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Title: Conversational agents in health care : scoping review and conceptual analysis
Authors: Car, Lorainne Tudor
Dhinagaran, Dhakshenya Ardhithy
Kyaw, Bhone Myint
Kowatsch, Tobias
Joty, Shafiq
Theng, Yin-Leng
Atun, Rifat
Keywords: Science::Medicine
Issue Date: 2020
Source: Car, L. T., Dhinagaran, D. A., Kyaw, B. M., Kowatsch, T., Joty, S., Theng, Y. & Atun, R. (2020). Conversational agents in health care : scoping review and conceptual analysis. Journal of Medical Internet Research, 22(8).
Journal: Journal of Medical Internet Research
Abstract: Background: Conversational agents, also known as chatbots, are computer programs designed to simulate human text or verbal conversations. They are increasingly used in a range of fields, including health care. By enabling better accessibility, personalization, and efficiency, conversational agents have the potential to improve patient care. Objective: This study aimed to review the current applications, gaps, and challenges in the literature on conversational agents in health care and provide recommendations for their future research, design, and application. Methods: We performed a scoping review. A broad literature search was performed in MEDLINE (Medical Literature Analysis and Retrieval System Online; Ovid), EMBASE (Excerpta Medica database; Ovid), PubMed, Scopus, and Cochrane Central with the search terms “conversational agents,” “conversational AI,” “chatbots,” and associated synonyms. We also searched the gray literature using sources such as the OCLC (Online Computer Library Center) WorldCat database and ResearchGate in April 2019. Reference lists of relevant articles were checked for further articles. Screening and data extraction were performed in parallel by 2 reviewers. The included evidence was analyzed narratively by employing the principles of thematic analysis. Results: The literature search yielded 47 study reports (45 articles and 2 ongoing clinical trials) that matched the inclusion criteria. The identified conversational agents were largely delivered via smartphone apps (n=23) and used free text only as the main input (n=19) and output (n=30) modality. Case studies describing chatbot development (n=18) were the most prevalent, and only 11 randomized controlled trials were identified. The 3 most commonly reported conversational agent applications in the literature were treatment and monitoring, health care service support, and patient education. Conclusions: The literature on conversational agents in health care is largely descriptive and aimed at treatment and monitoring and health service support. It mostly reports on text-based, artificial intelligence–driven, and smartphone app–delivered conversational agents. There is an urgent need for a robust evaluation of diverse health care conversational agents’ formats, focusing on their acceptability, safety, and effectiveness.
ISSN: 1438-8871
DOI: 10.2196/17158
Rights: © 2020 Lorainne Tudor Car, Dhakshenya Ardhithy Dhinagaran, Bhone Myint Kyaw, Tobias Kowatsch, Shafiq Joty, Yin-Leng Theng, Rifat Atun. Originally published in the Journal of Medical Internet Research (, 07.08.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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