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Lim WA, Custodio R, Sunga M, Amoranto AJ, Sarmiento RF. General Characteristics and Design Taxonomy of Chatbots for COVID-19: Systematic Review. J Med Internet Res 2024; 26:e43112. [PMID: 38064638 PMCID: PMC10773556 DOI: 10.2196/43112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/28/2023] [Accepted: 07/11/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND A conversational agent powered by artificial intelligence, commonly known as a chatbot, is one of the most recent innovations used to provide information and services during the COVID-19 pandemic. However, the multitude of conversational agents explicitly designed during the COVID-19 pandemic calls for characterization and analysis using rigorous technological frameworks and extensive systematic reviews. OBJECTIVE This study aims to describe the general characteristics of COVID-19 chatbots and examine their system designs using a modified adapted design taxonomy framework. METHODS We conducted a systematic review of the general characteristics and design taxonomy of COVID-19 chatbots, with 56 studies included in the final analysis. This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to select papers published between March 2020 and April 2022 from various databases and search engines. RESULTS Results showed that most studies on COVID-19 chatbot design and development worldwide are implemented in Asia and Europe. Most chatbots are also accessible on websites, internet messaging apps, and Android devices. The COVID-19 chatbots are further classified according to their temporal profiles, appearance, intelligence, interaction, and context for system design trends. From the temporal profile perspective, almost half of the COVID-19 chatbots interact with users for several weeks for >1 time and can remember information from previous user interactions. From the appearance perspective, most COVID-19 chatbots assume the expert role, are task oriented, and have no visual or avatar representation. From the intelligence perspective, almost half of the COVID-19 chatbots are artificially intelligent and can respond to textual inputs and a set of rules. In addition, more than half of these chatbots operate on a structured flow and do not portray any socioemotional behavior. Most chatbots can also process external data and broadcast resources. Regarding their interaction with users, most COVID-19 chatbots are adaptive, can communicate through text, can react to user input, are not gamified, and do not require additional human support. From the context perspective, all COVID-19 chatbots are goal oriented, although most fall under the health care application domain and are designed to provide information to the user. CONCLUSIONS The conceptualization, development, implementation, and use of COVID-19 chatbots emerged to mitigate the effects of a global pandemic in societies worldwide. This study summarized the current system design trends of COVID-19 chatbots based on 5 design perspectives, which may help developers conveniently choose a future-proof chatbot archetype that will meet the needs of the public in the face of growing demand for a better pandemic response.
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Affiliation(s)
- Wendell Adrian Lim
- National Telehealth Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Razel Custodio
- National Telehealth Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Monica Sunga
- National Telehealth Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Abegail Jayne Amoranto
- National Telehealth Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Raymond Francis Sarmiento
- National Telehealth Center, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
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El-Sherif DM, Ahmed AA, Sharif AF, Elzarif MT, Abouzid M. Greenway of Digital Health Technology During COVID-19 Crisis: Bibliometric Analysis, Challenges, and Future Perspective. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1458:315-334. [PMID: 39102206 DOI: 10.1007/978-3-031-61943-4_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Digital health has transformed the healthcare landscape by leveraging technology to improve patient outcomes and access to medical services. The COVID-19 pandemic has highlighted the urgent need for digital healthcare solutions that can mitigate the impact of the outbreak while ensuring patient safety. In this chapter, we delve into how digital health technologies such as telemedicine, mobile apps, and wearable devices can provide personalized care, reduce healthcare provider burden, and lower healthcare costs. We also explore the creation of a greenway of digital healthcare that safeguards patient confidentiality, enables efficient communication, and ensures cost-effective payment systems. This chapter showcases the potential of digital health to revolutionize healthcare delivery while ensuring patient well-being and medical staff satisfaction.
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Affiliation(s)
- Dina M El-Sherif
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, 214122, China.
- National Institute of Oceanography and Fisheries (NIOF), Cairo, Egypt.
| | - Alhassan Ali Ahmed
- Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, 60-781, Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, 60-812, Poznan, Poland
| | - Asmaa Fady Sharif
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt
- Clinical Medical Sciences Department, College of Medicine, Dar Al-Uloom University, Riyadh, Saudi Arabia
| | | | - Mohamed Abouzid
- Doctoral School, Poznan University of Medical Sciences, 60-812, Poznan, Poland
- Department of Physical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3 St., 60-806, Poznan, Poland
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Herrera-Espejel PS, Rach S. The Use of Machine Translation for Outreach and Health Communication in Epidemiology and Public Health: Scoping Review. JMIR Public Health Surveill 2023; 9:e50814. [PMID: 37983078 PMCID: PMC10696499 DOI: 10.2196/50814] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/11/2023] [Accepted: 10/06/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Culturally and linguistically diverse groups are often underrepresented in population-based research and surveillance efforts, leading to biased study results and limited generalizability. These groups, often termed "hard-to-reach," commonly encounter language barriers in the public health (PH) outreach material and information campaigns, reducing their involvement with the information. As a result, these groups are challenged by 2 effects: the medical and health knowledge is less tailored to their needs, and at the same time, it is less accessible for to them. Modern machine translation (MT) tools might offer a cost-effective solution to PH material language accessibility problems. OBJECTIVE This scoping review aims to systematically investigate current use cases of MT specific to the fields of PH and epidemiology, with a particular interest in its use for population-based recruitment methods. METHODS PubMed, PubMed Central, Scopus, ACM Digital Library, and IEEE Xplore were searched to identify articles reporting on the use of MT in PH and epidemiological research for this PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews)-compliant scoping review. Information on communication scenarios, study designs and the principal findings of each article were mapped according to a settings approach, the World Health Organization monitoring and evaluation framework and the service readiness level framework, respectively. RESULTS Of the 7186 articles identified, 46 (0.64%) were included in this review, with the earliest study dating from 2009. Most of the studies (17/46, 37%) discussed the application of MT to existing PH materials, limited to one-way communication between PH officials and addressed audiences. No specific article investigated the use of MT for recruiting linguistically diverse participants to population-based studies. Regarding study designs, nearly three-quarters (34/46, 74%) of the articles provided technical assessments of MT from 1 language (mainly English) to a few others (eg, Spanish, Chinese, or French). Only a few (12/46, 26%) explored end-user attitudes (mainly of PH employees), whereas none examined the legal or ethical implications of using MT. The experiments primarily involved PH experts with language proficiencies. Overall, more than half (38/70, 54% statements) of the summarizing results presented mixed and inconclusive views on the technical readiness of MT for PH information. CONCLUSIONS Using MT in epidemiology and PH can enhance outreach to linguistically diverse populations. The translation quality of current commercial MT solutions (eg, Google Translate and DeepL Translator) is sufficient if postediting is a mandatory step in the translation workflow. Postediting of legally or ethically sensitive material requires staff with adequate content knowledge in addition to sufficient language skills. Unsupervised MT is generally not recommended. Research on whether machine-translated texts are received differently by addressees is lacking, as well as research on MT in communication scenarios that warrant a response from the addressees.
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Affiliation(s)
- Paula Sofia Herrera-Espejel
- Department Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Leibniz ScienceCampus Digital Public Health, Bremen, Germany
| | - Stefan Rach
- Department Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Leibniz ScienceCampus Digital Public Health, Bremen, Germany
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Quintana Y, Cullen TA, Holmes JH, Joshi A, Novillo-Ortiz D, Liaw ST. Global Health Informatics: the state of research and lessons learned. J Am Med Inform Assoc 2023; 30:627-633. [PMID: 36924133 PMCID: PMC10018255 DOI: 10.1093/jamia/ocad027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/23/2023] [Indexed: 03/18/2023] Open
Affiliation(s)
- Yuri Quintana
- Division of Clinical Informatics, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Theresa A Cullen
- Public Health Department, Pima County Arizona, Tucson, Arizona, USA
| | - John H Holmes
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Ashish Joshi
- School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | | | - Siaw-Teng Liaw
- School of Population Health, UNSW, Sydney, Sydney, Australia
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Czerniak K, Pillai R, Parmar A, Ramnath K, Krocker J, Myneni S. A scoping review of digital health interventions for combating COVID-19 misinformation and disinformation. J Am Med Inform Assoc 2023; 30:752-760. [PMID: 36707998 PMCID: PMC10018269 DOI: 10.1093/jamia/ocad005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/15/2022] [Accepted: 01/25/2023] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE We provide a scoping review of Digital Health Interventions (DHIs) that mitigate COVID-19 misinformation and disinformation seeding and spread. MATERIALS AND METHODS We applied our search protocol to PubMed, PsychINFO, and Web of Science to screen 1666 articles. The 17 articles included in this paper are experimental and interventional studies that developed and tested public consumer-facing DHIs. We examined these DHIs to understand digital features, incorporation of theory, the role of healthcare professionals, end-user experience, and implementation issues. RESULTS The majority of studies (n = 11) used social media in DHIs, but there was a lack of platform-agnostic generalizability. Only half of the studies (n = 9) specified a theory, framework, or model to guide DHIs. Nine studies involve healthcare professionals as design or implementation contributors. Only one DHI was evaluated for user perceptions and acceptance. DISCUSSION The translation of advances in online social computing to interventions is sparse. The limited application of behavioral theory and cognitive models of reasoning has resulted in suboptimal targeting of psychosocial variables and individual factors that may drive resistance to misinformation. This affects large-scale implementation and community outreach efforts. DHIs optimized through community-engaged participatory methods that enable understanding of unique needs of vulnerable communities are urgently needed. CONCLUSIONS We recommend community engagement and theory-guided engineering of equitable DHIs. It is important to consider the problem of misinformation and disinformation through a multilevel lens that illuminates personal, clinical, cultural, and social pathways to mitigate the negative consequences of misinformation and disinformation on human health and wellness.
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Affiliation(s)
- Katarzyna Czerniak
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Raji Pillai
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Abhi Parmar
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Kavita Ramnath
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Joseph Krocker
- Department of Surgery, McGovern Medical School, Center for Translational Injury Research, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Sahiti Myneni
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA
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The Epidemiology of Infectious Diseases Meets AI: A Match Made in Heaven. Pathogens 2023; 12:pathogens12020317. [PMID: 36839589 PMCID: PMC9963936 DOI: 10.3390/pathogens12020317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
Infectious diseases remain a major threat to public health [...].
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Castillo-Sánchez G, Acosta MJ, Garcia-Zapirain B, De la Torre I, Franco-Martín M. Application of Machine Learning Techniques to Help in the Feature Selection Related to Hospital Readmissions of Suicidal Behavior. Int J Ment Health Addict 2022:1-22. [PMID: 35873865 PMCID: PMC9294773 DOI: 10.1007/s11469-022-00868-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 11/02/2022] Open
Abstract
Suicide was the main source of death from external causes in Spain in 2020, with 3,941 cases. The importance of identifying those mental disorders that influenced hospital readmissions will allow us to manage the health care of suicidal behavior. The feature selection of each hospital in this region was carried out by applying Machine learning (ML) and traditional statistical methods. The results of the characteristics that best explain the readmissions of each hospital after assessment by the psychiatry specialist are presented. Adjustment disorder, alcohol abuse, depressive syndrome, personality disorder, and dysthymic disorder were selected for this region. The most influential methods or characteristics associated with suicide were benzodiazepine poisoning, suicidal ideation, medication poisoning, antipsychotic poisoning, and suicide and/or self-harm by jumping. Suicidal behavior is a concern in our society, so the results are relevant for hospital management and decision-making for its prevention.
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Affiliation(s)
- Gema Castillo-Sánchez
- Department of Signal Theory and Communications, and Telematics Engineering, Universidad de Valladolid, Paseo de Belén 15, 47011 Valladolid, Spain
| | | | | | - Isabel De la Torre
- Department of Signal Theory and Communications, and Telematics Engineering, Universidad de Valladolid, Paseo de Belén 15, 47011 Valladolid, Spain
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Ramírez-del Real T, Martínez-García M, Márquez MF, López-Trejo L, Gutiérrez-Esparza G, Hernández-Lemus E. Individual Factors Associated With COVID-19 Infection: A Machine Learning Study. Front Public Health 2022; 10:912099. [PMID: 35844896 PMCID: PMC9279686 DOI: 10.3389/fpubh.2022.912099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
The fast, exponential increase of COVID-19 infections and their catastrophic effects on patients' health have required the development of tools that support health systems in the quick and efficient diagnosis and prognosis of this disease. In this context, the present study aims to identify the potential factors associated with COVID-19 infections, applying machine learning techniques, particularly random forest, chi-squared, xgboost, and rpart for feature selection; ROSE and SMOTE were used as resampling methods due to the existence of class imbalance. Similarly, machine and deep learning algorithms such as support vector machines, C4.5, random forest, rpart, and deep neural networks were explored during the train/test phase to select the best prediction model. The dataset used in this study contains clinical data, anthropometric measurements, and other health parameters related to smoking habits, alcohol consumption, quality of sleep, physical activity, and health status during confinement due to the pandemic associated with COVID-19. The results showed that the XGBoost model got the best features associated with COVID-19 infection, and random forest approximated the best predictive model with a balanced accuracy of 90.41% using SMOTE as a resampling technique. The model with the best performance provides a tool to help prevent contracting SARS-CoV-2 since the variables with the highest risk factor are detected, and some of them are, to a certain extent controllable.
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Affiliation(s)
- Tania Ramírez-del Real
- Cátedras Conacyt, National Council on Science and Technology, Mexico City, Mexico
- Center for Research in Geospatial Information Sciences, Mexico City, Mexico
| | - Mireya Martínez-García
- Clinical Research Division, National Institute of Cardiology “Ignacio Chávez”, Mexico City, Mexico
| | - Manlio F. Márquez
- Clinical Research Division, National Institute of Cardiology “Ignacio Chávez”, Mexico City, Mexico
| | - Laura López-Trejo
- Institute for Security and Social Services of State Workers, Mexico City, Mexico
| | - Guadalupe Gutiérrez-Esparza
- Cátedras Conacyt, National Council on Science and Technology, Mexico City, Mexico
- Clinical Research Division, National Institute of Cardiology “Ignacio Chávez”, Mexico City, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Division, National Institute of Genomic Medicine, Mexico City, Mexico
- Center for Complexity Sciences, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Raising Awareness of Smartphone Overuse among University Students: A Persuasive Systems Approach. INFORMATICS 2022. [DOI: 10.3390/informatics9010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Smartphone overuse can lead to a series of physical, mental and social disturbances. This problem is more prevalent among young adults as compared to other demographic groups. Additionally, university students are already undergoing high cognitive loads and stress conditions; therefore, they are more susceptible to smartphone addiction and its derived problems. In this paper, we present a novel approach where a conversational mobile agent uses persuasive messages exploring the reflective mind to raise users’ awareness of their usage and consequently induce reduction behaviors. We conducted a four-week study with 16 university students undergoing stressful conditions—a global lockdown during their semester—and evaluated the impact of the agent on smartphone usage reduction and the perceived usefulness of such an approach. Results show the efficacy of self-tracking in the behavior change process: 81% of the users reduced their usage time, and all of them mentioned that having a conversational agent alerting them about their usage was useful. Before this experiment, only 68% of them considered such an approach could be useful. In conclusion, users deemed it essential to have an engaging conversational agent on their smartphones, in terms of helping them become more aware of usage times.
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HIV Patients’ Tracer for Clinical Assistance and Research during the COVID-19 Epidemic (INTERFACE): A Paradigm for Chronic Conditions. INFORMATION 2022. [DOI: 10.3390/info13020076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The health emergency linked to the SARS-CoV-2 pandemic has highlighted problems in the health management of chronic patients due to their risk of infection, suggesting the need of new methods to monitor patients. People living with HIV/AIDS (PLWHA) represent a paradigm of chronic patients where an e-health-based remote monitoring could have a significant impact in maintaining an adequate standard of care. The key objective of the study is to provide both an efficient operating model to “follow” the patient, capture the evolution of their disease, and establish proximity and relief through a remote collaborative model. These dimensions are collected through a dedicated mobile application that triggers questionnaires on the basis of decision-making algorithms, tagging patients and sending alerts to staff in order to tailor interventions. All outcomes and alerts are monitored and processed through an innovative e-Clinical platform. The processing of the collected data aims into learning and evaluating predictive models for the possible upcoming alerts on the basis of past data, using machine learning algorithms. The models will be clinically validated as the study collects more data, and, if successful, the resulting multidimensional vector of past attributes will act as a digital composite biomarker capable of predicting HIV-related alerts. Design: All PLWH > 18 sears old and stable disease followed at the outpatient services of a university hospital (n = 1500) will be enrolled in the interventional study. The study is ongoing, and patients are currently being recruited. Preliminary results are yielding monthly data to facilitate learning of predictive models for the alerts of interest. Such models are learnt for one or two months of history of the questionnaire data. In this manuscript, the protocol—including the rationale, detailed technical aspects underlying the study, and some preliminary results—are described. Conclusions: The management of HIV-infected patients in the pandemic era represents a challenge for future patient management beyond the pandemic period. The application of artificial intelligence and machine learning systems as described in this study could enable remote patient management that takes into account the real needs of the patient and the monitoring of the most relevant aspects of PLWH management today.
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Translation and Expansion: Enabling Laypeople Access to the COVID-19 Academic Collection. DATA AND INFORMATION MANAGEMENT 2020; 4:177-190. [PMID: 35382101 PMCID: PMC8969476 DOI: 10.2478/dim-2020-0011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 05/31/2020] [Indexed: 11/20/2022]
Abstract
Academic collections, such as COVID-19 Open Research Dataset (CORD-19), contain a large number of scholarly articles regarding COVID-19 and other related viruses. These articles represent the latest development in combating COVID-19 pandemic in various disciplines. However, it is difficult for laypeople to access these articles due to the term mismatch problem caused by their limited medical knowledge. In this article, we present an effort of helping laypeople to access the CORD-19 collection by translating and expanding laypeople's keywords to their corresponding medical terminology using the National Library of Medicine's Consumer Health Vocabulary. We then developed a retrieval system called Search engine for Laypeople to access the COVID-19 literature (SLAC) using open-source software. Utilizing Centers for Disease Control and Prevention's FAQ questions as the basis for developing common questions that laypeople could be interested in, we performed a set of experiments for testing the SLAC system and the translation and expansion (T&E) process. Our experiment results demonstrate that the T&E process indeed helped to overcome the term mismatch problem and mapped laypeople terms to the medical terms in the academic articles. But we also found that not all laypeople's search topics are meaningful to search on the CORD-19 collection. This indicates the scope and the limitation of enabling laypeople to search on academic article collection for obtaining high-quality information.
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