52 for the patient-focused one (P = 0.75).

The authors call it a simple, low-cost prompt modification for patient education in breast imaging. Even with the change, the reading grade level stayed above widely recommended patient-education thresholds, and it is not yet known whether easier text improves patient comprehension.
limitation: The resulting reading grade level remained above widely recommended patient-education thresholds, and the study did not test whether the easier text improves patient comprehension.
tag: Evidence-backed gain
key_points: The study covered 48 questions: 15 FAQs and 33 questions derived from special information notes, all from European Society of Breast Imaging educational materials. | Each question was answered under two prompts, giving 96 GPT-5 Thinking responses, all generated prospectively in January 2026. | Readability was measured with four indices, averaged into a composite reading grade level. | Patient-focused prompting lowered reading level across all indices (P < 0.001). | Word count (P = 0.12) and sentence count (P = 0.63) did not differ significantly between the two prompts. | Two radiologists rated accuracy on a 5-point Likert scale: 4.54 ± 0.63 versus 4.52 ± 0.59 (P = 0.75). | Inter-rater agreement was almost perfect, with κ = 0.82 for FAQs and 0.81 for special information note questions.
rundown: The study tested whether a patient-focused prompt could make GPT-5 Thinking responses easier to read than a standard prompt, using European Society of Breast Imaging materials as the source of questions. All outputs were generated prospectively in January 2026.

Readability was scored with four indices combined into an averaged composite reading grade level. Two radiologists scored accuracy on a 5-point Likert scale, and their agreement was almost perfect (κ = 0.82 for FAQs, 0.81 for special information note questions).

The patient-focused prompt significantly lowered reading level on all indices (P < 0.001) without significant changes in word or sentence count. Mean accuracy was 4.54 ± 0.63 under the standard prompt and 4.52 ± 0.59 under the patient-focused prompt (P = 0.75).

The authors conclude the approach produces more accessible breast imaging content but note the resulting grade level remained above recommended patient-education thresholds. They say further work is needed to confirm that it improves patient comprehension.
sources:
- peer_reviewed | Diagnostic and Interventional Radiology | https://doi.org/10.4274/dir.2026.264309 | 2026-11-12
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