Weber, V;
Truelove, A;
Gohari, SS;
Wynne, LA;
Kearns, RJ;
O'Carroll, JE;
(2025)
Online patient information on labour epidural analgesia provided by UK NHS hospitals: assessment of readability and improvement of readability standards using ChatGPT.
International Journal of Obstetric Anesthesia
, 62
, Article 104344. 10.1016/j.ijoa.2025.104344.
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Abstract
Background: Labour epidurals are considered the gold standard for labour analgesia in pregnant patients. Inequities in health literacy levels can negatively impact understanding of online patient education materials, potentially affecting uptake of labour epidural analgesia. Generative artificial technology such as ChatGPT may be able to improve readability of patient information materials. Objectives: Firstly, to assess the readability of available online materials on labour epidurals in the United Kingdom (UK). Secondly, to evaluate the ability of generative artificial technology to improve readability. Methods: All UK public hospitals' websites performing obstetric anaesthesia were searched for patient education materials relating to labour epidurals. A readability assessment was conducted using three readability scoring systems. ChatGPT was used to rewrite content of online patient information material on labour epidural analgesia to be understandable by an individual with the health literacy level of an 11-year-old (sixth grade). Results: A total of 61.6% of UK hospitals provided some form of online patient education materials on labour analgesia and epidurals, 14.5% and 23.2% of the texts, met the target readability in two commonly used readability scores, respectively. The mean grade (8.4 ± 2.1) did not meet target readability levels. After AI-modification, 24.6% and 27.5% of the texts met targets using the same metrics, with the mean grade (7.7 ± 1.2) decreasing significantly (P <0.001), but still not meeting the target level. Conclusion: Online patient-information on labour epidural analgesia frequently exceeds the recommended sixth grade reading level. ChatGPT can be used to enhance readability but also fails to meet recommended health literacy standards.
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