Department of Genetic Medicine, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.
Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Kanagawa, Japan.
J Med Internet Res. 2024 Nov 27;26:e48914. doi: 10.2196/48914.
BACKGROUND: Hereditary breast and ovarian cancer (HBOC) is a major type of hereditary cancer. Establishing effective screening to identify high-risk individuals for HBOC remains a challenge. We developed a prototype of a chatbot system that uses artificial intelligence (AI) for preliminary HBOC screening to determine whether individuals meet the National Comprehensive Cancer Network BRCA1/2 testing criteria. OBJECTIVE: This study's objective was to validate the feasibility of this chatbot in a clinical setting by using it on a patient population that visited a hospital. METHODS: We validated the medical accuracy of the chatbot system by performing a test on patients who consecutively visited the Kanagawa Cancer Center. The participants completed a preoperation questionnaire to understand their background, including information technology literacy. After the operation, qualitative interviews were conducted to collect data on the usability and acceptability of the system and examine points needing improvement. RESULTS: A total of 11 participants were enrolled between October and December 2020. All of the participants were women, and among them, 10 (91%) had cancer. According to the questionnaire, 6 (54%) participants had never heard of a chatbot, while 7 (64%) had never used one. All participants were able to complete the chatbot operation, and the average time required for the operation was 18.0 (SD 5.44) minutes. The determinations by the chatbot of whether the participants met the BRCA1/2 testing criteria based on their medical and family history were consistent with those by certified genetic counselors (CGCs). We compared the medical histories obtained from the participants by the CGCs with those by the chatbot. Of the 11 participants, 3 (27%) entered information different from that obtained by the CGCs. These discrepancies were caused by the participant's omissions or communication errors with the chatbot. Regarding the family histories, the chatbot provided new information for 3 (27%) of the 11 participants and complemented information for the family members of 5 (45%) participants not interviewed by the CGCs. The chatbot could not obtain some information on the family history of 6 (54%) participants due to several reasons, such as being outside of the scope of the chatbot's interview questions, the participant's omissions, and communication errors with the chatbot. Interview data were classified into the following: (1) features, (2) appearance, (3) usability and preferences, (4) concerns, (5) benefits, and (6) implementation. Favorable comments on implementation feasibility and comments on improvements were also obtained. CONCLUSIONS: This study demonstrated that the preliminary screening system for HBOC using an AI chatbot was feasible for real patients.
背景:遗传性乳腺癌和卵巢癌(HBOC)是一种主要的遗传性癌症。建立有效的筛查方法来识别 HBOC 的高危个体仍然是一个挑战。我们开发了一种使用人工智能(AI)进行初步 HBOC 筛查的聊天机器人系统原型,以确定个体是否符合国家综合癌症网络 BRCA1/2 检测标准。
目的:本研究旨在通过对就诊于医院的患者群体使用该聊天机器人来验证该聊天机器人在临床环境中的可行性。
方法:我们通过对连续就诊于神奈川癌症中心的患者进行测试来验证聊天机器人系统的医学准确性。参与者完成了术前问卷,以了解他们的背景,包括信息技术素养。术后进行定性访谈,收集系统可用性和可接受性的数据,并检查需要改进的地方。
结果:2020 年 10 月至 12 月期间共纳入 11 名参与者。所有参与者均为女性,其中 10 名(91%)患有癌症。根据问卷,6 名(54%)参与者从未听说过聊天机器人,而 7 名(64%)从未使用过。所有参与者均能够完成聊天机器人操作,操作平均用时 18.0(SD 5.44)分钟。聊天机器人根据参与者的医疗和家族史判断其是否符合 BRCA1/2 检测标准的结果与认证遗传咨询师(CGC)的判断一致。我们比较了 CGC 从参与者那里获得的病史和聊天机器人获得的病史。在 11 名参与者中,有 3 名(27%)输入的信息与 CGC 获得的信息不同。这些差异是由于参与者与聊天机器人的遗漏或沟通错误所致。关于家族史,聊天机器人为 3 名(27%)参与者提供了新信息,并为 5 名(45%)未接受 CGC 访谈的参与者的家庭成员提供了补充信息。由于聊天机器人访谈问题的范围、参与者的遗漏以及与聊天机器人的沟通错误等多种原因,聊天机器人无法获得 6 名(54%)参与者的一些家族史信息。访谈数据分为以下几类:(1)特征,(2)外观,(3)可用性和偏好,(4)关注点,(5)收益,(6)实施。还获得了关于实施可行性的有利意见和改进意见。
结论:本研究表明,使用 AI 聊天机器人进行 HBOC 初步筛查的系统对真实患者是可行的。
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