Are Chatbots any good for researching pilonidal cysts?

A new age of internet search is upon us! In the past, we could search Google, Bing, Yahoo, etc, and these search engines would take us to thousands (if not millions) of web pages discussing the topic we queried. But, now we can just ask the Bing or Google Chatbot a question, and it can distill the information on the internet, and give us a full answer, without forcing us to wade through many web pages to find our specific answer.

But- does it work?

I tried some experiments, asking the Bing Chatbot some questions about pilonidal disease, to see how it would answer.

I asked it: What is the best way to treat pilonidal cysts? The answer it came up with was:

Pilonidal cysts can be treated with antibiotics, sitz baths, warm compresses, and surgery. The only way to get rid of a pilonidal cyst is through a minor surgical procedure. During this procedure, a doctor will make a cut and drain the cyst. If the infection is severe, you may need surgery. Injections (phenol) can treat and prevent mild and moderate cases of pilonidal cysts.

Hmmm. It looks like they are confusing pilonidal cysts with an acute pilonidal abscess, for which antibiotics, sitz baths, warm compresses, or surgical drainage is indeed recommended – but it is not the answer to the question. Phenol injections have been tried in the past, but are rarely used at the present time.

So, I would rate this answer as a complete failure, and quite confusing.

So, I slightly changed the question to: What is the best way to treat a recurring pilonidal cyst?

A pilonidal cyst is usually treated in your health care provider’s office. After numbing the area, your health care provider makes a small cut to drain the cysts. If the cyst returns, you may need surgery. If you need surgery, your health care provider numbs the area and removes the cyst through an incision.

Laser treatment is also an advanced and safe option to get rid of pilonidal sinus for once and for all. It is minimally invasive in nature and requires incisions. Laser treatment for pilonidal cyst takes about only 15 minutes to complete. It is a daycare procedure that enables the patient to return home on the same day of the treatment.

The chatbot is confusing a pilonidal abscess, pilonidal cyst, and pilonidal sinus again, but it does say that if it comes back surgical removal is appropriate. It also mentions laser treatment, which can be used for a pilonidal sinus. Laser surgery (SiLaC) is a newer treatment with uncertain success rates, but is not an unreasonable suggestion.

Overall, this answer is confusing and misleading, but a bit better than the first one.

At this point, I’ve resigned myself to the fact that the Bing Chatbot is not going to give me an answer that makes sense regarding the general treatment of a pilonidal cyst, so I added a fact that requires some additional knowledge, specifically that the best treatment for pilonidal disease requires surgery. I specifically asked: What is the best surgical treatment for a pilonidal cyst?

There are several surgical options for treating pilonidal disease. One option is the Bascom cleft lift operation, which leaves a closed, sutured wound and has a reported recurrence rate of less than 2%. Another option is laser surgery, which has been reported to have a high success rate.

It’s important to note that success rates can vary depending on the individual case and the surgeon performing the procedure. It’s best to consult with your healthcare provider to determine which surgical treatment is best for you.

This is a pretty good answer! But, unfortunately, you have to already know to specifically ask about surgery. I’m glad to see that it didn’t mention open or closed excision at all, since excisional procedures have very high failure rates.

Finally, I asked it: What operation for pilonidal disease has the best success rate?

According to a study comparing the cleft lift procedure with wide excision and packing for the treatment of pilonidal disease in adolescents, the cleft lift procedure resulted in primary healing, lower likelihood of recurrent disease, and simplified wound care. Only one cleft lift patient had recurrent disease (2.5%) compared with 7 (20.6%) of 34 excision patients.

It’s important to note that individual cases may vary and it’s best to consult with your healthcare provider to determine which surgical treatment is best for you.

Again, I think this is pretty good, but requires not only knowing that surgery is needed, but also knowing that there are multiple options for surgery and that a decision has to be made regarding which one to have.

So, these chatbots can provide some good information, but unfortunately a person needs to already know a bit about the subject to get the correct answers, and has to ask leading questions. These answers also had a number of web links as references (which I removed here for clarity) but I was happy to see that as the answers became more accurate, that was always listed as a reference!

Of course, this raises the question regarding why the Bing Chatbot knows that the cleft lift is the best operation for pilonidal disease, but many surgeons do not.

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