Objective The objective of this study is to assess the quality, empathy, and readability of large language model (LLM) responses regarding otologic questions from patients as they compare to verified physician responses in other patient-driven forums. This study aims to predict the potential utility of LLMs in patient-centered communication.
Study Design Comparative study
Methods A sample of 49 otology-related questions posted on Reddit r/AskDocs1 between January 2020 and June 2025 were selected using search terms including “hearing loss,” “ear infection,” “tinnitus,” “ear pain,” and “vertigo.” Posts were retrieved using Reddit’s “Top” filter. Each question was answered by a verified doctor on Reddit and three AI LLMs (ChatGPT-4o, ClaudeAI, Google Gemini). Responses were scored by five evaluators.
Results Common otologic concerns posed in patient questions were otalgia (38.7%), vertigo (28.6%), tinnitus (24.5%), hearing loss (22.4%), and aural fullness (20.4%). LLM responses were longer than physician responses (mean 145 vs 67 words; p < .05) and rated higher in quality (10.95 vs 9.58), empathy (7.26 vs 5.18), and readability (4.00 vs 3.73); (all p < .05). Evaluators correctly identified AI versus physician responses in 89.4% of cases with higher sensitivity for detecting physician responses (93.5%). By Flesch-Kincaid grade level, ChatGPT produced the most readable content (mean 7.25), while ClaudeAI responses were more complex (11.86; p < .05).
Conclusion LLM responses received higher ratings in quality, empathy, and readability than those of physicians in response to a variety of otologic concerns. When appropriately implemented, such systems may enhance access to understandable otologic information and complement clinician-delivered care.
Competing Interest StatementThe authors have declared no competing interest.
Funding StatementThis study did not receive any funding.
Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
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Data AvailabilityAll data produced in the present study are available upon reasonable request to the authors.
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