The purpose of the study is to to evaluate an artificial intelligence (AI) powered large language model (LLM) chatbot -PrioritiesAI -that assists patients in understanding, clarifying, and communicating their health priorities and desired outcomes related to elective hernia surgery.
Capacity to provide informed consent
Ability to communicate effectively by phone in English
Access to a working email address that the participant checks regularly
Scheduled for an upcoming outpatient consultation with one of our partner surgeons to discuss elective hernia surgery (femoral, ventral, inguinal, or umbilical)
Cognitive impairment sufficient to interfere with meaningful participation in Patient Priorities Care (PPC) discussions
Communication challenges that cannot be reasonably accommodated within the study protocol
Inability to complete patient-reported outcome measures independently or with minimal assistance
Lack of decision-making capacity regarding surgical care
Parallel
AI Chatbot
BehavioralParticipants receive a personalized web link by email . The link provides access to the Priorities AI chatbot on any internet-connected device. The chatbot guides participants through a structured conversation to identify their health priorities and goals related to their surgical decision,
Control Arm (Educational Preparation Guide)
BehavioralParticipants will receive a Portable Document Format(PDF) educational preparation guide ("Preparing for Your Surgical Consultation") by email, with sufficient time before the scheduled surgical consultation to review the materials. Participants review the materials independently on their own schedule.
Decision regret as assessed by the Decision regret scale
This is a 5 item questionnaire and each is scored from 0(no regret)-5 (high regret). Average of the item scores are calculated then 1 is subtracted and the final score is multiplied by 25 for a final metric from 0 to 100. Higher scores indicating worse outcome
Self-identified health goals following elective hernia surgery, as measured by the Goal Attainment Scale (GAS)
This is rated on a 5-point scale from -2 (much less than expected) to +2 (much better than expected), with 0 representing the expected level of goal attainment. Higher scores indicate greater attainment of individualized goals.
Decision-making quality in surgical consultations using the Shared Decision-Making Process (SDMP)Scale
The Shared Decision-Making Process (SDMP) Scale is a 4-item, patient-reported measure. Maximum scores range from 0 to 4, with higher scores indicating greater shared decision-making.
Perceived involvement in care using the Perceived Involvement in Care Scale (PICS, binary format)
This is a 13 item questionnaire and each is scored as 1(agree) or 0(disagree) for a total score 0-13, with higher scores indicating greater perceived involvement in care.
Decisional confidence using the SURE scale
This is a 4 item questionnaire and each is scored as a 1(yes) or 0(no) for a maximum score of 0-4,higher score indicating greater decisional confidence
Acceptability as assessed by the Acceptability of Intervention Measure (AIM)
This is a 4 item questionnaire and each is scored on a 5-point Likert scale from 1( completely disagree) to 5 (completely agree) for a maximum score of 4-20, higher scores indicate greater perceived acceptability
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