Leveraging artificial intelligence to decipher gynecologic cytopathology reports: Insights from an exploratory study for possible use in patient portals.

BACKGROUND: The 21st Century Cures Act allows patients to have immediate access to their medical records. However, it is documented that health literacy levels in patient portal users vary, and results shared with patients may require further explanation. The objective of this exploratory study was to evaluate if an artificial intelligence (AI) chatbot assistant (ChatGPT; Open AI, Inc.) may be used to simplify gynecologic cytopathology reports for patients. The authors also assessed pathologists' opinions on the quality of simplified pathology reports generated with ChatGPT. METHODS: An experienced cytopathologist created 15 unique gynecologic cytopathology reports based on The Bethesda System for Reporting Cervical Cytology. Two cytopathologists evaluated multiple possible prompts to ask ChatGPT for simplified, summarized explanations of cytopathology reports. The two prompts selected for this study were prompt 1 ("Explain this medical report to a child using simple language") and prompt 2 ("What are the most important things I should know from my pathology report?"). Six pathologists received a questionnaire to evaluate factual accuracy, the inclusion of relevant medical information, and potential harm to the patient. They were asked to score each simplified explanation using a five-point Likert scale. Pathologists were also asked to list any missing information and potential physical and/or psychological harm. The scores were tabulated and analyzed. RESULTS: Six board-certified pathologists provided 180 evaluations of ChatGPT's explanations. The vast majority were scored as accurate, factually complete, and not perceived as a possible cause of harm for the patients, especially when using prompt 2. Explanations from ChatGPT for prompt 1 were scored less favorably. CONCLUSIONS: This study provides insight into the field of automated simplification of pathology reports using ChatGPT. With proper prompting, AI chatbots have potential to serve as powerful assistants to patients desiring accurate, simple summaries of their gynecologic cytopathology reports, with minimal or no harm. These findings are based on pathologists' opinions-an indirect measure of patient understanding. Future studies should directly measure patient comprehension and intended follow-up actions to ensure that AI-simplified reports are not only medically accurate but truly patient-centered.