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Breast cancer patients’ questions about radiotherapy-induced skin toxicity: a comparative analysis of ChatGPT-4.0 and Gemini 2.5 flash

2026-07Artigo científico Acesso aberto
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datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorCaetano, Marco
dc.contributor.authorVicente, D.
dc.contributor.authorCaetano, Leonor
dc.contributor.authorCarolino, Elisabete
dc.contributor.authorGrilo, Ana
dc.date.accessioned2026-07-07T07:57:11Z
dc.date.available2026-07-07T07:57:11Z
dc.date.issued2026-07
dc.description.abstractIntroduction: Artificial Intelligence (AI) is increasingly being deployed in health communication, a trend particularly visible in specialised domains, such as breast cancer radiotherapy. The subsequent clinical and educational value is fundamentally determined by the reliability and clarity of the responses generated. However, the comparative performance of different AI models in addressing patient concerns about radiotherapy side effects remains unclear, creating uncertainty regarding the optimal tool selection for patient education and support. This study aimed to compare the performance of ChatGPT 4.0 and Gemini 2.5 FLASH using a mixed-methods analytical-descriptive approach. Methods: Twenty-three unique questions, derived from a literature review and rephrased to simulate patient enquiries about the skin effects of radiotherapy, were submitted to both models. Sixteen expert Radiation Therapists (RTTs) independently assessed the responses using a seven-point Likert scale. The analyses included semantic cosine similarity and linguistic readability (Flesch Reading Ease/Flesch-Kincaid Grade Level), with statistical comparisons performed using Mann-Whitney tests. Results: Gemini 2.5 FLASH achieved higher median scores (6/7) than ChatGPT 4.0 (5/7), demonstrating particular strengths in clinical detail and empathy. Conversely, ChatGPT 4.0 produced more direct and structured answers, although it occasionally simplified complex concepts. Models showed low semantic similarity (median 0.78). Readability analysis revealed that ChatGPT aligned with an 8th-grade level, whereas Gemini operated at an 11th-grade level. Expert agreement was robust, with Gemini achieving greater consistency (α = 0.78; κ = 0.70) than ChatGPT (α = 0.72; κ = 0.65). Conclusion: Gemini was more effective for complex psychosocial issues, whereas ChatGPT provided more accessible guidance, necessitating ongoing professional validation for reliable integration into patient education workflows. Implications for practice: The use of AI in counselling patients undergoing breast radiotherapy enhances accessibility but requires ongoing professional validation to ensure clinical reliability.eng
dc.identifier.citationCaetano M, Vicente D, Caetano L, Carolino E, Grilo A. Breast cancer patients' questions about radiotherapy-induced skin toxicity: a comparative analysis of ChatGPT-4.0 and Gemini 2.5 flash. Radiography (Lond). 2026;32(5):103469.
dc.identifier.doi10.1016/j.radi.2026.103469
dc.identifier.issn1078-8174
dc.identifier.urihttp://hdl.handle.net/10400.21/22946
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier BV
dc.relation.hasversionhttps://www.sciencedirect.com/science/article/pii/S1078817426001458
dc.relation.ispartofRadiography
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectArtificial Intelligence
dc.subjectAI
dc.subjectBreast cancer
dc.subjectLarge language models
dc.subjectPatient education
dc.subjectRadiotherapy
dc.subjectSkin toxicity
dc.subjectChatGPT
dc.subjectGemini
dc.titleBreast cancer patients’ questions about radiotherapy-induced skin toxicity: a comparative analysis of ChatGPT-4.0 and Gemini 2.5 flasheng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue5
oaire.citation.startPage103469
oaire.citation.titleRadiography
oaire.citation.volume32
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.affiliation.nameESTeSL
person.familyNameCaetano
person.familyNameCarolino
person.familyNameGrilo
person.givenNameMarco
person.givenNameElisabete
person.givenNameAna
person.identifier.ciencia-id6E17-A1D8-95BE
person.identifier.orcid0000-0002-8128-1830
person.identifier.orcid0000-0003-4165-7052
person.identifier.orcid0000-0003-1986-8814
person.identifier.scopus-author-id55936359500
relation.isAuthorOfPublication00b462e2-2c1e-4177-96ae-60e43f4dc42a
relation.isAuthorOfPublication31223136-1531-4060-aec7-4d3fc8529916
relation.isAuthorOfPublication3f6308c3-b858-4307-bfc6-4533bc5181c0
relation.isAuthorOfPublication.latestForDiscovery00b462e2-2c1e-4177-96ae-60e43f4dc42a

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