AI-assisted PEG aftercare education for older adults: clinician-informed chatbot design (PEGAssist)

Abstract

To evaluate whether a geriatric-focused, ChatGPT-based chatbot ( PEGAssist ) provides clinically adequate and comprehensible guidance for percutaneous endoscopic gastrostomy (PEG) aftercare in older adults. We examined whether its answers met expert expectations for depth/clinical usefulness, clarity/actionability, and scientific accuracy, with emphasis on complication recognition and triage. Methods A multidisciplinary panel (geriatrics, nursing, surgery) independently rated chatbot responses to a curated set of common PEG aftercare questions spanning education, routine care, troubleshooting, and complications. Ratings addressed depth, clarity, and accuracy; inter-rater reliability was calculated. Free-text comments were analyzed to identify safety–critical omissions and practical improvements. Results Overall answer quality was considered clinically appropriate, with good inter-rater agreement. Performance was strongest in complication management, where responses consistently highlighted clear red-flag signs (e.g., infection, tube dislodgement, and persistent pain) and specified escalation pathways (self-care, 24–48 h contact, urgent evaluation). No unsafe recommendations were identified. Needed refinements included frailty-aware tailoring and more stepwise, caregiver-oriented instructions. Conclusions A geriatric-focused LLM chatbot can deliver clinically useful, understandable PEG aftercare guidance aligned with expert expectations, particularly for recognizing complications and directing timely care. This clinician-informed evaluation assessed expert perceptions of chatbot responses; patient or caregiver usability and comprehension were not examined in this phase. Integrating such tools into discharge education may enhance safety and caregiver confidence. Prospective usability and effectiveness studies in older adults and caregivers are warranted. Aim To determine whether a geriatric-focused, ChatGPT-based chatbot (“PEGAssist”) provides clinically adequate and understandable guidance for PEG aftercare, with emphasis on complication recognition and triage. Findings Expert reviewers judged overall answer quality clinically acceptable with good-to-excellent inter-rater agreement. Performance was strongest in complication management, consistently identifying red-flag signs and appropriate escalation pathways; no overtly unsafe recommendations were detected. Areas for improvement included frailty-aware tailoring and more stepwise, caregiver-oriented instructions. Message A geriatric-focused LLM chatbot can support safer PEG aftercare by delivering clinically useful, comprehensible guidance for older adults and caregivers; prospective usability and effectiveness studies are warranted.