A truly human interface: interacting face-to-face with someone whose words are determined by a computer program

Implementation of Chatbot Technology in Health Care: Protocol for a Bibliometric Analysis

BACKGROUND

Chatbots have the potential to increase people's access to quality health care. However, the implementation of chatbot technology in the health care system is unclear due to the scarce analysis of publications on the adoption of chatbot in health and medical settings.

OBJECTIVE

This paper presents a protocol of a bibliometric analysis aimed at offering the public insights into the current state and emerging trends in research related to the use of chatbot technology for promoting health.

METHODS

In this bibliometric analysis, we will select published papers from the databases of CINAHL, IEEE Xplore, PubMed, Scopus, and Web of Science that pertain to chatbot technology and its applications in health care. Our search strategy includes keywords such as "chatbot," "virtual agent," "virtual assistant," "conversational agent," "conversational AI," "interactive agent," "health," and "healthcare." Five researchers who are AI engineers and clinicians will independently review the titles and abstracts of selected papers to determine their eligibility for a full-text review. The corresponding author (ZN) will serve as a mediator to address any discrepancies and disputes among the 5 reviewers. Our analysis will encompass various publication patterns of chatbot research, including the number of annual publications, their geographic or institutional distribution, and the number of annual grants supporting chatbot research, and further summarize the methodologies used in the development of health-related chatbots, along with their features and applications in health care settings. Software tool VOSViewer (version 1.6.19; Leiden University) will be used to construct and visualize bibliometric networks.

RESULTS

The preparation for the bibliometric analysis began on December 3, 2021, when the research team started the process of familiarizing themselves with the software tools that may be used in this analysis, VOSViewer and CiteSpace, during which they consulted 3 librarians at the Yale University regarding search terms and tentative results. Tentative searches on the aforementioned databases yielded a total of 2340 papers. The official search phase started on July 27, 2023. Our goal is to complete the screening of papers and the analysis by February 15, 2024.

CONCLUSIONS

Artificial intelligence chatbots, such as ChatGPT (OpenAI Inc), have sparked numerous discussions within the health care industry regarding their impact on human health. Chatbot technology holds substantial promise for advancing health care systems worldwide. However, developing a sophisticated chatbot capable of precise interaction with health care consumers, delivering personalized care, and providing accurate health-related information and knowledge remain considerable challenges. This bibliometric analysis seeks to fill the knowledge gap in the existing literature on health-related chatbots, entailing their applications, the software used in their development, and their preferred functionalities among users.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/54349.

Physicians' Perceptions of the Use of a Chatbot for Information Seeking: Qualitative Study

Background

Seeking medical information can be an issue for physicians. In the specific context of medical practice, chatbots are hypothesized to present additional value for providing information quickly, particularly as far as drug risk minimization measures are concerned.

Objective

This qualitative study aimed to elicit physicians’ perceptions of a pilot version of a chatbot used in the context of drug information and risk minimization measures.

Methods

General practitioners and specialists were recruited across France to participate in individual semistructured interviews. Interviews were recorded, transcribed, and analyzed using a horizontal thematic analysis approach.

Results

Eight general practitioners and 2 specialists participated. The tone and ergonomics of the pilot version were appreciated by physicians. However, all participants emphasized the importance of getting exhaustive, trustworthy answers when interacting with a chatbot.

Conclusions

The chatbot was perceived as a useful and innovative tool that could easily be integrated into routine medical practice and could help health professionals when seeking information on drug and risk minimization measures.

Family health history collected by virtual conversational agents: An empirical study to investigate the efficacy of this approach

Family health history (FHx) is one of the simplest and most cost-effective and efficient ways to collect health information that could help diagnose and treat genetic diseases at an early stage. This study evaluated the efficacy of collecting such family health histories through a virtual conversational agent (VCA) interface, a new method for collecting this information. Standard and VCA interfaces for FHx collection were investigated with 50 participants, recruited via email and word of mouth, using a within-subject experimental design with the order of the interfaces randomized and counterbalanced. Interface workload, usability, preference, and satisfaction were assessed using the NASA Task Load Index workload instrument, the IBM Computer System Usability Questionnaire, and a brief questionnaire derived from the Technology Acceptance Model. The researchers also recorded the number of errors and the total task completion time. It was found that the completion times for 2 of the 5 tasks were shorter for the VCA interface than for the standard one, but the overall completion time was longer (17 min 44 s vs. 16 min 51 s, p = .019). We also found the overall workload to be significantly lower (34.32 vs. 42.64, p = .003) for the VCA interface, and usability metrics including overall satisfaction (5.62 vs. 4.72, p < .001), system usefulness (5.76 vs. 4.84, p = .001), information quality (5.43 vs. 4.62, p < .001), and interface quality (5.66 vs. 4.64, p < .001) to be significantly higher for this interface as well. Approximately 3 out of 4 participants preferred the VCA interface to the standard one. Although the overall time taken was slightly longer than with standard interface, the VCA interface was rated significantly better across all other measures and was preferred by the participants. These findings demonstrate the advantages of an innovative VCA interface for collecting FHx, validating the efficacy of using VCAs to collect complex patient-specific data in health care.

Voices off: Stanley Milgram's cyranoids in historical context

This article revisits a forgotten, late project by the social psychologist Stanley Milgram: the 'cyranoid' studies he conducted from 1977 to 1984. These investigations, inspired by the play Cyrano de Bergerac, explored how individuals often fail to notice when others do not speak their own thoughts, but instead relay messages from a hidden source. We situate these experiments amidst the intellectual, cultural, and political concerns of late Cold War America, and show how Milgram's studies pulled together a variety of ideas, anxieties, and interests that were prevalent at that time and have returned in new guises since. In discussing the cyranoid project's background and afterlife, we argue that its strikingly equivocal quality has lent itself to multiple reinterpretations by historians, psychologists, performers, artists, and others. Our purpose is neither to champion Milgram's work nor to amplify the critiques already made of his methods. Rather, it is to consider the uncertain, allusive, and elusive aspects of the cyranoid project, and to seek to place that project in context, whilst asking where 'context' might end. We show how the experiments' range of meanings, in different temporal registers, far exceeded the explanatory rubric that Milgram and his intellectual critics provided at that time, and ponder the risk for the historian of making anachronistic or teleological assumptions. In short, we argue, cyranoids invite our open-ended exploration of 'voices offstage' in social and psychological relations, and offer a useful tool for thinking about historical context and the nature of historical interpretations.

Participants Over-Estimate How Helpful They Are in a Two-Player Game Scenario Toward an Artificial Confederate That Discloses a Diagnosis of Autism

Research on how autistic people are perceived by neurotypical people indicates that disclosing a diagnosis leads to a positive discriminatory bias; however, autobiographical autistic accounts indicate that diagnostic disclosure often results in negative discriminatory behavior. We report on an exploratory study to compare people’s self-reported helping behavior with their actual helping behavior toward an assumed autistic collaborator. We led 255 participants to believe that they were interacting online with a real person to play Dyad3D, a maze navigation game where players must work together to open doors, and complete the levels. However, participants were actually playing with an artificial confederate (AC) that is programmed to behave the same way across all interactions. This design enabled us to manipulate the diagnostic status of the AC that participants received prior to collaboration across three conditions: no disclosure, dyslexia-disclosure, and autism-disclosure. We use this method to explore two research questions: (1) is Dyad3D viable in creating a simulated interaction that could deceive participants into believing they were collaborating with another human player online? and (2) what are the effects of disclosing an autism diagnosis on social perception and collaboration? Combined with a post-game questionnaire, we compared differences between diagnostic conditions and differences between self-reported behavior and actual behavior in the game. Our findings show that Dyad3D proved to be an efficient and viable method for creating a believable interaction (deception success rate >96%). Moreover, diagnostic disclosure of autism results in the AC being perceived as more intelligent and useful, but participants also perceived themselves to be more helpful toward the AC than they actually were. We evaluate the strengths and limitations of the current method and provide recommendations for future research. The source code for Dyad3D is freely available (CC-BY-NC 4.0) so that the study is reproducible and open to future adaptation.

The Body That Speaks: Recombining Bodies and Speech Sources in Unscripted Face-to-Face Communication

This article examines advances in research methods that enable experimental substitution of the speaking body in unscripted face-to-face communication. A taxonomy of six hybrid social agents is presented by combining three types of bodies (mechanical, virtual, and human) with either an artificial or human speech source. Our contribution is to introduce and explore the significance of two particular hybrids: (1) the cyranoid method that enables humans to converse face-to-face through the medium of another person's body, and (2) the echoborg method that enables artificial intelligence to converse face-to-face through the medium of a human body. These two methods are distinct in being able to parse the unique influence of the human body when combined with various speech sources. We also introduce a new framework for conceptualizing the body's role in communication, distinguishing three levels: self's perspective on the body, other's perspective on the body, and self's perspective of other's perspective on the body. Within each level the cyranoid and echoborg methodologies make important research questions tractable. By conceptualizing and synthesizing these methods, we outline a novel paradigm of research on the role of the body in unscripted face-to-face communication.

Interviewing Suspects with Avatars: Avatars Are More Effective When Perceived as Human

It has been consistently demonstrated that deceivers generally can be discriminated from truth tellers by monitoring an increase in their physiological response. But is this still the case when deceivers interact with a virtual avatar? The present research investigated whether the mere “belief” that the virtual avatar is computer or human operated forms a crucial factor for eliciting physiological cues to deception. Participants were interviewed about a transgression they had been seduced to commit, by a human-like virtual avatar. In a between-subject design, participants either deceived or told the truth about this transgression. During the interviews, we measured the physiological responses assessing participants' electrodermal activity (EDA). In line with our hypothesis, EDA differences between deceivers and truth tellers only were significant for participants who believed they interacted with a human operated (compared to a computer operated) avatar. These results have theoretical as well as practical implications which we will discuss.