scholarly journals Effectiveness of Conversational Agents (Virtual Assistants) in Health Care: Protocol for a Systematic Review

10.2196/16934 ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. e16934 ◽  
Author(s):  
Caroline de Cock ◽  
Madison Milne-Ives ◽  
Michelle Helena van Velthoven ◽  
Abrar Alturkistani ◽  
Ching Lam ◽  
...  

Background Conversational agents (also known as chatbots) have evolved in recent decades to become multimodal, multifunctional platforms with potential to automate a diverse range of health-related activities supporting the general public, patients, and physicians. Multiple studies have reported the development of these agents, and recent systematic reviews have described the scope of use of conversational agents in health care. However, there is scarce research on the effectiveness of these systems; thus, their viability and applicability are unclear. Objective The objective of this systematic review is to assess the effectiveness of conversational agents in health care and to identify limitations, adverse events, and areas for future investigation of these agents. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols will be used to structure this protocol. The focus of the systematic review is guided by a population, intervention, comparator, and outcome framework. A systematic search of the PubMed (Medline), EMBASE, CINAHL, and Web of Science databases will be conducted. Two authors will independently screen the titles and abstracts of the identified references and select studies according to the eligibility criteria. Any discrepancies will then be discussed and resolved. Two reviewers will independently extract and validate data from the included studies into a standardized form and conduct quality appraisal. Results As of January 2020, we have begun a preliminary literature search and piloting of the study selection process. Conclusions This systematic review aims to clarify the effectiveness, limitations, and future applications of conversational agents in health care. Our findings may be useful to inform the future development of conversational agents and promote the personalization of patient care. International Registered Report Identifier (IRRID) PRR1-10.2196/16934

2019 ◽  
Author(s):  
Caroline de Cock ◽  
Madison Milne-Ives ◽  
Michelle Helena van Velthoven ◽  
Abrar Alturkistani ◽  
Ching Lam ◽  
...  

BACKGROUND Conversational agents (also known as chatbots) have evolved in recent decades to become multimodal, multifunctional platforms with potential to automate a diverse range of health-related activities supporting the general public, patients, and physicians. Multiple studies have reported the development of these agents, and recent systematic reviews have described the scope of use of conversational agents in health care. However, there is scarce research on the effectiveness of these systems; thus, their viability and applicability are unclear. OBJECTIVE The objective of this systematic review is to assess the effectiveness of conversational agents in health care and to identify limitations, adverse events, and areas for future investigation of these agents. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols will be used to structure this protocol. The focus of the systematic review is guided by a population, intervention, comparator, and outcome framework. A systematic search of the PubMed (Medline), EMBASE, CINAHL, and Web of Science databases will be conducted. Two authors will independently screen the titles and abstracts of the identified references and select studies according to the eligibility criteria. Any discrepancies will then be discussed and resolved. Two reviewers will independently extract and validate data from the included studies into a standardized form and conduct quality appraisal. RESULTS As of January 2020, we have begun a preliminary literature search and piloting of the study selection process. CONCLUSIONS This systematic review aims to clarify the effectiveness, limitations, and future applications of conversational agents in health care. Our findings may be useful to inform the future development of conversational agents and promote the personalization of patient care. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/16934


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017868
Author(s):  
Joey S.W. Kwong ◽  
Sheyu Li ◽  
Wan-Jie Gu ◽  
Hao Chen ◽  
Chao Zhang ◽  
...  

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.


2018 ◽  
Vol 53 (16) ◽  
pp. 996-1002 ◽  
Author(s):  
Melanie K Farlie ◽  
Lauren Robins ◽  
Romi Haas ◽  
Jennifer L Keating ◽  
Elizabeth Molloy ◽  
...  

ObjectiveThe objective of this systematic review was to examine the effects of different balance exercise interventions compared with non-balance exercise controls on balance task performance in older adults.DesignSystematic review.Data sourcesMedline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Scopus and Cochrane Database of Systematic Reviews were searched until July 2017.Eligibility criteria for selecting studiesSystematic reviews and meta-analyses of randomised trials of balance exercise interventions for older adults were identified for extraction of eligible randomised trials. Eligibility criteria for inclusion of randomised trials in meta-analyses were comparison of a balance exercise intervention with a control group that did not perform balance exercises, report of at least one end-intervention balance outcome measurement that was consistent with the five subgroups of balance exercise identified, and full-text article available in English.ResultsNinety-five trials were included in meta-analyses and 80 in meta-regressions. For four balance exercise types (control centre of mass, multidimensional, mobility and reaching), significant effects for balance exercise interventions were found in meta-analyses (standardised mean difference (SMD) 0.31–0.50), however with considerable heterogeneity in observed effects (I2: 50.4%–80.6%). Risk of bias assessments (Physiotherapy Evidence Database score and funnel plots) did not explain heterogeneity. One significant relationship identified in the meta-regressions of SMD and balance exercise frequency, time and duration explained 2.1% of variance for the control centre of mass subgroup.ConclusionLimitations to this study included the variability in design of balance interventions, incomplete reporting of data and statistical heterogeneity. The design of balance exercise programmes provides inadequate explanation of the observed benefits of these interventions.


2020 ◽  
pp. 219256822090681 ◽  
Author(s):  
Muthu Sathish ◽  
Ramakrishnan Eswar

Study Design: Systematic review. Objectives: To assess the methodological quality of systematic reviews and meta-analyses in spine surgery over the past 2 decades. Materials and Methods: We conducted independent and in duplicate systematic review of the published systematic reviews and meta-analyses between 2000 and 2019 from PubMed Central and Cochrane Database pertaining to spine surgery involving surgical intervention. We searched bibliographies to identify additional relevant studies. Methodological quality was evaluated with AMSTAR score and graded with AMSTAR 2 criteria. Results: A total of 96 reviews met the eligibility criteria, with mean AMSTAR score of 7.51 (SD = 1.98). Based on AMSTAR 2 criteria, 13.5% (n = 13) and 18.7% (n = 18) of the studies had high and moderate level of confidence of results, respectively, without any critical flaws. A total of 29.1% (n = 28) of the studies had at least 1 critical flaw and 38.5% (n = 37) of the studies had more than 1 critical flaw, so that their results have low and critically low confidence, respectively. Failure to analyze the conflict of interest of authors of primary studies included in review and lack of list of excluded studies with justification were the most common critical flaw. Regression analysis demonstrated that studies with funding and studies published in recent years were significantly associated with higher methodological quality. Conclusion: Despite improvement in methodological quality of systematic reviews and meta-analyses in spine surgery in current decade, a substantial proportion continue to show critical flaws. With increasing number of review articles in spine surgery, stringent measures must be taken to adhere to methodological quality by following PRISMA and AMSTAR guidelines to attain higher standards of evidence in published literature.


2020 ◽  
Vol 13 (4) ◽  
pp. 341-350
Author(s):  
Akilesh Anand Prakash

Diagnosis and management of isolated syndesmotic injuries are controversial and highly debated. Hence, the aim of this study is to explore and gain the current understanding pertaining to detailed anatomy of syndesmotic ligaments through a systematic review of published cadaveric studies. A systematic review was conducted online for literature published in English using PubMed and Google Scholar, as per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, up to April 30, 2019. Predefined eligibility criteria were applied, and the data thus compiled was analyzed. Study quality was assessed based on Quality Appraisal for Cadaveric Studies (QUACS) scale. A total of 12 studies reporting 365 ankles were included in this review. Considerable inconsistency in the naming and description of syndesmotic ligaments was observed, with only 2 studies reporting the vasculature of the ligaments. Hence further investigation of the anatomy of the syndesmotic ligaments is recommended so as to better inform clinical practice, as awareness of anatomy is critical for assessment, healing, and successful surgical management. Levels of Evidence: Level III: Systematic review of anatomical dissections


2020 ◽  
Author(s):  
Hervé Tchala Vignon Zomahoun ◽  
José Massougbodji ◽  
André Bussières ◽  
Aliki Thomas ◽  
Dahlia Kairy ◽  
...  

Abstract Background: The literature on the implementation of knowledge products is extensive. However, this literature is still difficult to interpret for policymakers and other stakeholders when faced with choosing implementation strategies likely to bring about successful change in their health systems. This work has the particularity to examine the scope of this literature, and to clarify the effectiveness of implementation strategies for different knowledge products. Consequently, we aim to: 1) determine the strengths and weaknesses of existing literature overviews; 2) produce a detailed portrait of the literature on implementation strategies for various knowledge products; and 3) assess the effectiveness of implementation strategies for each knowledge product identified and classify them.Methods: We will use a three-phase approach consisting of a critical analysis of existing literature overviews, a systematic review of systematic reviews, and a series of systematic reviews and meta-analyses. We will follow the Cochrane Methodology for each of three phases. Our eligibility criteria are defined following a PICOS approach: Population, individuals or stakeholders participating in healthcare delivery, specifically, healthcare providers, caregivers, and end users; Intervention, any type of strategy aiming to implement a knowledge product including, but not limited to, a decision support tool, a clinical practice guideline, a policy brief, or a decision-making tool, a one-pager, or a health intervention; Comparison, any comparator will be considered; Outcomes, Phases 1 and 2 – any outcome related to implementation strategies including, but not limited to, the measures of adherence/fidelity to the use of knowledge products, their acceptability, adoption, appropriateness, feasibility, adaptability, implementation costs, penetration/reach and sustainability; Phase 3 – any additional outcome related to patients (psychosocial, health behavioral, and clinical outcomes) or healthcare professionals (behavioral and performance outcomes); Setting, primary healthcare has to be covered. We will search MEDLINE (Ovid), EMBASE, Web of Science, PsycINFO, CINAHL, and the Cochrane Library from their inception onwards. For each phase, two reviewers will independently perform the selection of studies, data extraction, and assess their methodological quality. We will analyze extracted data, and perform narrative syntheses, and meta-analyses when possible.Discussion: Our results could inform not only the overviews’ methodology, but also the development of an online platform for the implementation strategies of knowledge products. This platform could be useful for stakeholders in implementation science.Systematic review registration: Protocol registered on Open science Framework, https://osf.io/hqbx8


Author(s):  
Alejandro Prieto-Ayuso ◽  
Juan Carlos Pastor-Vicedo ◽  
Sixto González-Víllora ◽  
Javier Fernández-Río

Objectives: The goal of this study was to shed light on the existent knowledge, internationally published over the last decade (2009–2019), on how to deal with talented children in physical education (PE). Methods: A mixed systematic review (SR) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number: CRD42019117211. Study eligibility criteria: The articles included were selected using the following criteria: (a) studies published in peer-reviewed international journals; (b) studies published from 2009 to 2019 (both inclusive); (c) studies that included quantitative and/or qualitative methods and findings; (d) research conducted within school contexts; (e) articles that focused on both talent/gift and PE, and (f) studies published in English or Spanish. Results: A total of 11 articles were identified. Results showed a gradual change in both methods and instruments used for talent identification (TI) in PE, focused currently on children’s health and involvement in sports. Second, there is consensus on the lack of clarity in schools’ policies and guidelines on how to deal with talented children in PE. Conclusions: Finally, there are alternative programs to elite athlete models that better fit in PE to deal with talented children and to avoid child disengagement in PE and sports.


Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 429
Author(s):  
Sanjeev B. Khanagar ◽  
Ali Al-Ehaideb ◽  
Ahmed Jamleh ◽  
Khansa Ababneh ◽  
Prabhadevi C. Maganur ◽  
...  

The objective of this paper was to evaluate the studies that have reported on psychological issues among dental students in Saudi Arabia and to develop coping strategies to overcome these mental health-related issues. The present systematic review is in accordance with the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search for the articles was carried out in the electronic databases by four independent researchers. The data search was performed in the electronic search engines like PubMed, Google Scholar, Web of Science, Scopus, Medline, Embase, Cochrane and Saudi Digital Library for scientific research articles published from January 2000 until December 2020. STROBE guidelines were adopted for qualitative analysis of six articles which met the eligibility criteria. The analysis of the literature revealed that most of the studies included were conducted in the past 8 years in different regions of Saudi Arabia. Findings of this systematic review clearly state that dental students in Saudi Arabia experience higher levels of depression, stress and anxiety and stress during their education period, with a higher stress for female students compared to male students. There is an urgent need to introduce interventional programs and preventive strategies to overcome the long-term effects.


10.2196/15490 ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. e15490 ◽  
Author(s):  
Clemens Scott Kruse

Background The protocol in this manuscript was designed to help graduate students publish. It is the result of a challenge from our provost in 2013. I developed this protocol over the last 6 years and have exercised the protocol for the last 5 years. The current version of the protocol has remained mostly static for the last 2 years—only small changes have been made to the process. Objective The objective of this protocol is to enable students to learn a valuable skill of conducting a systematic review and to write the review in a way that can be published. I have designed the protocol to fit into the schedule of a traditional semester, but also used it in compressed semesters. Methods An image map was created in HTML 5.0 and imported into a learning management system. It augments traditional instruction by providing references to published articles, examples, and previously recorded instructional videos. Students use the image map outside the classroom after traditional instruction. The image map helps students create manuscripts that follow established practice and are reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and whose authorship follows guidelines by the International Committee of Medical Journal Editors. Results Since its inception, this protocol has helped 77 students publish 27 systematic reviews in nine journals worldwide. Some manuscripts take multiple years to progress through multiple review processes at multiple journals submitted in sequence. Two other professors in the School of Health Administration have used this protocol in their classes. Conclusions So far, this method has helped 51% of graduate students who used it in my graduate courses publish articles (with more manuscripts under consideration whose numbers have remained uncounted in this sum). I wish success to others who might use this protocol.


2019 ◽  
Author(s):  
Clemens Scott Kruse

BACKGROUND The protocol in this manuscript was designed to help graduate students publish. It is the result of a challenge from our provost in 2013. I developed this protocol over the last 6 years and have exercised the protocol for the last 5 years. The current version of the protocol has remained mostly static for the last 2 years—only small changes have been made to the process. OBJECTIVE The objective of this protocol is to enable students to learn a valuable skill of conducting a systematic review and to write the review in a way that can be published. I have designed the protocol to fit into the schedule of a traditional semester, but also used it in compressed semesters. METHODS An image map was created in HTML 5.0 and imported into a learning management system. It augments traditional instruction by providing references to published articles, examples, and previously recorded instructional videos. Students use the image map outside the classroom after traditional instruction. The image map helps students create manuscripts that follow established practice and are reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and whose authorship follows guidelines by the International Committee of Medical Journal Editors. RESULTS Since its inception, this protocol has helped 77 students publish 27 systematic reviews in nine journals worldwide. Some manuscripts take multiple years to progress through multiple review processes at multiple journals submitted in sequence. Two other professors in the School of Health Administration have used this protocol in their classes. CONCLUSIONS So far, this method has helped 51% of graduate students who used it in my graduate courses publish articles (with more manuscripts under consideration whose numbers have remained uncounted in this sum). I wish success to others who might use this protocol.


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