Abstract The recently mandated US Food and Drug Administration (FDA) patient decision checklists were developed with the goal of improving the informed decision-making process for patients considering breast implants. Yet, prior research has demonstrated that these checklists are written at reading levels far in excess of that recommended by the National Institutes of Health and the American Medical Association. Patients considering breast implants are required to sign these forms prior to surgery, even if they have little to no comprehension of their contents. This study aims to improve the accessibility, and therefore the utility, of the mandated FDA patient literature using the assistance of artificial intelligence (AI). Patient decision checklists were obtained from the three most utilized breast implant manufacturers in the United States– Allergan, Mentor, and Sientra. AI was then asked to synthesize a novel patient decision checklist, written at the 6th grade reading level, using these checklists as source material. The AI-assisted checklist was edited by plastic surgeons for both formatting and content. Readability analysis of all documents was performed using the Flesch Reading-Ease Score, Flesch-Kincaid Grade Level, Gunning-Fog Index, Coleman-Liau Index, Simplified Measure of Gobbledygook, and Automated Readability Index. Textual analysis included sentence count, word count, number and percentage of complex words, average number of words per sentence, and average number of syllables per word. The overall readability of Allergan, Mentor, and Sientra patient checklists correlated with the college reading level. These documents were of a statistically significantly higher reading level the AI-assisted checklist, which was written at the recommended 6th grade level. Text composition analysis similarly demonstrated substantial differences between the AI-assisted and FDA mandated literature. The currently mandated breast implant patient checklists are written at a college reading level and are inaccessible to the average patient. We propose a new patient decision checklist, generated with the assistance of artificial intelligence, in order to improve healthcare access within plastic surgery. This simplified material can be used as an adjunct to the current checklists in order to improve shared decision making.
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