Embodied Conversational Agents for Chronic Diseases: Scoping Review

• Published in: Journal of medical Internet research Vol. 26; no. 4; p. e47134
• Main Authors: Jiang, Zhili, Huang, Xiting, Wang, Zhiqian, Liu, Yang, Huang, Lihua, Luo, Xiaolin
• Format: Journal Article
• Language: English
• Published: Canada Journal of Medical Internet Research 09.01.2024; Gunther Eysenbach MD MPH, Associate Professor; JMIR Publications
• Subjects: Atrial Fibrillation; Cancer; Chronic Disease; Chronic diseases; Chronic illnesses; Clinical outcomes; Communication; Cues; Diabetes; Diabetes Mellitus, Type 2; Digital libraries; Disease; Female; Global health; Health status; Humans; Literature reviews; Long-term care of the sick; Medical personnel; Medical screening; Medical technology; Mental disorders; Middle age; Middle Aged; Multimedia; Nonverbal communication; Patients; Productivity; Public health; Review; Selfmanagement; Systematic review; Telemedicine; Type 2 diabetes; Type 2 diabetes mellitus; Voice; Women; embodied conversational agent; ECA; chronic diseases; mobile phone; eHealth; health care
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/47134

Embodied conversational agents (ECAs) are computer-generated animated humanlike characters that interact with users through verbal and nonverbal behavioral cues. They are increasingly used in a range of fields, including health care. This scoping review aims to identify the current practice in the development and evaluation of ECAs for chronic diseases. We applied a methodological framework in this review. A total of 6 databases (ie, PubMed, Embase, CINAHL, ACM Digital Library, IEEE Xplore Digital Library, and Web of Science) were searched using a combination of terms related to ECAs and health in October 2023. Two independent reviewers selected the studies and extracted the data. This review followed the PRISMA-ScR (Preferred Reporting Items of Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) statement. The literature search found 6332 papers, of which 36 (0.57%) met the inclusion criteria. Among the 36 studies, 27 (75%) originated from the United States, and 28 (78%) were published from 2020 onward. The reported ECAs covered a wide range of chronic diseases, with a focus on cancers, atrial fibrillation, and type 2 diabetes, primarily to promote screening and self-management. Most ECAs were depicted as middle-aged women based on screenshots and communicated with users through voice and nonverbal behavior. The most frequently reported evaluation outcomes were acceptability and effectiveness. This scoping review provides valuable insights for technology developers and health care professionals regarding the development and implementation of ECAs. It emphasizes the importance of technological advances in the embodiment, personalized strategy, and communication modality and requires in-depth knowledge of user preferences regarding appearance, animation, and intervention content. Future studies should incorporate measures of cost, efficiency, and productivity to provide a comprehensive evaluation of the benefits of using ECAs in health care.