Google AI Overview was rated as providing high-quality, reliable preoperative information on fibula free flap surgery, but the material required a reading age of about 17 years—well above the recommended 11 to 13 years for health education materials, researchers reported.
In the study, Rachel O'Donoghue of the Department of Oral and Maxillofacial Surgery, Mater Misericordiae, Dublin, Ireland, and colleagues evaluated Google AI Overview responses to six frequently asked questions on fibula free flap surgery. The questions were drawn from the British Association of Oral and Maxillofacial Surgeons, and the responses were collected from Google Search on August 28, 2025, to reduce variation from ongoing updates.
Two oral and maxillofacial surgery clinicians independently assessed the responses using the Global Quality Score and the Modified DISCERN tool. Readability was measured with the Simplified Flesch-Kincaid formula.
Across 12 total assessments, the mean Global Quality Score was 4.75 out of 5, indicating that all responses were rated at least good. On the Modified DISCERN tool, mean scores were 2.67 out of 3 for clarity, 2.58 for reliability, 2.58 for balance, and 3.00 for areas of uncertainty. Currency received the lowest score, at 2.33, suggesting limited indication of how current the information was. Inter-rater agreement between the two reviewers was moderate, with a Cohen kappa of 0.40.
The readability analysis showed a mean reading age of 16.5 years, with individual responses ranging from 15.2 to 17.6 years. The researchers identified this as a key limitation for patient use, given that patient education materials are generally recommended to be written for readers aged 11 to 13 years.
The findings suggest that Google AI Overview may serve as an additional information resource for patients undergoing fibula free flap surgery, but does not replace individualized discussions with the treating surgical team. The researchers also noted that responses consistently addressed areas of uncertainty, while lower scores for currency reflected the lack of an obvious time stamp or other indicator of recency.
The study had several limitations. Responses were captured on a single day and were not reassessed over time as the system changed. The researchers also noted limited transparency in how AI Overview synthesized its summaries and said that including more than two reviewers could have strengthened the findings.
In their conclusion, the researchers wrote that, “The information can be a challenge to read due to the use of complex language warranting a reading age of approximately 16.5 years.” They also noted that fibula free flap surgery planning requires individualized discussion between patients and their care teams that artificial intelligence cannot replace.
The researchers reported no relevant financial or nonfinancial conflicts of interest.
