Abstract
BackgroundThe personalization of conversational agents with natural language user interfaces is seeing increasing use in health care applications, shaping the content, structure, or purpose of the dialogue between humans and conversational agents.ObjectiveThe goal of this systematic review was to understand the ways in which personalization has been used with conversational agents in health care and characterize the methods of its implementation.MethodsWe searched on PubMed, Embase, CINAHL, PsycInfo, and ACM Digital Library using a predefined search strategy. The studies were included if they: (1) were primary research studies that focused on consumers, caregivers, or health care professionals; (2) involved a conversational agent with an unconstrained natural language interface; (3) tested the system with human subjects; and (4) implemented personalization features.ResultsThe search found 1958 publications. After abstract and full-text screening, 13 studies were included in the review. Common examples of personalized content included feedback, daily health reports, alerts, warnings, and recommendations. The personalization features were implemented without a theoretical framework of customization and with limited evaluation of its impact. While conversational agents with personalization features were reported to improve user satisfaction, user engagement and dialogue quality, the role of personalization in improving health outcomes was not assessed directly.ConclusionsMost of the studies in our review implemented the personalization features without theoretical or evidence-based support for them and did not leverage the recent developments in other domains of personalization. Future research could incorporate personalization as a distinct design factor with a more careful consideration of its impact on health outcomes and its implications on patient safety, privacy, and decision-making.
Highlights
Recent advancements in natural language recognition and synthesis have resulted in the adoption of conversational agents (CAs) in many fields
The personalization features were implemented without a theoretical framework of customization and with limited evaluation of its impact
Informed by the recent theoretical developments in personalization [7], a broader understanding of personalization in health care [22,29], and an increasing interest in health care CAs [3,4,5], this study aims to review the use of personalization in health care CAs and characterize the methods that have been applied to implement this personalization
Summary
Background Recent advancements in natural language recognition and synthesis have resulted in the adoption of conversational agents (CAs) in many fields. CAs can be defined as systems that support conversational interaction with users by means of speech or other modalities [1]. There have been other recent reviews on health care conversational agents [3,4,5]. This study differs from them in that it focuses on the implementation of personalization in health care conversational agents. The personalization of conversational agents with natural language user interfaces is seeing increasing use in health care applications, shaping the content, structure, or purpose of the dialogue between humans and conversational agents
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