Surgeon, Trainee, or GPT? A Blinded Multicentric Study of AI-Augmented Operative Notes.

Journal: The Laryngoscope
Published Date:

Abstract

OBJECTIVES: Clear, complete operative documentation is essential for surgical safety, continuity of care, and medico-legal standards. Large language models such as ChatGPT offer promise for automating clinical documentation; however, their performance in operative note generation, particularly in surgical subspecialties, remains underexplored. This study aimed to compare the quality, accuracy, and efficiency of operative notes authored by a surgical resident, attending surgeon, GPT alone, and an attending surgeon using GPT as a writing aid. METHODS: Five publicly available otolaryngologic procedures were selected. For each procedure, four operative notes were generated, one by a resident, one by an attending, one by GPT alone, and one by a hybrid of attending plus GPT. Ten blinded otolaryngologists (five residents, five attendings) independently reviewed all 20 notes. Reviewers scored each note across eight domains using a five-point scale, assigned a final approval rating, and provided qualitative feedback. Writing time was recorded to assess documentation efficiency. RESULTS: Hybrid notes written by an attending surgeon with GPT assistance received the highest average domain scores and the highest "as is" approval rate (79%), outperforming all other groups. GPT-only notes were the fastest to generate but had the lowest approval rate (23%) and the highest incidence of both omissions and overdocumentation. Writing time was significantly reduced in both AI-assisted groups compared to human-only authorship. Inter-rater reliability among reviewers was moderate to high across most domains. CONCLUSION: In this limited dataset, hybrid human-AI collaboration outperformed both human-only and AI-only authorship in operative documentation. These findings support GPT-assisted documentation to improve operative note efficiency and consistency. LEVEL OF EVIDENCE: N/A.

Authors

  • Sholem Hack
    St. Georges University London School of Medicine, Program Delivered by University of Nicosia at The Chaim Sheba Medical Center, Ramat Gan, Israel. [email protected].
  • Rebecca Attal
    St. Georges University London School of Medicine, Program Delivered by University of Nicosia, London, UK.
  • Giacomo Locatelli
    Otolaryngology Unit, Santi Paolo E Carlo Hospital, Department of Health Sciences, Università Degli Studi Di Milano, Milan, Italy.
  • Gianluca Scotta
    Department of Otolaryngology, Sheffield Teaching Hospitals, Sheffield, UK.
  • Antonino Maniaci
    GOS, Young Otolaryngologists Group of the Italian Society of Otorhinolaryngology-Head and Neck Surgery, Rome, Italy.
  • Federica Maria Parisi
    Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, University of Catania, Via S. Sofia, 78, 95125 Catania, Italy.
  • Nicolien van der Poel
    Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.
  • Margot Van Daele
    Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.
  • Ainhoa Garcia-Lliberos
    Department of Otolaryngology, Valencia University General Hospital, Valencia, Spain.
  • Cristina Rodriguez-Prado
    Department of Otolaryngology, Valencia University General Hospital, Valencia, Spain.
  • Carlos Miguel Chiesa-Estomba
    Osakidetza, Donostia University Hospital, Department of Otorhinolaryngology, San Sebastian, Spain; Biodonostia Health Research Institute, San Sebastian, Spain. Electronic address: [email protected].
  • Maider Andueza-Guembe
    Department of Otorhinolaryngology, Biodonostia Research Institute, Osakidetza, Donostia University Hospital, San Sebastian, Spain.
  • Pollara Cobb
    Division of Otolaryngology-Head and Neck Surgery, Children's National Hospital, Washington, District of Columbia, USA.
  • Habib G Zalzal
    Division of Otolaryngology-Head and Neck Surgery Children's National Hospital Washington District of Columbia USA.
  • Alberto Maria Saibene
    Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.

Keywords

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