Chatbots Utility in Healthcare Industry: An Umbrella Review

Amir Masoud Afsahi, Seyed Ahmad Seyed Alinaghi, Ayoob Molla, Pegah Mirzapour, Shima Jahani, Armin Razi, Paniz Mojdeganlou, Elaheh Karimi, Mohammad Mehrtak, Omid Dadras, Ghazaleh Afsahi, Shahla F. Syed, Alexander Norbash, Esmaeil Mehraeen
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Abstract

Introduction: Chatbots, computer programs emulating natural language conversations, have gained attention in healthcare. Recent advances address issues like obesity, dementia, oncology, and insomnia. A comprehensive assessment of their utility is essential for widespread adoption. This study aims to summarize chatbots' role in healthcare.

Material and Methods: The methodology involved a systematic review of English-language literature up to May 8, 2023, from databases of Embase, PubMed, Web of Science, and Scopus. Selection followed a two-step process based on inclusion/exclusion criteria. The PRISMA checklist and AMSTAR-2 tool ensured quality.

Results: The review encompassed 38 articles. Findings reveal chatbots primarily promote healthy lifestyles, improving mental well-being. They are widely used for treatment, education, and screening due to their accessibility.

Conclusion: Chatbots hold transformative potential in healthcare, especially in mental health, cancer management, and public health. They are poised to revolutionize the industry, offering innovative solutions and improving patient outcomes.

Keywords

Chatbots; Healthcare; ChatGPT; Large Language Models; LLMs; COVID-19;

References

McTear MF, Callejas Z, Griol D. The conversational interface: Talking to smart devices. Springer; 2016.

Davenport T, Kalakota R. The potential for artificial intelligence in healthcare. Future Healthc J. 2019; 6(2): 94-8. PMID: 31363513 DOI: 10.7861/futurehosp.6-2-94

Shamsabadi A, Pashaei Z, Karimi A, Mirzapour P, Qaderi K, Marhamati M, et al. Internet of things in the management of chronic diseases during the COVID-19 pandemic: A systematic review. Health Sci Rep. 2022; 5(2): e557. PMID: 35308419 DOI: 10.1002/hsr2.557

Mehraeen E, Mehrtak M, Seyed Alinaghi S, Nazeri Z, Afsahi AM, Behnezhad F, et al. Technology in the era of COVID-19: A systematic review of current evidence. Infect Disord Drug Targets. 2022; 22(4): e240322202551. PMID: 35331123 DOI: 10.2174/1871526522666220324090245

Vaidyam AN, Wisniewski H, Halamka JD, Kashavan MS, Torous JB. Chatbots and conversational agents in mental health: A review of the psychiatric landscape. Can J Psychiatry. 2019; 64(7): 456-64. PMID: 30897957 DOI: 10.1177/0706743719828977

Seyed Alinaghi S, Abbaspour F, Mehraeen E. The challenges of ChatGPT in healthcare scientific writing. Shiraz E-Medical Journal. 2024; 25(2): e141861.

Mohammadi S, Seyed Alinaghi S, Heydari M, Pashaei Z, Mirzapour P, Karimi A, et al. Artificial intelligence in COVID-19 management: A systematic review. Journal of Computer Science. 2023;19(5): 554-68.

Abdul-Kader SA, Woods JC. Survey on chatbot design techniques in speech conversation systems. International Journal of Advanced Computer Science and Applications. 2015; 6(7): 72-80.

Brandtzaeg PB, Følstad A. Why people use chatbots. International Conference of Internet Science. Springer; 2017.

Weizenbaum J. Eliza: A computer program for the study of natural language communication between man and machine. Communications of the ACM. 1983; 26(1): 23-8.

Donath J. The imperfect observer: Mind, machines, and materialism in the 21st century [Internet]. 2007 [cited: 10 Apr 2023]. Available from: https://smg.media.mit.edu/papers/Donath/TheImperfectObserver.pdf

Vijayarani M, Balamurugan G. Chatbot in mental health care. Indian Journal of Psychiatric Nursing. 2019; 16(2): 126.

Batacharia B, Levy D, Catizone R, Krotov A, Wilks Y. CONVERSE: A conversational companion. In: Wilks Y (Ed). Machine conversations. Springer; 1999.

Shawar BA, Atwell E. A comparison between Alice and Elizabeth chatbot systems. University of Leeds, School of Computing; 2002.

Bickmore TW, Schulman D, Sidner C. Automated interventions for multiple health behaviors using conversational agents. Patient Educ Couns. 2013; 92(2): 142-8. PMID: 23763983 DOI: 10.1016/j.pec.2013.05.011

Watson A, Bickmore T, Cange A, Kulshreshtha A, Kvedar J. An Internet-based virtual coach to promote physical activity adherence in overweight adults: Randomized controlled trial. J Med Internet Res. 2012; 14(1): e1. PMID: 22281837 DOI: 10.2196/jmir.1629

Edwards RA, Bickmore T, Jenkins L, Foley M, Manjourides J. Use of an interactive computer agent to support breastfeeding. Matern Child Health J. 2013; 17(10): 1961-8. PMID: 23329167 DOI: 10.1007/s10995-013-1222-0

Bickmore TW, Silliman RA, Nelson K, Cheng DM, Winter M, Henault L, et al. A randomized controlled trial of an automated exercise coach for older adults. J Am Geriatr Soc. 2013; 61(10): 1676-83. PMID: 24001030 DOI: 10.1111/jgs.12449

Radziwill NM, Benton MC. Evaluating quality of chatbots and intelligent conversational agents. Milwaukee. 2017; 19(3): 25-36.

McTear MF. Spoken dialogue technology: enabling the conversational user interface. ACM Computing Surveys. 2002; 34(1): 90-169.

Borah B, Pathak D, Sarmah P, Som B, Nandi S. Survey of textbased chatbot in perspective of recent technologies. International Conference of Computational Intelligence, Communications, and Business Analytics. Springer; 2018.

Dale R. The return of the chatbots. Natural Language Engineering. 2016; 22(5): 811-7.

Harvath TA, Mongoven JM, Bidwell JT, Cothran FA, Sexson KE, Mason DJ, et al. Research priorities in family caregiving: process and outcomes of a conference on family-centered care across the trajectory of serious illness. Gerontologist. 2020; 60(Suppl 1): S5-13. PMID: 32057081 DOI: 10.1093/geront/gnz138

Rodsawang C, Thongkliang P, Intawong T, Sonong A, Thitiwatthana Y, Chottanapund S. Designing a competent chatbot to counter the COVID-19 pandemic and empower risk communication in an emergency response system. Outbreak, Surveillance, Investigation & Response (OSIR) Journal. 2020; 13(2): 71-7.

Anders G. Alexa understand me. Technology Review. 2017; 120(5): 26-31.

Laranjo L, Dunn AG, Tong HL, Kocaballi AB, Chen J, Bashir R, et al. Conversational agents in healthcare: a systematic review. J Am Med Inform Assoc. 2018; 25(9): 1248-58. PMID: 30010941 DOI: 10.1093/jamia/ocy072

Zeni Montenegro JL, daCosta CA, daRosa Righi R. Survey of conversational agents in health. Expert Systems with Applications. 2019; 129: 56-67.

Bhirud N, Tataale S, Randive S, Nahar S. A literature review on chatbots in healthcare domain. International Journal of Scientific & Technology Research. 2019; 8(7): 225-31.

Tanielian TL, Tanielian T, Jaycox L. Invisible wounds of war: Psychological and cognitive injuries, their consequences, and services to assist recovery. Rand Corporation; 2008.

Lucas GM, Gratch J, King A, Morency L-P. It’s only a computer: Virtual humans increase willingness to disclose. Computers in Human Behavior. 2014; 37: 94-100.

Wolters MK, Kelly F, Kilgour J. Designing a spoken dialogue interface to an intelligent cognitive assistant for people with dementia. Health Informatics J. 2016; 22(4): 854-66. PMID: 26276794 DOI: 10.1177/1460458215593329

Nishida T, Nakazawa A, Ohmoto Y, Mohammad Y. Conversational informatics: A data-intensive approach with emphasis on nonverbal communication. Springer; 2014.

Bibault J-E, Chaix B, Nectoux P, Pienkowski A, Guillemasé A, Brouard B. Healthcare ex machina: Are conversational agents ready for prime time in oncology? Clin Transl Radiat Oncol. 2019; 16: 55-9. PMID: 31008379 DOI: 10.1016/j.ctro.2019.04.002

Luxton DD. Ethical implications of conversational agents in global public health. Bull World Health Organ. 2020; 98(4): 285-7. PMID: 32284654 DOI: 10.2471/BLT.19.237636

Tudor Car L, Dhinagaran DA, Kyaw BM, Kowatsch T, Joty S, Theng Y-L, et al. Conversational agents in health care: scoping review and conceptual analysis. J Med Internet Res. 2020; 22(8): e17158. PMID: 32763886 DOI: 10.2196/17158

Mehraeen E, SeyedAlinaghi S, Heydari M, Karimi A, Mahdavi A, Mashoufi M, et al. Telemedicine technologies and applications in the era of COVID-19 pandemic: A systematic review. Health Informatics J. 2023; 29(2): 14604582231167431. PMID: 37076954 DOI: 10.1177/14604582231167431

Huang C-Y, Yang M-C, Huang C-Y, Chen Y-J, Wu M-L, Chen K-W. A chatbot-supported smart wireless interactive healthcare system for weight control and health promotion. IEEE International Conference on Industrial Engineering and Engineering Management. IEEE; 2018.

Ruggiano N, Brown EL, Roberts L, Framil Suarez CV, Luo Y, Hao Z, et al. Chatbots to support people with dementia and their caregivers: Systematic review of functions and quality. J Med Internet Res. 2021; 23(6): e25006. PMID: 34081019 DOI: 10.2196/25006

Ogilvie L, Prescott J, Carson J. The use of chatbots as supportive agents for people seeking help with substance use disorder: A systematic review. Eur Addict Res. 2022; 28(6): 405-18. PMID: 36041418 DOI: 10.1159/000525959

Ahmed A, Hassan A, Aziz S, Abd-Alrazaq AA, Ali N, Alzubaidi M, et al. Chatbot features for anxiety and depression: A scoping review. Health Informatics J. 2023; 29(1): 14604582221146719. PMID: 36693014 DOI: 10.1177/14604582221146719

Kataoka Y, Takemura T, Sasajima M, Katoh N. Development and early feasibility of chatbots for educating patients with lung cancer and their caregivers in Japan: Mixed methods study. JMIR Cancer. 2021; 7(1): e26911. PMID: 33688839 DOI: 10.2196/26911

Pereira J, Díaz Ó. Using health chatbots for behavior change: a mapping study. J Med Syst. 2019; 43(5): 135. PMID: 30949846 DOI: 10.1007/s10916-019-1237-1

Wang R, Wang J, Liao Y, Wang J. Supervised machine learning chatbots for perinatal mental healthcare. International Conference on Intelligent Computing and Human-Computer Interaction. IEEE; 2020.

Brixey J, Hoegen R, Lan W, Rusow J, Singla K, Yin X, et al. SHIHbot: A facebook chatbot for sexual health information on hiv/aids. Annual SIGdial Meeting on Discourse and Dialogue. Association for Computational Linguistics; 2017.

Ahmed A, Ali N, Aziz S, Abd-Alrazaq AA, Hassan A, Khalifa M, et al. A review of mobile chatbot apps for anxiety and depression and their self-care features. Computer Methods and Programs in Biomedicine Update. 2021; 1: 100012.

Gonzalez R. Virtual therapists help veterans open up about PTSD [Internet]. 2017 [cited: 23 Jul 2023]. Available from: https://www.wired.com/story/virtual-therapists-help-veterans-open-up-about-ptsd/

Hernandez D. Meet the chatbots providing mental health care [Internet]. 2018 [cited: 18 Jul 2023]. Available from: https://www.wsj.com/articles/meet-the-chatbots-providing-mental-healthcare-1533828373

Abd-Alrazaq AA, Alajlani M, Alalwan AA, Bewick BM, Gardner P, Househ M. An overview of the features of chatbots in mental health: A scoping review. Int J Med Inform. 2019; 132: 103978. PMID: 31622850 DOI: 10.1016/j.ijmedinf.2019.103978

Abd-Alrazaq A, Safi Z. Technical metrics used to evaluate health care chatbots: Scoping review. J Med Internet Res. 2020; 22(6): e18301. PMID: 32442157 DOI: 10.2196/18301

Abd-Alrazaq AA. Perceptions and Opinions of Patients About Mental Health Chatbots: Scoping Review. J Med Internet Res. 2021; 23(1): e17828. PMID: 33439133 DOI: 10.2196/17828

Abd-Alrazaq AA, Alajlani M, Ali N, Denecke K, Bewick BM, Househ M. Patients’ perceptions and opinions about mental health chatbots: A scoping review. J Med Internet Res. 2021; 23(1): e17828. PMID: 33439133 DOI: 10.2196/17828

Aggarwal A, Tam CC, Wu D, Li X, Qiao S. Artificial intelligence–based chatbots for promoting health behavioral changes: Systematic review. J Med Internet Res. 2023; 25: e40789. PMID: 36826990 DOI: 10.2196/40789

Albites-Tapia A, Gamboa-Cruzado J, Almeyda-Ortiz J, Lazaro AM. Chatbots for the detection of COVID-19: A systematic review of the literature. International Journal of Advanced Computer Science and Applications. 2022; 13(4): 991-8.

Almalki M, Azeez F. Health chatbots for fighting COVID-19: A scoping review. Acta Inform Med. 2020; 28(4): 241-7. PMID: 33627924 DOI: 10.5455/aim.2020.28.241-247

Amiri P, Karahanna E. Chatbot use cases in the Covid-19 public health response. J Am Med Inform Assoc. 2022; 29(5): 1000-10. PMID: 35137107 DOI: 10.1093/jamia/ocac014

Bendig E, Erb B, Schulze-Thuesing L, Baumeister H. The next generation: Chatbots in clinical psychology and psychotherapy to foster mental health- A scoping review. Verhaltenstherapie. 2022; 32(Suppl 1): 64-76.

Boumans R, van de Sande Y, Thill S, Bosse T. Voice-enabled intelligent virtual agents for people with amnesia: Systematic review. JMIR Aging. 2022; 5(2): e32473. PMID: 35468084 DOI: 10.2196/32473

Chew HSJ. The use of artificial intelligence-based conversational agents (chatbots) for weight loss: Scoping review and practical recommendations. JMIR Med Inform. 2022; 10(4): e32578. PMID: 35416791 DOI: 10.2196/32578

Denecke K, May R. Usability assessment of conversational agents in healthcare: A literature review. Stud Health Technol Inform. 2022; 294: 169-73. PMID: 35612050 DOI: 10.3233/SHTI220431

Fgaier M, Zrubka Z. Cost-effectiveness of using chatbots in healthcare: A systematic review. International Symposium on Computational Intelligence and Informatics and International Conference on Recent Achievements in Mechatronics, Automation, Computer Science and Robotics. IEEE; 2022.

Gabarron E, Larbi D, Denecke K, Ã…rsand E. What do we know about the use of chatbots for public health? Stud Health Technol Inform. 2020; 270: 796-800. PMID: 32570492 DOI: 10.3233/SHTI200270

Garg S, Williams NL, Ip A, Dicker AP. Clinical integration of digital solutions in health care: An overview of the current landscape of digital technologies in cancer care. JCO Clin Cancer Inform. 2018; 2: 1-9. PMID: 30652580 DOI: 10.1200/CCI.17.00159

He Y, Yang L. Conversational agent interventions for mental health problems: systematic review and meta-analysis of randomized controlled trials. J Med Internet Res. 2023; 25: e43862. PMID: 37115595 DOI: 10.2196/43862

Hoermann S, McCabe KL, Milne DN, Calvo RA. Application of synchronous text-based dialogue systems in mental health interventions: Systematic review. J Med Internet Res. 2017; 19(8): e267. PMID: 28784594 DOI: 10.2196/jmir.7023

Lim SM, Shiau CWC, Cheng LJ, Lau Y. Chatbot-delivered psychotherapy for adults with depressive and anxiety symptoms: A systematic review and meta-regression. Behav Ther. 2022; 53(2): 334-47. PMID: 35227408 DOI: 10.1016/j.beth.2021.09.007

Martinengo L. Conversational agents in health care: Scoping review of their behavior change techniques and underpinning theory. J Med Internet Res. 2022; 24(10): e39243. PMID: 36190749 DOI: 10.2196/39243

Milne-Ives M, de Cock C, Lim E, Shehadeh MH, de Pennington N, Mole G, et al. The effectiveness of artificial intelligence conversational agents in health care: Systematic review. J Med Internet Res. 2020; 22(10): e20346. PMID: 33090118 DOI: 10.2196/20346

Oh YJ, Zhang J, Fang M-L, Fukuoka Y. A systematic review of artificial intelligence chatbots for promoting physical activity, healthy diet, and weight loss. Int J Behav Nutr Phys Act. 2021; 18(1): 160. PMID: 34895247 DOI: 10.1186/s12966-021-01224-6

Provoost S, Lau HM. Embodied conversational agents in clinical psychology: A scoping review. J Med Internet Res. 2017; 19(5): e151. PMID: 28487267 DOI: 10.2196/jmir.6553

Safi Z, Abd-Alrazaq A, Khalifa M, Househ M. Technical aspects of developing chatbots for medical applications: Scoping review. J Med Internet Res. 2020; 22(12): e19127. PMID: 33337337 DOI: 10.2196/19127

Sallam M. ChatGPT utility in healthcare education, research, and practice: Systematic review on the promising perspectives and valid concerns. Healthcare (Basel). 2023; 11(6): 887. PMID: 36981544 DOI: 10.3390/healthcare11060887

Tjiptomongsoguno ARW, Chen A, Sanyoto HM, Irwansyah E, Kanigoro B. Medical chatbot techniques: A review. Conference of Computational Methods in Systems and Software. Springer; 2020.

Vaidyam AN, Linggonegoro D, Torous J. Changes to the psychiatric chatbot landscape: A systematic review of conversational agents in serious mental illness. Can J Psychiatry. 2021; 66(4): 339-48. PMID: 33063526 DOI: 10.1177/0706743720966429

Wang A, Qian Z, Briggs L, Cole AP, Reis LO, Trinh Q-D. The use of chatbots in oncological care: A narrative review. Int J Gen Med. 2023; 16: 1591-602. PMID: 37152273 DOI: 10.2147/IJGM.S408208

White BK, Martin A, White JA. User experience of COVID-19 chatbots: Scoping review. J Med Internet Res. 2022; 24(12): e35903. PMID: 36520624 DOI: 10.2196/35903

Whittaker R, Dobson R, Garner K. Chatbots for smoking cessation: Scoping review. J Med Internet Res. 2022; 24(9): e35556. PMID: 36095295 DOI: 10.2196/35556

Wilson L, Marasoiu M. The development and use of chatbots in public health: Scoping review. JMIR Hum Factors. 2022; 9(4): e35882. PMID: 36197708 DOI: 10.2196/35882

Xu L, Sanders L, Li K, Chow JCL. Chatbot for health care and oncology applications using artificial intelligence and machine learning: Systematic review. JMIR Cancer. 2021; 7(4): e27850. PMID: 34847056 DOI: 10.2196/27850

Geoghegan L, Scarborough A, Wormald JCR, Harrison CJ, Collins D, Gardiner M, et al. Automated conversational agents for post-intervention follow-up: A systematic review. BJS Open. 2021; 5(4): zrab070. PMID: 34323916 DOI: 10.1093/bjsopen/zrab070

Abd-Alrazaq AA, Rababeh A, Alajlani M, Bewick BM, Househ M. Effectiveness and safety of using chatbots to improve mental health: Systematic review and meta-analysis. J Med Internet Res. 2020; 22(7): e16021. PMID: 32673216 DOI: 10.2196/16021

Boucher EM, Harake NR, Ward HE, Stoeckl SE, Vargas J, Minkel J, et al. Artificially intelligent chatbots in digital mental health interventions: A review. Expert Rev Med Devices. 2021; 18(sup1): 37-49. PMID: 34872429 DOI: 10.1080/17434440.2021.2013200

Prthaban PN, Rana ME. Use of recommendation engine and chatbot for depression consultancy platforms. Journal of Critical Reviews. 2020; 7(3): 41-6.

Viduani A, Cosenza V, Araújo RM, Kieling C. Chatbots in the field of mental health: Challenges and opportunities. In: Passos IC, Rabelo-da-Ponte FD, Kapczinski F (Eds). Digital mental health: A practitioner's guide. Springer; 2023.

Singh B, Olds T, Brinsley J, Dumuid D, Virgara R, Matricciani L, et al. Systematic review and meta-analysis of the effectiveness of chatbots on lifestyle behaviours. NPJ Digit Med. 2023; 6(1): 118. PMID: 37353578 DOI: 10.1038/s41746-023-00856-1

Cameron G, Cameron D, Megaw G, Bond R, Mulvenna M, O’Neill S, et al. Assessing the usability of a chatbot for mental health care. International Workshops on Internet Science. Springer; 2019.




DOI: https://doi.org/10.30699/fhi.v13i0.561

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