AJO International最新文献

{"title":"What patients ask: Evaluating google search queries and webpage transparency in common ophthalmologic malignancies","authors":"Siddharth Gandhi ,&nbsp;Janmejay Buranpuri ,&nbsp;Michael Balas ,&nbsp;Rachel Curtis","doi":"10.1016/j.ajoint.2026.100224","DOIUrl":"10.1016/j.ajoint.2026.100224","url":null,"abstract":"<div><h3>Objective/Purpose</h3><div>To characterize the online information landscape for ocular malignancies by analyzing patient search queries and evaluating the transparency and readability of linked websites.</div></div><div><h3>Design</h3><div>Cross-sectional infodemiologic analysis. Searches were conducted on June 12, 2025, using a private, location-masked web browser.</div></div><div><h3>Subjects, Participants, and/or Controls</h3><div>A total of 300 Google “People Also Ask” (PAA) questions and 205 unique linked websites associated with three search terms: uveal melanoma, retinoblastoma, and ocular surface tumours (100 questions per term).</div></div><div><h3>Methods, Intervention, or Testing</h3><div>Questions were categorized by type and topic using an adapted Rothwell classification. Websites were classified by source (e.g., commercial, government) and evaluated using the JAMA Benchmark Criteria (transparency) and Flesch-Kincaid Reading Ease (FKRE) and Coleman-Liau Index (readability).</div></div><div><h3>Results</h3><div>Fact-based queries predominated (71 %). Search topics varied significantly by diagnosis: prognosis was the primary concern for uveal melanoma (17 %) and retinoblastoma (15 %), whereas technical details (24 %) dominated for ocular surface tumours. Commercial websites were the most visible source (44 %). Government sites achieved the highest transparency (mean JAMA Benchmark 3.30) yet were amongst the most difficult to read (FKRE 37.8). Conversely, commercial sites were more readable (FKRE 51.8) but less transparent (JAMA Benchmark 2.67). Academic sources performed surprisingly poorly on transparency (JAMA Benchmark 2.36). Overall, content complexity typically exceeded the recommended 6th- to 8th-grade reading levels for public health information.</div></div><div><h3>Conclusions</h3><div>Patient information needs are tumor-specific, reflecting distinct clinical anxieties regarding survival versus function. A significant discordance exists in the current online landscape: highly transparent government resources are often too complex, while accessible commercial content lacks transparency. Clinicians must guide patients toward resources that balance accuracy with readability to ensure informed decision-making.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100224"},"PeriodicalIF":0.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What patients search: Analyzing Google queries on laser refractive surgery and information transparency","authors":"Siddharth Gandhi ,&nbsp;Anne Cao ,&nbsp;Michael Balas ,&nbsp;Davin Johnson","doi":"10.1016/j.ajoint.2025.100223","DOIUrl":"10.1016/j.ajoint.2025.100223","url":null,"abstract":"<div><h3>Objective/Purpose</h3><div>To analyze the most common patient questions about laser refractive surgery on Google and to evaluate the transparency of the corresponding online information.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Subjects, Participants, and/or Controls</h3><div>The first 100 Google “People Also Ask” (PAA) questions were extracted for each of five search terms (“Laser-assisted in situ keratomileusis”, “LASIK”, “Photorefractive Keratectomy”, “PRK”, and “Laser eye surgery”). After deduplication, the study sample comprised 189 unique PAA questions and 284 unique source websites.</div></div><div><h3>Methods, Intervention, or Testing</h3><div>Data were collected on September 27, 2024, using an automated script. Questions were categorized by topic and type using Rothwell’s classification system. Source websites were assessed for transparency using the Journal of the American Medical Association (JAMA) Benchmark Criteria. A repeat data extraction was performed on November 17, 2025, to assess temporal stability.</div></div><div><h3>Results</h3><div>Of the 189 unique questions analyzed (88 LASIK, 60 PRK, 41 laser eye surgery), most focused on evaluating the procedures (26 %), recovery timelines (17 %), and indications/management (14 %). Fact-based questions were the most common (43 %). Among the 284 unique websites, medical practice websites were the most frequent (75 %) but had amongst the lowest mean JAMA scores (1.64). Commercial websites had the highest JAMA scores (3.42). LASIK-related searches had the highest mean JAMA score (2.01), followed by laser eye surgery (2.00) and PRK (1.67). The repeat data extraction on November 17, 2025, demonstrated low temporal stability, with only 9 % to 18 % of questions and 18 % to 27 % of websites recurring.</div></div><div><h3>Conclusions</h3><div>At the primary sampled time point, a transparency deficit characterized the online information most frequently encountered by patients. Although medical practice websites were the most visible sources, they often lacked transparency compared to other site types. These findings suggest that clinicians and academic institutions should prioritize the transparency of their online educational content to better support informed patient decision making.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100223"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-rich fibrin membrane versus conjunctival autograft in primary pterygium surgery: A comparative 12 months single center study","authors":"Hassan Moutei,&nbsp;Meriem bouzidi,&nbsp;Fouad Chraibi,&nbsp;Meriem Abdellaoui,&nbsp;Idriss Benatiya","doi":"10.1016/j.ajoint.2025.100222","DOIUrl":"10.1016/j.ajoint.2025.100222","url":null,"abstract":"<div><h3>Objective/Purpose</h3><div>To compare the safety and preliminary efficacy of platelet-rich fibrin membrane (PRFm) versus conjunctival autograft (CA) for primary pterygium surgery.</div></div><div><h3>Design</h3><div>Prospective, comparative, non-randomized pilot study.</div></div><div><h3>Subjects, Participants, and/or Controls</h3><div>This pilot study enrolled 141 patients (76 Group A/CA; 65 Group B/PRFm) undergoing primary pterygium surgery between February 2024 and April 2025. Patients selected their preferred treatment approach.</div></div><div><h3>Methods, Intervention, or Testing</h3><div>Primary outcome was pterygium recurrence at 12 months (Solomon grading scale). Secondary outcomes included conjunctival inflammation (Efron scale), ocular surface symptoms (Visual Analog Scale and Ocular Surface Disease Index), corneal epithelialization time, visual acuity, surgical time, and graft integration (AS-OCT imaging).</div></div><div><h3>Results</h3><div>Recurrence occurred in 7 eyes (9.2%; 95% CI 3.8–17.8%) in Group A and 1 eye (1.5%; 95% CI 0.0–8.2%) in Group B. Mean surgical time was substantially shorter with PRFm (18.2 ± 5.2 min versus 38.5 ± 7.1 min; 53% reduction; <em>p</em> &lt; 0.001). Conjunctival inflammation was consistently lower in Group B through 3 months (<em>p</em> &lt; 0.001 at 1 month), with resolution in both groups by 12 months. Within-group improvements in symptom scores were substantially greater with PRFm (VAS frequency 88.6% decrease versus 41.5%; OSDI 44.2% decrease versus 18.6%), with PRFm crossing from moderate to mild symptom category. However, between-group comparisons at individual postoperative timepoints demonstrated no statistically significant differences in symptom outcomes (all <em>p</em> &gt; 0.05). AS-OCT measurements were comparable between groups at all timepoints, with no significant associations between graft morphology and clinical outcomes. Both procedures demonstrated excellent safety profiles with no serious adverse events.</div></div><div><h3>Conclusions</h3><div>This pilot study suggests PRFm may offer operational advantages and potentially favorable preliminary trends in recurrence and symptom improvement compared with CA for primary pterygium surgery. These exploratory findings warrant investigation in a larger randomized controlled trial with adequate power to determine whether observed trends represent clinically meaningful advantages.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100222"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of diabetic foot ulcers and nephropathy on risk of treatment-warranted diabetic eye disease: A retrospective cohort study","authors":"Alexander T. Hong ,&nbsp;Ivan Y. Luu ,&nbsp;Tze-Woei Tan ,&nbsp;Brian C. Toy","doi":"10.1016/j.ajoint.2025.100220","DOIUrl":"10.1016/j.ajoint.2025.100220","url":null,"abstract":"<div><h3>Purpose</h3><div>Microvascular complications of type 2 diabetes (T2DM), such as diabetic retinopathy, nephropathy (DN), and foot ulcers (DFU), are interrelated outcomes of hyperglycemia-induced vascular injury. Whether comorbid DFU or DN merely indicate diabetic microvascular disease burden or specifically contribute to progression to treatment-warranted diabetic eye disease (TW-DED) remains insufficiently explored. We hypothesized that DFU and DN are independently associated with increased risk of TW-DED.</div></div><div><h3>Design</h3><div>This retrospective cohort study used electronic health records from a nationwide federated database and followed patients for up to 10 years after index non-proliferative diabetic retinopathy (NPDR) diagnosis.</div></div><div><h3>Setting</h3><div>Data were aggregated from a multicenter network of 70 U.S.-based healthcare organizations, including both academic and non-academic institutions.</div></div><div><h3>Participants</h3><div>Patients aged ≥40 years with T2DM and NPDR were included, while those with prior TW-DED were excluded.</div></div><div><h3>Exposures</h3><div>Baseline DN and/or DFU, with propensity-matched clinical covariates, including demographics, comorbidities, medications, laboratory values, and healthcare utilization.</div></div><div><h3>Main Outcomes</h3><div>The primary outcome was progression to TW-DED, defined as proliferative DR, macular edema, vitreous hemorrhage, or need for DR-related treatments (intravitreal injection, panretinal photocoagulation, pars plana vitrectomy). Risk of blindness or low vision was also assessed. Cox proportional hazard models estimated hazard ratios (HRs) and 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Among 135,172 patients with NPDR, 21.5% had DN only, 8.5% had DFU only, and 7.0% had both. Compared to those without DN or DFU, patients with DFU (HR 1.27, 95% CI 1.19–1.36), DN (HR 1.17, 95% CI 1.05–1.21), or both DFU and DN (HR 1.49, 95% CI 1.33–1.68) had an associated increased risk of TW-DED. DFU alone was associated with greater risk of TW-DED than DN alone (HR 1.15, 95% CI 1.05–1.28). Patients with DFU or DN had a 2-fold increased risk of PDR and VH, 50% increased risk of blindness/low vision, and 2-fold increased risk of undergoing vitrectomy.</div></div><div><h3>Conclusions</h3><div>Comorbid DFU and DN are associated with increased risk of diabetic eye disease progression, with DFU showing greater independent risk. Proactively identifying these complications may support risk stratification and guide more intensive ophthalmic monitoring for patients with NPDR.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100220"},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Effectiveness of intracameral antibiotics in reducing postoperative endophthalmitis risk after cataract surgery: A meta-analysis”","authors":"Prashant Ramdas Kokiwar ,&nbsp;Amit Singh Pawaiya ,&nbsp;Ranjana Roy ,&nbsp;Reenoo Jauhari","doi":"10.1016/j.ajoint.2025.100219","DOIUrl":"10.1016/j.ajoint.2025.100219","url":null,"abstract":"","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100219"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of diabetic retinopathy and visual impairment with falls and falls reporting injuries: Findings from the behavioral risk factor surveillance system","authors":"Neel Edupuganti ,&nbsp;Danny Alevy ,&nbsp;Tommy Bui ,&nbsp;George Liu ,&nbsp;Kevin Dobbin ,&nbsp;John E. Crews ,&nbsp;Atalie C. Thompson","doi":"10.1016/j.ajoint.2025.100221","DOIUrl":"10.1016/j.ajoint.2025.100221","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the associations between visual impairment (VI) and diabetic retinopathy (DR) with the prevalence of falls, recurrent falls, and falls reporting injuries (FRIs).</div></div><div><h3>Design</h3><div>Cross-sectional analyses of associations between VI, DR, or both VI and DR with the prevalence of any fall, recurrent falls, and FRIs using data from 65,046 adults (45+ years) who completed the 2018 Behavioral Risk Factor Surveillance System (BRFSS) Diabetes Module.</div></div><div><h3>Subjects, participants, and/or controls</h3><div>Participants were categorized into four groups: no VI or DR (reference), DR only, VI only, and both VI and DR.</div></div><div><h3>Methods</h3><div>Separate multivariable logistic regression models, adjusted for sociodemographics and comorbidities, were used to analyze the association between VI, DR, or VI and DR with the odds of experiencing any fall, recurrent falls, or FRIs.</div></div><div><h3>Main Outcome Measures</h3><div>The association between VI, DR, or VI and DR with the odds of experiencing any fall, recurrent falls, or FRIs.</div></div><div><h3>Results</h3><div>Compared to adults with no VI or DR, those with VI reported 1.72 greater odds of experiencing any fall (adjusted odds ratio (aOR)=1.716, <em>p</em> &lt; 0.001), 1.82 greater odds of an increasing number of falls (aOR=1.824, <em>p</em> &lt; 0.001), and 2.08 greater odds of FRIs (aOR=2.076, <em>p</em> &lt; 0.001). Similarly, those with DR only also had substantially greater odds of experiencing any fall (aOR=1.741, <em>p</em> &lt; 0.001), an increasing number of falls (aOR = 1.735, <em>p</em> &lt; 0.001), and FRIs (aOR=1.658, <em>p</em> = 0.004). The interaction effect between VI and DR was not significant. Subjects with both VI and DR experienced 3.80 greater odds of any fall, 2.73 greater odds of increasing falls, and 2.79 greater odds of FRIs, which was greater than those with VI or DR alone or neither condition. Further, subjects aged 45–64 years had significantly higher odds of FRIs than those aged 65+.</div></div><div><h3>Conclusions</h3><div>Using data from 17 states and territories implementing the 2018 BRFSS Diabetes Module, we found that adults with both VI and DR experienced a greater likelihood of falls, recurrent falls, and FRIs than those with neither or either condition. However, the inability to infer temporal or causal relationships from this cross-sectional, self-reported analysis should be considered. These findings underscore the importance for practitioners to communicate fall risks among people with DR and VI and support policies promoting tailored interventions for people experiencing these specific conditions.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100221"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating patient-facing eye disease information: ChatGPT-5 vs. Pfizer health answers","authors":"Adriana Kaganovski ,&nbsp;Anisha Kasi ,&nbsp;Aliya Grinberg ,&nbsp;Michael Kozlov ,&nbsp;Riya Patel ,&nbsp;Minwoo Kwon ,&nbsp;Carolyn Lai ,&nbsp;Inci Dersu","doi":"10.1016/j.ajoint.2025.100215","DOIUrl":"10.1016/j.ajoint.2025.100215","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate and compare the quality, accuracy, understandability, and actionability of responses generated by a health-specific AI chatbot (Health Answers by Pfizer) and a general-purpose AI chatbot (ChatGPT/GPT-5) to ophthalmology-related patient queries.</div></div><div><h3>Methods</h3><div>We input the top five Google Trends search queries on three leading causes of blindness worldwide — glaucoma, cataract, and age-related macular degeneration — into both chatbots. We evaluated each chatbot response with the Flesch Reading Ease test, Flesch-Kincaid Grade Level, Patient Education Materials Assessment Tool, and DISCERN tool to assess the quality, accuracy, understandability, and actionability of each response.</div></div><div><h3>Results</h3><div>ChatGPT-5 produced responses that were easier to read (Flesch Reading Ease of 48.1 vs 39.0, <em>p</em> = 0.02) and written at a lower grade level (Flesch-Kincaid Grade Level of 8.9 vs 12.2, <em>p</em> = 0.003). ChatGPT-5 also scored higher for understandability (PEMAT-P understandability scores of 83.8% vs 80.5%, <em>p</em> = 0.024) and information quality (DISCERN scores of 41.3 vs 36.4, <em>p</em> = 0.047). In contrast, Health Answers by Pfizer produced content that was significantly more actionable (PEMAT-P actionability scores of 41.3% vs 23.3%, <em>p</em> = 0.004).</div></div><div><h3>Conclusions</h3><div>This study highlights the utility of Health Answers by Pfizer in producing content of higher actionability, compared to ChatGPT-5, which produced content of greater understandability, quality, and readability. It is paramount for effective patient education in ophthalmology to improve AI chatbots to balance clarity with actionability, especially given the critical nature of silently progressing diseases like glaucoma.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100215"},"PeriodicalIF":0.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical and visual outcomes of pneumatic retinopexy in primary rhegmatogenous retinal detachment","authors":"Hassan Moutei,&nbsp;Meriem Abdellaoui,&nbsp;Fouad Chraibi,&nbsp;Idriss Benatiya","doi":"10.1016/j.ajoint.2025.100218","DOIUrl":"10.1016/j.ajoint.2025.100218","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate pneumatic retinopexy (PnR) outcomes for primary rhegmatogenous retinal detachment (RRD) in a real-world North African cohort and identify factors associated with surgical failure.</div></div><div><h3>Design</h3><div>Retrospective observational case series.</div></div><div><h3>Methods</h3><div>A total of 112 eyes from 112 patients treated for primary RRD with PnR (January 2023–March 2025) were reviewed. Patient selection followed PIVOT trial criteria, including single retinal break or clustered breaks ≤1 clock hour, located within superior 8 clock hours (between 8 and 4 o'clock), with documented postoperative compliance. Preoperative demographics, ocular characteristics, and postoperative complications were systematically recorded. The primary anatomical outcome was defined as complete retinal reattachment without additional surgery at 6 months. Anatomical failure was defined as subretinal fluid persistence exceeding 4 weeks requiring secondary intervention. The primary visual outcome was best-corrected visual acuity (BCVA) at 6 months and its change over time. Logistic regression was used to identify factors associated with anatomical and visual failure.</div></div><div><h3>Results</h3><div>Single-operation anatomical success was 67 % (75/112 eyes); secondary procedures achieved 98 % final reattachment (110/112). Mean final BCVA was 0.12 logMAR, with 80 % of visual improvement occurring within the first postoperative month (0.62 logMAR gain; <em>p</em> &lt; 0.001). Pseudophakia (OR=3.49, <em>p</em> &lt; 0.001), high myopia (OR=1.82, <em>p</em> = 0.02), and prolonged symptom duration (OR=1.12 per day, <em>p</em> = 0.002) were independent factors associated with anatomical failure. New or missed retinal breaks (OR=2.16, <em>p</em> = 0.03) and proliferative vitreoretinopathy (PVR) (OR=1.96, <em>p</em> = 0.02) were independent postoperative factors of failure. For visual outcomes, pseudophakia (OR=3.2, <em>p</em> = 0.001), high myopia (OR=2.49, <em>p</em> = 0.004), worse preoperative BCVA (OR = 2.23, <em>p</em> = 0.002), and prolonged symptom duration (OR=1.35 per day, <em>p</em> = 0.002) were independent factors associated with poor outcomes. Postoperative complications (missed breaks OR=2.8; PVR OR=1.8) also independently contributed to poor visual recovery.</div></div><div><h3>Conclusions</h3><div>PnR achieves competitive anatomical and visual outcomes in real-world practice when rigorous patient selection and meticulous surgical technique are applied. Success depends equally on preoperative patient selection and surgical execution. Optimization through timely intervention, comprehensive preoperative examination, enhanced visualization, and rigorous surveillance may increase real-world success rates toward trial-level performance while maintaining procedural simplicity and cost-effectiveness in resource-limited settings.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100218"},"PeriodicalIF":0.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In memoriam, Nobuhiko Matsuo, 1931-2025","authors":"Toshihiko Matsuo","doi":"10.1016/j.ajoint.2025.100217","DOIUrl":"10.1016/j.ajoint.2025.100217","url":null,"abstract":"","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100217"},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing demographic variation in large language model outputs for patient education materials in cataract surgery","authors":"Angel Gao ,&nbsp;Abu Bakar Butt ,&nbsp;Fred Min ,&nbsp;Amin Hatamnejad ,&nbsp;Keean Nanji ,&nbsp;Husayn Gulamhusein","doi":"10.1016/j.ajoint.2025.100216","DOIUrl":"10.1016/j.ajoint.2025.100216","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate whether large language model (LLM)-generated patient education materials for cataract surgery vary in readability, length, and accuracy based on demographic modifiers including race, gender, geography, and insurance status.</div></div><div><h3>Design</h3><div>Cross-sectional study</div></div><div><h3>Methods</h3><div>This study analyzed 7,000 responses from five LLMs (ChatGPT, Claude, Copilot, DeepSeek, and Gemini) between March-May 2025 using 280 standardized prompts that varied by race, gender, province/territory, and insurance coverage. Each prompt was submitted five times. Readability was assessed using the Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease (FRE), and SMOG index. Accuracy was assessed by dual blinded reviewers against AAO clinical guidelines. ANOVA was performed (α = 0.05).</div></div><div><h3>Results</h3><div>LLM outputs differed significantly across all metrics (<em>p</em> &lt; 0.001). Gemini generated the longest (876 ± 143 words) and among the most complex text (FKGL 11.9 ± 1.2). Race, insurance status, and geography significantly impacted readability. Prompts referencing Indigenous patients were the most complex (FKGL 11.1 ± 1.8, FRE 36.5 ± 7.9). Insured prompts were longer and more complex (11.0 ± 1.7 vs. 10.8 ± 1.7; 429 vs. 399 words; <em>p</em> &lt; 0.001). Prompts from Nunavut and Manitoba were the least readable (FKGL ≥ 11.1), while Quebec and PEI were most readable. Gender had minimal impact. No outputs contained clinically unsafe information, but most lacked sufficient depth. None of the responses met the AMA’s sixth-grade readability recommendation.</div></div><div><h3>Conclusion</h3><div>LLM-generated patient education for cataract surgery varies by patient demographics. These disparities may hinder equitable access to health information and highlight the need for bias-aware development of AI tools in healthcare.</div></div>","PeriodicalId":100071,"journal":{"name":"AJO International","volume":"3 1","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}