# Integration of AI-generated clinic letters in complex paediatric neurosurgery outpatient settings

## TL;DR

This study shows that AI-generated clinic letters are more readable than manually dictated ones in pediatric neurosurgery settings, without losing clinical accuracy.

## Contribution

Validates AI-generated clinic letters in complex, multi-stakeholder clinical settings for improved readability and accuracy.

## Key findings

- AI-generated letters had significantly better readability scores than clinician-dictated letters.
- Blinded clinicians preferred AI-generated letters in 75% of cases.
- AI-generated letters maintained clinical accuracy while improving readability.

## Abstract

Dictation of outpatient clinic letters can result in increased workload for clinicians. The use of generative, natural language processing artificial intelligence (AI) software could be used to supplant dictation and typing, alleviating the clinician’s workload. Therefore, our objective was to validate the use of AI software, Lyrebird AI (Lyrebird Health, Ltd.) to create accurate and readable clinic letters, in the context of a single clinician general paediatric neurosurgery clinic and a multi-disciplinary craniofacial clinic.

Twenty consultations were included, wherein a microphone was used to record the entire consultation. For each consultation, two letters were generated independently: (1) Lyrebird AI letter automatically generated at the end of the recording and (2) human clinician manual dictation in the usual manner. The letters were compared using objective readability metrics and a subjective rating by an independent blinded clinician for clinical accuracy.

AI-generated clinic letters significantly improved readability compared to clinician-dictated letters, when using the Flesch–Kincaid Grade Level (median 10.3, IQR 0.75), (median 10.9, IQR 1.15) (z = 2.73, p < 0.05), and SMOG Index (median 11.7, IQR 1.25) (median 13.1, IQR 0.9) (z =  − 3.36, p < 0.001) metrics. An independent blinded clinician subjectively chose the AI-generated letters for overall preference in 75% of cases.

Lyrebird AI–generated clinic letters increased readability whilst maintaining clinical accuracy. Future work should focus on time, effort, and cost saving analysis. Presently, the findings of this study provide validation of Lyrebird AI for complex, multi-stakeholder clinical settings.

The online version contains supplementary material available at 10.1007/s00381-026-07171-6.