Improving Access to Online Health Information With Conversational Agents: A Randomized Controlled Experiment

Background: conventional web-based search engines may be unusable by individuals with low health literacy for finding health-related information,thus precluding their use by this population.objective: we describe a conversational search engine interface designed to allow individuals with low health and computer literacy identify and learn about clinical trials on the internet.methods: a randomized trial involving 89 participants compared the conversational search engine interface (n=43) to the existing conventional keyword- and facet-based search engine interface (n=46) for the national cancer institute clinical trials database. each participant performed 2 tasks: finding a clinical trial for themselves and finding a trial that met prespecified criteria.results: results indicated that all participants were more satisfied with the conversational interface based on 7-point self-reported satisfaction ratings (task 1: mean 4.9,sd 1.8 vs mean 3.2,sd 1.8,p<.001; task 2: mean 4.8,sd 1.9 vs mean 3.2,sd 1.7,p<.001) compared to the conventional web form-based interface. all participants also rated the trials they found as better meeting their search criteria,based on 7-point self-reported scales (task 1: mean 3.7,sd 1.6 vs mean 2.7,sd 1.8,p=.01; task 2: mean 4.8,sd 1.7 vs mean 3.4,sd 1.9,p<.01). participants with low health literacy failed to find any trials that satisfied the prespecified criteria for task 2 using the conventional search engine interface,whereas 36% (5/14) were successful at this task using the conversational interface (p=.05).conclusions: conversational agents can be used to improve accessibility to web-based searches in general and clinical trials in particular,and can help decrease recruitment bias against disadvantaged populations.