title: Improving Access to Online Health Information With Conversational Agents: A Randomized Controlled Experiment.
abstract: 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.
authors.affiliation: Northeastern University, College of Computer and Information Science, Boston, MA, United States. bickmore@ccs.neu.edu.
authors.forename: Timothy W
authors.identifier: http://orcid.org/0000-0002-2676-9788
authors.initials: TW
authors.lastname: Bickmore
authors.forename: Dina
authors.identifier: http://orcid.org/0000-0001-7477-244X
authors.initials: D
authors.lastname: Utami
authors.forename: Robin
authors.identifier: http://orcid.org/0000-0002-0859-7505
authors.initials: R
authors.lastname: Matsuyama
authors.forename: Michael K
authors.identifier: http://orcid.org/0000-0002-9276-7190
authors.initials: MK
authors.lastname: Paasche-Orlow
mesh_terms: D000368:Aged; D002986:Clinical Trials as Topic; D003197:Computer Literacy; D019992:Databases as Topic; D005260:Female; D057220:Health Literacy; D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods*; D020407:Internet; D008297:Male; D008875:Middle Aged; D057386:Search Engine; D013358:Subject Headings; D014584:User-Computer Interface
keywords: Internet; Web search; computer literacy; embodied conversational agent; health literacy; information retrieval user interface; relational agent; search engine; search user interface