Use of Artificial Intelligence Chatbots in Interpretation of Pathology Reports.

Importance: Anatomic pathology reports are an essential part of health care, containing vital diagnostic and prognostic information. Currently, most patients have access to their test results online. However, the reports are complex and are generally incomprehensible to laypeople. Artificial intelligence chatbots could potentially simplify pathology reports. Objective: To evaluate the ability of large language model chatbots to accurately explain pathology reports to patients. Design, Setting, and Participants: This cross-sectional study used 1134 pathology reports from January 1, 2018, to May 31, 2023, from a multispecialty hospital in Brooklyn, New York. A new chat was started for each report, and both chatbots (Bard [Google Inc], hereinafter chatbot 1; GPT-4 [OpenAI], hereinafter chatbot 2) were asked in sequential prompts to explain the reports in simple terms and identify key information. Chatbot responses were generated between June 1 and August 31, 2023. The mean readability scores of the original and simplified reports were compared. Two reviewers independently screened and flagged reports with potential errors. Three pathologists reviewed the flagged reports and categorized them as medically correct, partially medically correct, or medically incorrect; they also recorded any instances of hallucinations. Main Outcomes and Measures: Outcomes included improved mean readability scores and a medically accurate interpretation. Results: For the 1134 reports included, the Flesch-Kincaid grade level decreased from a mean of 13.19 (95% CI, 12.98-13.41) to 8.17 (95% CI, 8.08-8.25; t = 45.29; P < .001) by chatbot 1 and 7.45 (95% CI, 7.35-7.54; t = 49.69; P < .001) by chatbot 2. The Flesch Reading Ease score was increased from a mean of 10.32 (95% CI, 8.69-11.96) to 61.32 (95% CI, 60.80-61.84; t = -63.19; P < .001) by chatbot 1 and 70.80 (95% CI, 70.32-71.28; t = -74.61; P < .001) by chatbot 2. Chatbot 1 interpreted 993 reports (87.57%) correctly, 102 (8.99%) partially correctly, and 39 (3.44%) incorrectly; chatbot 2 interpreted 1105 reports (97.44%) correctly, 24 (2.12%) partially correctly, and 5 (0.44%) incorrectly. Chatbot 1 had 32 instances of hallucinations (2.82%), while chatbot 2 had 3 (0.26%). Conclusions and Relevance: The findings of this cross-sectional study suggest that artificial intelligence chatbots were able to simplify pathology reports. However, some inaccuracies and hallucinations occurred. Simplified reports should be reviewed by clinicians before distribution to patients.

Forgotten clientele: A systematic review of patient-centered pathology reports.

CONTEXT: Patient portals, designed to give ready access to medical records, have led to important improvements in patient care. However, there is a downside: much of the information available on portals is not designed for lay people. Pathology reports are no exception. Access to complex reports often leaves patients confused, concerned and stressed. We conducted a systematic review to explore recommendations and guidelines designed to promote a patient centered approach to pathology reporting. DESIGN: In consultation with a research librarian, a search strategy was developed to identify literature regarding patient-centered pathology reports (PCPR). Terms such as "pathology reports," "patient-centered," and "lay-terms" were used. The PubMed, Embase and Scopus databases were searched during the first quarter of 2023. Studies were included if they were original research and in English, without date restrictions. RESULTS: Of 1,053 articles identified, 17 underwent a full-text review. Only 5 studies (≈0.5%) met eligibility criteria: two randomized trials; two qualitative studies; a patient survey of perceived utility of potential interventions. A major theme that emerged from the patient survey/qualitative studies is the need for pathology reports to be in simple, non-medical language. Major themes of the quantitative studies were that patients preferred PCPRs, and patients who received PCPRs knew and recalled their cancer stage/grade better than the control group. CONCLUSION: Pathology reports play a vital role in the decision-making process for patient care. Yet, they are beyond the comprehension of most patients. No framework or guidelines exist for generating reports that deploy accessible language. PCPRs should be a focus of future interventions to improve patient care.

Effect on nurse and patient experience: overnight use of blue-depleted illumination.

BACKGROUND: Typical hospital lighting is rich in blue-wavelength emission, which can create unwanted circadian disruption in patients when exposed at night. Despite a growing body of evidence regarding the effects of poor sleep on health outcomes, physiologically neutral technologies have not been widely implemented in the US healthcare system. OBJECTIVE: The authors sought to determine if rechargeable, proximity-sensing, blue-depleted lighting pods that provide wireless task lighting can make overnight hospital care more efficient for providers and less disruptive to patients. DESIGN: Non-randomised, controlled interventional trial in an intermediate-acuity unit at a large urban medical centre. METHODS: Night-time healthcare providers abstained from turning on overhead patient room lighting in favour of a physiologically neutral lighting device. 33 nurses caring for patients on that unit were surveyed after each shift. 21 patients were evaluated after two nights with standard-of-care light and after two nights with lighting intervention. RESULTS: Providers reported a satisfaction score of 8 out of 10, with 82% responding that the lighting pods provided adequate lighting for overnight care tasks. Among patients, a median 2-point improvement on the Hospital Anxiety and Depression Scale was reported. CONCLUSION AND RELEVANCE: The authors noted improved caregiver satisfaction and decreased patient anxiety by using a blue-depleted automated task-lighting alternative to overhead room lights. Larger studies are needed to determine the impact of these lighting devices on sleep measures and patient health outcomes like delirium. With the shift to patient-centred financial incentives and emphasis on patient experience, this study points to the feasibility of a physiologically targeted solution for overnight task lighting in healthcare environments.