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Comparative Performance of AI-Generated Responses to Patient Questions on Systemic Isotretinoin: ChatGPT versus Gemini (Preprint)

Year: 2026
Type: preprint
Abstract: BACKGROUND The use of artificial intelligence(AI) in healthcare is rapidly expanding due to its accessibility, with growing reliance among both physicians and patients. OBJECTIVE This study evaluated ChatGPT(OpenAI) and Gemini (Google) responses to patient questions on systemic isotretinoin. METHODS Forty commonly anticipated patient questions were developed based on online sources and patient education materials and categorized into five groups. Responses were generated using the January 2025 free versions of ChatGPT-4o and Gemini 2.0 Flash. Five experienced dermatologists evaluated the responses in a blinded manner using a five-point Likert scale assessing accuracy, clarity, completeness, usefulness, and overall quality score (GQS). Readability was measured using Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease (FRE), and SMOG (Simple Measure of Gobbledygook) Index scores. Mixed-effects modeling was performed to adjust for reviewer and question variability, and ICCs (intraclass correlation coefficient) were calculated to assess inter-rater reliability. RESULTS ChatGPT achieved significantly higher ratings in accuracy, completeness, usefulness, and GQS, while clarity showed a non-significant trend. When questions were analyzed by subtype no statistically significant differences were observed between models across evaluation parameters. Mixed-effects modeling confirmed higher odds of superior ratings for ChatGPT across domains (ORs 1.82–5.88; all p<0.001). However, inter-rater reliability was lower for ChatGPT (global ICC 0.401) compared to Gemini (0.677). Readability analyses demonstrated that ChatGPT required a higher reading level (FKGL 12.6 vs. 11.2; SMOG 11.3 vs. 10.0). CONCLUSIONS ChatGPT outperformed in terms of data accuracy and quality, while Gemini offered superior readability and consistency. Both models exceeded recommended readability thresholds, highlighting a gap between informational quality and linguistic accessibility in AI-generated health communication.
Language: English
Field: Medicine
Open Access status: green
OpenAlex ID: W7161119690
Cites: 31
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Related to: 10