Voice-Based Conversational Agents for the Prevention and Management of Chronic and Mental Health Conditions: Systematic Literature Review.
Voice-Based Conversational Agents for the Prevention and Management of Chronic and Mental Health Conditions: Systematic Literature Review.
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DOI：
10.2196/25933
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发表时间：
2021-03-29
影响因子：
7.4
通讯作者：
Kowatsch T
中科院分区：
文献类型：
--
作者：
Bérubé C;Schachner T;Keller R;Fleisch E;V Wangenheim F;Barata F;Kowatsch T
慢性病和精神健康状况在全世界日益普遍。随着我们日常生活中的设备提供越来越多的基于语音的自助服务，基于语音的会话代理（VCA）有可能以可扩展的方式支持这些条件的预防和管理。然而，关于VCA专门用于预防和管理慢性和精神健康状况的证据尚不清楚。这项研究提供了一个更好地了解目前使用的方法，在评估健康干预措施的预防和管理的慢性和心理健康状况，通过自愿捐款提供。我们使用PubMed MEDLINE、Embase、PsycINFO、Scopus和Web of Science数据库进行了系统的文献综述。我们纳入了主要研究，涉及通过VCA预防或管理慢性或心理健康状况，并报告了系统准确性、技术接受度或两者的实证评估。共有2名独立评审员进行了筛选和数据提取，并使用Cohen kappa测量了他们之间的一致性。采用叙述性方法对选定的记录进行综合。在7170篇预筛选论文中，12篇符合纳入标准。所有研究都是非实验性的。VCA提供行为支持（n=5），健康监测服务（n=3），或两者兼而有之（n=4）。通过智能手机（n=5）、平板电脑（n=2）或智能扬声器（n=3）进行干预。在2例病例中，未指明器械。共有3种VCA靶向癌症，而2种VCA靶向糖尿病和心力衰竭。其他VCA针对听力障碍，哮喘，帕金森病，痴呆症，自闭症，智力残疾和抑郁症。大多数研究（n=7）评估了技术可接受性，但只有少数研究（n=3）使用了经确认的仪器。一半的研究（n=6）报告了语音识别或VCA响应健康相关查询的能力的性能指标。只有少数研究（n=2）报告了行为措施或对干预目标健康行为的态度措施。此外，只有少数研究（n=4）报告控制了参与者以前的技术经验。最后，风险偏好差异显著。方法的异质性，确定的研究数量有限，以及偏倚的高风险表明，对慢性和精神健康状况的VCA研究仍处于起步阶段。尽管系统准确性和技术接受度的结果令人鼓舞，但仍然需要建立更多确凿的证据来证明VCA在预防和管理慢性和心理健康疾病方面的功效，无论是从绝对意义上还是与标准医疗保健相比。
Chronic and mental health conditions are increasingly prevalent worldwide. As devices in our everyday lives offer more and more voice-based self-service, voice-based conversational agents (VCAs) have the potential to support the prevention and management of these conditions in a scalable manner. However, evidence on VCAs dedicated to the prevention and management of chronic and mental health conditions is unclear. This study provides a better understanding of the current methods used in the evaluation of health interventions for the prevention and management of chronic and mental health conditions delivered through VCAs. We conducted a systematic literature review using PubMed MEDLINE, Embase, PsycINFO, Scopus, and Web of Science databases. We included primary research involving the prevention or management of chronic or mental health conditions through a VCA and reporting an empirical evaluation of the system either in terms of system accuracy, technology acceptance, or both. A total of 2 independent reviewers conducted the screening and data extraction, and agreement between them was measured using Cohen kappa. A narrative approach was used to synthesize the selected records. Of 7170 prescreened papers, 12 met the inclusion criteria. All studies were nonexperimental. The VCAs provided behavioral support (n=5), health monitoring services (n=3), or both (n=4). The interventions were delivered via smartphones (n=5), tablets (n=2), or smart speakers (n=3). In 2 cases, no device was specified. A total of 3 VCAs targeted cancer, whereas 2 VCAs targeted diabetes and heart failure. The other VCAs targeted hearing impairment, asthma, Parkinson disease, dementia, autism, intellectual disability, and depression. The majority of the studies (n=7) assessed technology acceptance, but only few studies (n=3) used validated instruments. Half of the studies (n=6) reported either performance measures on speech recognition or on the ability of VCAs to respond to health-related queries. Only a minority of the studies (n=2) reported behavioral measures or a measure of attitudes toward intervention-targeted health behavior. Moreover, only a minority of studies (n=4) reported controlling for participants’ previous experience with technology. Finally, risk bias varied markedly. The heterogeneity in the methods, the limited number of studies identified, and the high risk of bias show that research on VCAs for chronic and mental health conditions is still in its infancy. Although the results of system accuracy and technology acceptance are encouraging, there is still a need to establish more conclusive evidence on the efficacy of VCAs for the prevention and management of chronic and mental health conditions, both in absolute terms and in comparison with standard health care.
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