Achieving health equity through conversational AI: A roadmap for design and implementation of inclusive chatbots in healthcare.

<h4>Background</h4>The rapid evolution of conversational and generative artificial intelligence (AI) has led to the increased deployment of AI tools in healthcare settings. While these conversational AI tools promise efficiency and expanded access to healthcare services, there are growin...

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Main Authors: Tom Nadarzynski, Nicky Knights, Deborah Husbands, Cynthia A Graham, Carrie D Llewellyn, Tom Buchanan, Ian Montgomery, Damien Ridge
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-05-01
Series:PLOS Digital Health
Online Access:https://doi.org/10.1371/journal.pdig.0000492
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author Tom Nadarzynski
Nicky Knights
Deborah Husbands
Cynthia A Graham
Carrie D Llewellyn
Tom Buchanan
Ian Montgomery
Damien Ridge
author_facet Tom Nadarzynski
Nicky Knights
Deborah Husbands
Cynthia A Graham
Carrie D Llewellyn
Tom Buchanan
Ian Montgomery
Damien Ridge
author_sort Tom Nadarzynski
collection DOAJ
description <h4>Background</h4>The rapid evolution of conversational and generative artificial intelligence (AI) has led to the increased deployment of AI tools in healthcare settings. While these conversational AI tools promise efficiency and expanded access to healthcare services, there are growing concerns ethically, practically and in terms of inclusivity. This study aimed to identify activities which reduce bias in conversational AI and make their designs and implementation more equitable.<h4>Methods</h4>A qualitative research approach was employed to develop an analytical framework based on the content analysis of 17 guidelines about AI use in clinical settings. A stakeholder consultation was subsequently conducted with a total of 33 ethnically diverse community members, AI designers, industry experts and relevant health professionals to further develop a roadmap for equitable design and implementation of conversational AI in healthcare. Framework analysis was conducted on the interview data.<h4>Results</h4>A 10-stage roadmap was developed to outline activities relevant to equitable conversational AI design and implementation phases: 1) Conception and planning, 2) Diversity and collaboration, 3) Preliminary research, 4) Co-production, 5) Safety measures, 6) Preliminary testing, 7) Healthcare integration, 8) Service evaluation and auditing, 9) Maintenance, and 10) Termination.<h4>Discussion</h4>We have made specific recommendations to increase conversational AI's equity as part of healthcare services. These emphasise the importance of a collaborative approach and the involvement of patient groups in navigating the rapid evolution of conversational AI technologies. Further research must assess the impact of recommended activities on chatbots' fairness and their ability to reduce health inequalities.
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spelling doaj-art-4477db9db50d4d9ea7dc3e209b259aba2025-08-20T01:56:46ZengPublic Library of Science (PLoS)PLOS Digital Health2767-31702024-05-0135e000049210.1371/journal.pdig.0000492Achieving health equity through conversational AI: A roadmap for design and implementation of inclusive chatbots in healthcare.Tom NadarzynskiNicky KnightsDeborah HusbandsCynthia A GrahamCarrie D LlewellynTom BuchananIan MontgomeryDamien Ridge<h4>Background</h4>The rapid evolution of conversational and generative artificial intelligence (AI) has led to the increased deployment of AI tools in healthcare settings. While these conversational AI tools promise efficiency and expanded access to healthcare services, there are growing concerns ethically, practically and in terms of inclusivity. This study aimed to identify activities which reduce bias in conversational AI and make their designs and implementation more equitable.<h4>Methods</h4>A qualitative research approach was employed to develop an analytical framework based on the content analysis of 17 guidelines about AI use in clinical settings. A stakeholder consultation was subsequently conducted with a total of 33 ethnically diverse community members, AI designers, industry experts and relevant health professionals to further develop a roadmap for equitable design and implementation of conversational AI in healthcare. Framework analysis was conducted on the interview data.<h4>Results</h4>A 10-stage roadmap was developed to outline activities relevant to equitable conversational AI design and implementation phases: 1) Conception and planning, 2) Diversity and collaboration, 3) Preliminary research, 4) Co-production, 5) Safety measures, 6) Preliminary testing, 7) Healthcare integration, 8) Service evaluation and auditing, 9) Maintenance, and 10) Termination.<h4>Discussion</h4>We have made specific recommendations to increase conversational AI's equity as part of healthcare services. These emphasise the importance of a collaborative approach and the involvement of patient groups in navigating the rapid evolution of conversational AI technologies. Further research must assess the impact of recommended activities on chatbots' fairness and their ability to reduce health inequalities.https://doi.org/10.1371/journal.pdig.0000492
spellingShingle Tom Nadarzynski
Nicky Knights
Deborah Husbands
Cynthia A Graham
Carrie D Llewellyn
Tom Buchanan
Ian Montgomery
Damien Ridge
Achieving health equity through conversational AI: A roadmap for design and implementation of inclusive chatbots in healthcare.
PLOS Digital Health
title Achieving health equity through conversational AI: A roadmap for design and implementation of inclusive chatbots in healthcare.
title_full Achieving health equity through conversational AI: A roadmap for design and implementation of inclusive chatbots in healthcare.
title_fullStr Achieving health equity through conversational AI: A roadmap for design and implementation of inclusive chatbots in healthcare.
title_full_unstemmed Achieving health equity through conversational AI: A roadmap for design and implementation of inclusive chatbots in healthcare.
title_short Achieving health equity through conversational AI: A roadmap for design and implementation of inclusive chatbots in healthcare.
title_sort achieving health equity through conversational ai a roadmap for design and implementation of inclusive chatbots in healthcare
url https://doi.org/10.1371/journal.pdig.0000492
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