Application of Large Language Models in Stroke Rehabilitation Health Education: 2-Phase Study

Abstract BackgroundStroke is a leading cause of disability and death worldwide, with home-based rehabilitation playing a crucial role in improving patient prognosis and quality of life. Traditional health education often lacks precision, personalization, and accessibility. In...

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Main Authors: Shiqi Qiang, Haitao Zhang, Yang Liao, Yue Zhang, Yanfen Gu, Yiyan Wang, Zehui Xu, Hui Shi, Nuo Han, Haiping Yu
Format: Article
Language:English
Published: JMIR Publications 2025-07-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2025/1/e73226
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author Shiqi Qiang
Haitao Zhang
Yang Liao
Yue Zhang
Yanfen Gu
Yiyan Wang
Zehui Xu
Hui Shi
Nuo Han
Haiping Yu
author_facet Shiqi Qiang
Haitao Zhang
Yang Liao
Yue Zhang
Yanfen Gu
Yiyan Wang
Zehui Xu
Hui Shi
Nuo Han
Haiping Yu
author_sort Shiqi Qiang
collection DOAJ
description Abstract BackgroundStroke is a leading cause of disability and death worldwide, with home-based rehabilitation playing a crucial role in improving patient prognosis and quality of life. Traditional health education often lacks precision, personalization, and accessibility. In contrast, large language models (LLMs) are gaining attention for their potential in medical health education, owing to their advanced natural language processing capabilities. However, the effectiveness of LLMs in home-based stroke rehabilitation remains uncertain. ObjectiveThis study evaluates the effectiveness of 4 LLMs—ChatGPT-4, MedGo, Qwen, and ERNIE Bot—selected for their diversity in model type, clinical relevance, and accessibility at the time of study design in home-based stroke rehabilitation. The aim is to offer patients with stroke more precise and secure health education pathways while exploring the feasibility of using LLMs to guide health education. MethodsIn the first phase of this study, a literature review and expert interviews identified 15 common questions and 2 clinical cases relevant to patients with stroke in home-based rehabilitation. These were input into 4 LLMs for simulated consultations. Six medical experts (2 clinicians, 2 nursing specialists, and 2 rehabilitation therapists) evaluated the LLM-generated responses using a Likert 5-point scale, assessing accuracy, completeness, readability, safety, and humanity. In the second phase, the top 2 performing models from phase 1 were selected. Thirty patients with stroke undergoing home-based rehabilitation were recruited. Each patient asked both models 3 questions, rated the responses using a satisfaction scale, and assessed readability, text length, and recommended reading age using a Chinese readability analysis tool. Data were analyzed using one-way ANOVA, post hoc Tukey Honestly Significant Difference tests, and paired t ResultsThe results revealed significant differences across the 4 models in 5 dimensions: accuracy (PPPPP ConclusionsLLMs, particularly ChatGPT-4 and MedGo, demonstrated promising performance in home-based stroke rehabilitation education. However, discrepancies between expert and patient evaluations highlight the need for improved alignment with patient comprehension and expectations. Enhancing clinical accuracy, readability, and oversight mechanisms will be essential for future real-world integration.
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spelling doaj-art-d3dd67add0af4011a8277890dccdb2532025-08-20T03:09:23ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-07-0127e73226e7322610.2196/73226Application of Large Language Models in Stroke Rehabilitation Health Education: 2-Phase StudyShiqi Qianghttp://orcid.org/0009-0009-5888-3524Haitao Zhanghttp://orcid.org/0009-0009-8481-1559Yang Liaohttp://orcid.org/0009-0009-6297-2562Yue Zhanghttp://orcid.org/0009-0009-2497-4161Yanfen Guhttp://orcid.org/0000-0003-0430-7133Yiyan Wanghttp://orcid.org/0000-0002-7746-3623Zehui Xuhttp://orcid.org/0009-0001-1219-5250Hui Shihttp://orcid.org/0000-0002-0971-9738Nuo Hanhttp://orcid.org/0009-0005-7054-0787Haiping Yuhttp://orcid.org/0000-0002-3394-2841 Abstract BackgroundStroke is a leading cause of disability and death worldwide, with home-based rehabilitation playing a crucial role in improving patient prognosis and quality of life. Traditional health education often lacks precision, personalization, and accessibility. In contrast, large language models (LLMs) are gaining attention for their potential in medical health education, owing to their advanced natural language processing capabilities. However, the effectiveness of LLMs in home-based stroke rehabilitation remains uncertain. ObjectiveThis study evaluates the effectiveness of 4 LLMs—ChatGPT-4, MedGo, Qwen, and ERNIE Bot—selected for their diversity in model type, clinical relevance, and accessibility at the time of study design in home-based stroke rehabilitation. The aim is to offer patients with stroke more precise and secure health education pathways while exploring the feasibility of using LLMs to guide health education. MethodsIn the first phase of this study, a literature review and expert interviews identified 15 common questions and 2 clinical cases relevant to patients with stroke in home-based rehabilitation. These were input into 4 LLMs for simulated consultations. Six medical experts (2 clinicians, 2 nursing specialists, and 2 rehabilitation therapists) evaluated the LLM-generated responses using a Likert 5-point scale, assessing accuracy, completeness, readability, safety, and humanity. In the second phase, the top 2 performing models from phase 1 were selected. Thirty patients with stroke undergoing home-based rehabilitation were recruited. Each patient asked both models 3 questions, rated the responses using a satisfaction scale, and assessed readability, text length, and recommended reading age using a Chinese readability analysis tool. Data were analyzed using one-way ANOVA, post hoc Tukey Honestly Significant Difference tests, and paired t ResultsThe results revealed significant differences across the 4 models in 5 dimensions: accuracy (PPPPP ConclusionsLLMs, particularly ChatGPT-4 and MedGo, demonstrated promising performance in home-based stroke rehabilitation education. However, discrepancies between expert and patient evaluations highlight the need for improved alignment with patient comprehension and expectations. Enhancing clinical accuracy, readability, and oversight mechanisms will be essential for future real-world integration.https://www.jmir.org/2025/1/e73226
spellingShingle Shiqi Qiang
Haitao Zhang
Yang Liao
Yue Zhang
Yanfen Gu
Yiyan Wang
Zehui Xu
Hui Shi
Nuo Han
Haiping Yu
Application of Large Language Models in Stroke Rehabilitation Health Education: 2-Phase Study
Journal of Medical Internet Research
title Application of Large Language Models in Stroke Rehabilitation Health Education: 2-Phase Study
title_full Application of Large Language Models in Stroke Rehabilitation Health Education: 2-Phase Study
title_fullStr Application of Large Language Models in Stroke Rehabilitation Health Education: 2-Phase Study
title_full_unstemmed Application of Large Language Models in Stroke Rehabilitation Health Education: 2-Phase Study
title_short Application of Large Language Models in Stroke Rehabilitation Health Education: 2-Phase Study
title_sort application of large language models in stroke rehabilitation health education 2 phase study
url https://www.jmir.org/2025/1/e73226
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