Western Norway Familial Cancer Center, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway.
Faculty of Health Studies, VID Specialized University, Bergen, Norway.
J Med Internet Res. 2023 Sep 1;25:e46571. doi: 10.2196/46571.
BACKGROUND: Genetic testing has become an integrated part of health care for patients with breast or ovarian cancer, and the increasing demand for genetic testing is accompanied by an increasing need for easy access to reliable genetic information for patients. Therefore, we developed a chatbot app (Rosa) that is able to perform humanlike digital conversations about genetic BRCA testing. OBJECTIVE: Before implementing this new information service in daily clinical practice, we wanted to explore 2 aspects of chatbot use: the perceived utility and trust in chatbot technology among healthy patients at risk of hereditary cancer and how interaction with a chatbot regarding sensitive information about hereditary cancer influences patients. METHODS: Overall, 175 healthy individuals at risk of hereditary breast and ovarian cancer were invited to test the chatbot, Rosa, before and after genetic counseling. To secure a varied sample, participants were recruited from all cancer genetic clinics in Norway, and the selection was based on age, gender, and risk of having a BRCA pathogenic variant. Among the 34.9% (61/175) of participants who consented for individual interview, a selected subgroup (16/61, 26%) shared their experience through in-depth interviews via video. The semistructured interviews covered the following topics: usability, perceived usefulness, trust in the information received via the chatbot, how Rosa influenced the user, and thoughts about future use of digital tools in health care. The transcripts were analyzed using the stepwise-deductive inductive approach. RESULTS: The overall finding was that the chatbot was very welcomed by the participants. They appreciated the 24/7 availability wherever they were and the possibility to use it to prepare for genetic counseling and to repeat and ask questions about what had been said afterward. As Rosa was created by health care professionals, they also valued the information they received as being medically correct. Rosa was referred to as being better than Google because it provided specific and reliable answers to their questions. The findings were summed up in 3 concepts: "Anytime, anywhere"; "In addition, not instead"; and "Trustworthy and true." All participants (16/16) denied increased worry after reading about genetic testing and hereditary breast and ovarian cancer in Rosa. CONCLUSIONS: Our results indicate that a genetic information chatbot has the potential to contribute to easy access to uniform information for patients at risk of hereditary breast and ovarian cancer, regardless of geographical location. The 24/7 availability of quality-assured information, tailored to the specific situation, had a reassuring effect on our participants. It was consistent across concepts that Rosa was a tool for preparation and repetition; however, none of the participants (0/16) supported that Rosa could replace genetic counseling if hereditary cancer was confirmed. This indicates that a chatbot can be a well-suited digital companion to genetic counseling.
背景:基因检测已成为乳腺癌或卵巢癌患者医疗护理的一个组成部分,对基因检测的需求不断增加,同时也需要患者更容易获得可靠的基因信息。因此,我们开发了一款名为“Rosa”的聊天机器人应用程序,它能够进行类似人类的数字对话,提供有关基因 BRCA 检测的信息。
目的:在将这项新的信息服务应用于日常临床实践之前,我们希望探讨聊天机器人使用的两个方面:有遗传性癌症风险的健康患者对聊天机器人技术的感知实用性和信任程度,以及与聊天机器人就遗传性癌症的敏感信息进行互动如何影响患者。
方法:我们共邀请了 175 名有遗传性乳腺癌和卵巢癌风险的健康个体在接受遗传咨询之前和之后测试聊天机器人“Rosa”。为了确保样本的多样性,我们从挪威所有的癌症遗传诊所招募参与者,选择标准是年龄、性别和携带 BRCA 致病性变异的风险。在同意接受个人访谈的 34.9%(61/175)的参与者中,一个选定的亚组(16/61,26%)通过视频进行了深入访谈,分享了他们的体验。半结构化访谈涵盖了以下主题:可用性、感知实用性、对通过聊天机器人收到的信息的信任程度、Rosa 对用户的影响,以及对未来在医疗保健中使用数字工具的想法。对转录本采用逐步演绎归纳法进行分析。
结果:总体而言,参与者非常欢迎这款聊天机器人。他们赞赏其 24/7 随时随地可用的功能,以及可以用它来为遗传咨询做准备,并在咨询后重复和询问相关问题。由于“Rosa”是由医疗保健专业人员创建的,他们还认为他们收到的信息在医学上是正确的。与谷歌相比,参与者认为“Rosa”更好,因为它提供了针对他们问题的具体和可靠的答案。研究结果总结为 3 个概念:“随时随地”;“补充,而非替代”;“值得信赖和真实”。所有参与者(16/16)均表示,在“Rosa”中阅读有关基因检测和遗传性乳腺癌和卵巢癌的信息后,他们的担忧并没有增加。
结论:我们的研究结果表明,一款遗传信息聊天机器人有可能为有遗传性乳腺癌和卵巢癌风险的患者提供方便获取统一信息的途径,无论其地理位置如何。这款聊天机器人提供的 24/7 全天候、质量保证的个性化信息具有令人安心的作用。在所有概念中,“Rosa”都是一个用于准备和重复的工具,但没有参与者(0/16)支持如果遗传性癌症得到确认,“Rosa”可以替代遗传咨询。这表明聊天机器人可以成为遗传咨询的一个很好的数字伴侣。
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