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Enhancing Patient Understanding of Perianal Fistula MRI Findings Using ChatGPT: A Randomized, Single Centre Study

Title: Enhancing Patient Understanding of Perianal Fistula MRI Findings Using ChatGPT: A Randomized, Single Centre Study
Authors: Anand, Easan; Ghersin, Itai; Lingam, Gita; Devlin, Katie; Pelly, Theo; Singer, Daniel; Tomlinson, Chris; Munro, Robin EJ; Capstick, Rachel; Antoniou, Anna; Hart, Ailsa L; Tozer, Phil; Sahnan, Kapil; Lung, Phillip
Source: Diagnostics , 16 (1) , Article 72. (2026)
Publisher Information: MDPI AG
Publication Year: 2026
Collection: University College London: UCL Discovery
Subject Terms: artificial intelligence; Crohn’s disease; cryptoglandular fistula; large language models; magnetic resonance imaging; patient communication; perianal fistula
Description: Background/Objectives: Large Language Models (LLMs) may help translate complex Magnetic Resonance Imaging (MRI) fistula reports into accessible, patient-friendly summaries. This study evaluated the clinical utility, safety, and patient acceptability of Generative Pre-trained Transformer (GPT-4o) in generating such reports. / / Methods: A three-phase study was conducted at a single centre. Phase I involved prompt engineering and pilot testing of GPT-4o outputs for feasibility. Phase II assessed 250 consecutive MRI fistula reports from September 2024 to November 2024, each reviewed by a multi-disciplinary panel to determine hallucinations and thematic content. Phase III randomised patients to review either a simple or complex fistula case, each containing an original report and an Artificial Intelligence (AI)-generated summary (order randomised, origin blinded), and rate readability, trustworthiness, usefulness and comprehension. / / Results: Sixteen patients participated in Phase I pilot testing. In Phase II, hallucinations occurred in 11% of outputs, with unverified recommendations also identified. In Phase III, 61 patients (mean age 48, 41% female) evaluated paired original and AI-generated summaries. AI summaries scored significantly higher for readability, comprehension, and usefulness than original reports (all p < 0.001), with equivalent trust ratings. Mean Flesch-Kincaid scores were markedly higher for AI-generated summaries (66 vs. 26; p < 0.001). Clinicians highlighted improved anatomical structuring and accessible language, but emphasised risks of inaccuracies. A revised template incorporating Multi-Disciplinary Team (MDT)-focused action points and a lay summary section was co-developed. / / Conclusions: LLMs can enhance the readability and patient understanding of complex MRI reports but remain limited by hallucinations and inconsistent terminology. Safe implementation requires structured oversight, domain-specific refinement, and clinician validation. Future development should prioritise ...
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: https://discovery.ucl.ac.uk/id/eprint/10219498/
Availability: https://discovery.ucl.ac.uk/id/eprint/10219498/1/diagnostics-16-00072.pdf; https://discovery.ucl.ac.uk/id/eprint/10219498/
Rights: open
Accession Number: edsbas.8B6DEB3D
Database: BASE