Conversational agents in healthcare: a systematic review
Top Cited Papers
Open Access
- 11 July 2018
- journal article
- review article
- Published by Oxford University Press (OUP) in Journal of the American Medical Informatics Association
- Vol. 25 (9), 1248-1258
- https://doi.org/10.1093/jamia/ocy072
Abstract
Our objective was to review the characteristics, current applications, and evaluation measures of conversational agents with unconstrained natural language input capabilities used for health-related purposes. We searched PubMed, Embase, CINAHL, PsycInfo, and ACM Digital using a predefined search strategy. Studies were included if they focused on consumers or healthcare professionals; involved a conversational agent using any unconstrained natural language input; and reported evaluation measures resulting from user interaction with the system. Studies were screened by independent reviewers and Cohen’s kappa measured inter-coder agreement. The database search retrieved 1513 citations; 17 articles (14 different conversational agents) met the inclusion criteria. Dialogue management strategies were mostly finite-state and frame-based (6 and 7 conversational agents, respectively); agent-based strategies were present in one type of system. Two studies were randomized controlled trials (RCTs), 1 was cross-sectional, and the remaining were quasi-experimental. Half of the conversational agents supported consumers with health tasks such as self-care. The only RCT evaluating the efficacy of a conversational agent found a significant effect in reducing depression symptoms (effect size d = 0.44, p = .04). Patient safety was rarely evaluated in the included studies. The use of conversational agents with unconstrained natural language input capabilities for health-related purposes is an emerging field of research, where the few published studies were mainly quasi-experimental, and rarely evaluated efficacy or safety. Future studies would benefit from more robust experimental designs and standardized reporting. The protocol for this systematic review is registered at PROSPERO with the number CRD42017065917.Keywords
Funding Information
- National Health and Medical Research Council (APP1134919)
- Centre for Research Excellence in Digital Health (APP1054146)
This publication has 51 references indexed in Scilit:
- Mobile phone-based asthma self-management aid for adolescents (mASMAA): a feasibility studyPatient Preference and Adherence, 2014
- A Randomized Controlled Trial of an Automated Exercise Coach for Older AdultsJournal of the American Geriatrics Society, 2013
- An Internet-Based Virtual Coach to Promote Physical Activity Adherence in Overweight Adults: Randomized Controlled TrialJournal of Medical Internet Research, 2012
- CONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health InterventionsJournal of Medical Internet Research, 2011
- Can Tweets Predict Citations? Metrics of Social Impact Based on Twitter and Correlation with Traditional Metrics of Scientific ImpactJournal of Medical Internet Research, 2011
- The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and ElaborationPLoS Medicine, 2009
- Evaluation of Spoken Dialogue Technology for Real-Time Health Data CollectionJournal of Medical Internet Research, 2006
- Automatic generation of spoken dialogue from medical plans and ontologiesJournal of Biomedical Informatics, 2006
- Health dialog systems for patients and consumersJournal of Biomedical Informatics, 2006
- Some Unintended Consequences of Information Technology in Health Care: The Nature of Patient Care Information System-related ErrorsJournal of the American Medical Informatics Association, 2003