Health literacy has been linked to patient outcomes, yet medical consent forms, which facilitate and document the doctor-patient conversation around consenting to a procedure, are notoriously complex. Dating back to 1980, the New England Journal of Medicine⁠(opens in a new window) published research findings that surgical consent forms are written at a college reading level. Dr. Ali, Dr. Mirza, and their colleagues found that the same continued to be true in 2023 when they evaluated forms from over a dozen academic medical centers nationwide.

With over half of Americans reading at or below the 6th grade level⁠(opens in a new window), Dr. Ali and Dr. Mirza proposed using GPT‑4 to simplify surgical consent forms from a college reading level to a middle school reading level. To mitigate the risk of bias and hallucination, Lifespan leadership created a system where GPT‑4 would do a first pass, and then legal and medical reviewers would check the output.

From left: Dr. Ziya Gokaslan, Dr. Dean Roye, Dr. Fatima N Mirza, Dr. Rohaid Ali, Mr. John Fernandez, Dr. Tiffany J Libby

The setup was simple. Dr. Ali and Dr. Mirza fed Lifespan’s surgical consent form into GPT‑4, along with a short prompt: “While preserving content and meaning, convert this consent form to the average American reading level.” GPT‑4 generated a draft of the surgical consent form at approximately a 6th grade reading level with a 25 percent reduction in word count. GPT‑4 was so accurate that Lifespan’s clinicians only added one single modification: Anesthesiology leadership inserted the term "sleep medicine" next to the word “anesthesia” on the consent form.