Patient Interactions With an Automated Conversational Agent Delivering Pretest Genetics Education: Descriptive Study.
Patient Interactions With an Automated Conversational Agent Delivering Pretest Genetics Education: Descriptive Study.
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DOI：
10.2196/29447
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发表时间：
2021-11-18
影响因子：
7.4
通讯作者：
Kaphingst KA
中科院分区：
文献类型：
--
作者：
Chavez-Yenter D;Kimball KE;Kohlmann W;Lorenz Chambers R;Bradshaw RL;Espinel WF;Flynn M;Gammon A;Goldberg E;Hagerty KJ;Hess R;Kessler C;Monahan R;Temares D;Tobik K;Mann DM;Kawamoto K;Del Fiol G;Buys SS;Ginsburg O;Kaphingst KA
用于评估个人癌症风险并实现基于基因组学的癌症治疗的癌症基因测试在过去十年中呈指数级增长。由于这种持续增长和卫生保健工作者的短缺，需要一种自动化策略来为患者提供高质量的遗传学服务，以减少对遗传学提供者的临床需求。对话代理在管理心理健康、疼痛和其他慢性疾病方面已显示出前景，并且越来越多地用于癌症遗传服务。然而，关于患者如何与这些药物相互作用以满足其信息需求的研究有限。我们的主要目标是评估用户与对话代理的交互，以进行预测试遗传学教育。我们对用户与对话代理的交互进行了可行性研究，该对话代理向有资格接受癌症遗传评估的未患癌症的初级保健患者提供测试前遗传学教育。对话代理提供的脚本内容类似于癌症基因检测的预测试遗传咨询访问中提供的内容。除了向所有患者提供的一组核心信息之外，用户还可以在聊天中导航以请求其感兴趣领域的其他内容。还建立了一个基于人工智能的预编程库，允许用户向对话代理提出开放式问题。记录了交互的文字记录。在这里，我们描述了选择的信息、完成聊天所花费的时间以及开放式问题功能的使用。描述性统计用于定量测量，主题分析用于定性反应。我们邀请了 103 名患者参与，其中 88.3% (91/103) 可以访问对话代理，39% (36/91) 开始聊天，32% (30/91) 完成聊天。大多数完成聊天的用户表示他们希望继续进行基因检测（21/30，70%），很少有人不确定（9/30，30%），并且没有患者拒绝继续进行检测。那些决定进行测试的人平均花费 10 (SD 2.57) 分钟进行聊天，平均选择 1.87 (SD 1.2) 条额外信息，并且通常不会提出开放式问题。那些不确定的人平均多花 4 分钟（平均 14.1，SD 7.41；P=.03）进行聊天，平均选择 3.67 (SD 2.9) 条额外信息，并至少提出一个开放式问题。正如少数开放式问题所示，预测试聊天为大多数患者提供了足够的信息来决定是否进行癌症基因检测。一部分参与者仍然不确定是否接受基因检测，在做出检测决定之前可能需要额外的教育或人际支持。对话代理有潜力成为预测试遗传学教育的可扩展替代方案，减少对遗传学提供者的临床需求。
Cancer genetic testing to assess an individual’s cancer risk and to enable genomics-informed cancer treatment has grown exponentially in the past decade. Because of this continued growth and a shortage of health care workers, there is a need for automated strategies that provide high-quality genetics services to patients to reduce the clinical demand for genetics providers. Conversational agents have shown promise in managing mental health, pain, and other chronic conditions and are increasingly being used in cancer genetic services. However, research on how patients interact with these agents to satisfy their information needs is limited. Our primary aim is to assess user interactions with a conversational agent for pretest genetics education. We conducted a feasibility study of user interactions with a conversational agent who delivers pretest genetics education to primary care patients without cancer who are eligible for cancer genetic evaluation. The conversational agent provided scripted content similar to that delivered in a pretest genetic counseling visit for cancer genetic testing. Outside of a core set of information delivered to all patients, users were able to navigate within the chat to request additional content in their areas of interest. An artificial intelligence–based preprogrammed library was also established to allow users to ask open-ended questions to the conversational agent. Transcripts of the interactions were recorded. Here, we describe the information selected, time spent to complete the chat, and use of the open-ended question feature. Descriptive statistics were used for quantitative measures, and thematic analyses were used for qualitative responses. We invited 103 patients to participate, of which 88.3% (91/103) were offered access to the conversational agent, 39% (36/91) started the chat, and 32% (30/91) completed the chat. Most users who completed the chat indicated that they wanted to continue with genetic testing (21/30, 70%), few were unsure (9/30, 30%), and no patient declined to move forward with testing. Those who decided to test spent an average of 10 (SD 2.57) minutes on the chat, selected an average of 1.87 (SD 1.2) additional pieces of information, and generally did not ask open-ended questions. Those who were unsure spent 4 more minutes on average (mean 14.1, SD 7.41; P=.03) on the chat, selected an average of 3.67 (SD 2.9) additional pieces of information, and asked at least one open-ended question. The pretest chat provided enough information for most patients to decide on cancer genetic testing, as indicated by the small number of open-ended questions. A subset of participants were still unsure about receiving genetic testing and may require additional education or interpersonal support before making a testing decision. Conversational agents have the potential to become a scalable alternative for pretest genetics education, reducing the clinical demand on genetics providers.
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影响因子：
4
作者：
Curras-Freixes, Maria;Inglada-Perez, Lucia;Robledo, Mercedes
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影响因子：
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通讯作者：
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影响因子：
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作者：
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