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Giakas et al. Art Int Surg 2024;4:233-46 https://dx.doi.org/10.20517/ais.2024.24 Page 235

METHODS
Methods
Question selection
First, a literature review was performed for commonly asked questions by patients considering orthopedic
surgery - 17 questions were identified [4,12,15,18] . Next, we reviewed the “frequently asked questions” on the
websites of 10 prominent healthcare institutions to further identify potential patient questions. 5 additional
questions were pooled from this website review. Lastly, we queried ChatGPT itself for common questions
patients ask when considering spine surgery. 12 questions were elicited from ChatGPT itself. Ultimately, 10
questions were selected from these three sources by two attending, fellowship-trained orthopedic spine
surgeons at a high-volume academic institution. The questions selected were felt to encompass some of the
most common questions and pressing concerns patients may have regarding lumbar decompression
surgery.

ChatGPT queries
The selected 10 questions were then posed to ChatGPT (Version 4.0) using its free online interface (https://
chat.openai.com). Initial responses were then recorded, and no follow-up or clarifying questions were
permitted. Responses have been truncated in this manuscript for the purpose of publication. Complete
responses can be found in the Supplementary Materials.

Analysis
The two previously mentioned attending orthopedic spine surgeons analyzed each response from the
chatbot using a modified Global Quality Scale to assign a score out of 5 possible points evaluating
[22]
ChatGPT’s accuracy and utility [Table 1] . A score of 5 was reserved for evidence-based, comprehensive
responses of excellent quality that were both accurate and very useful for patients. A score of 4 denoted
good quality, useful responses with minimal unsubstantiated claims. A score of 3 signified a response of
moderate quality, somewhat useful for patients with some poorly discussed important information. A score
of 2 denoted a generally poor-quality response, with many important topics missing and some
unsubstantiated claims that have very little use to patients. Finally, a score of 1 signified a poor-quality
response lacking any utility with missing information and multiple unsubstantiated claims. Scores given to
all responses by each attending were recorded [Table 1].

RESULTS
1. When should I get lumbar decompression surgery?
The decision to undergo lumbar decompression surgery should be made in consultation with a qualified
healthcare professional, preferably a spine specialist or orthopedic surgeon. The timing of surgery depends
on various factors, including the severity of your symptoms, the underlying condition causing the
symptoms, your overall health, and the effectiveness of non-surgical treatments. Here are some
considerations for determining when you might consider lumbar decompression surgery:

(1) Conservative treatment failure
(2) Persistent severe pain
(3) Progressive neurological deficits
(4) Loss of function
(5) Quality of life impact
(6) Emergent cases
(7) Health status
(8) Patient preference