The Extent to Which Artificial Intelligence Can Help Fulfill Metastatic Breast Cancer Patient Healthcare Needs: A Mixed-Methods Study.

Journal: Current oncology (Toronto, Ont.)
PMID: 40136349

Abstract

The Artificial Intelligence Patient Librarian (AIPL) was designed to meet the psychosocial and supportive care needs of Metastatic Breast Cancer (MBC) patients with HR+/HER2- subtypes. AIPL provides conversational patient education, answers user questions, and offers tailored online resource recommendations. This study, conducted in three phases, assessed AIPL's impact on patients' ability to manage their advanced disease. In Phase 1, educational content was adapted for chatbot delivery, and over 100 credible online resources were annotated using a Convolutional Neural Network (CNN) to drive recommendations. Phase 2 involved 42 participants who completed pre- and post-surveys after using AIPL for two weeks. The surveys measured patient activation using the Patient Activation Measure (PAM) tool and evaluated user experience with the System Usability Scale (SUS). Phase 3 included focus groups to explore user experiences in depth. Of the 42 participants, 36 completed the study, with 10 participating in focus groups. Most participants were aged 40-64. PAM scores showed no significant differences between pre-survey (mean = 59.33, SD = 5.19) and post-survey (mean = 59.22, SD = 6.16), while SUS scores indicated good usability. Thematic analysis revealed four key themes: AIPL offers basic wellness and health guidance, provides limited support for managing relationships, offers limited condition-specific medical information, and is unable to offer hope to patients. Despite showing no impact on the PAM, possibly due to high baseline activation, AIPL demonstrated good usability and met basic information needs, particularly for newly diagnosed MBC patients. Future iterations will incorporate a large language model (LLM) to provide more comprehensive and personalized assistance.

Authors

  • Yvonne W Leung
    Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada.
  • Jeremiah So
    de Souza Institute, University Health Network, Toronto, ON M5G 2C4, Canada.
  • Avneet Sidhu
    de Souza Institute, University Health Network, Toronto, ON M5G 2C4, Canada.
  • Veenaajaa Asokan
    de Souza Institute, University Health Network, Toronto, ON M5G 2C4, Canada.
  • Mathew Gancarz
    de Souza Institute, University Health Network, Toronto, ON M5G 2C4, Canada.
  • Vishrut Bharatkumar Gajjar
    College of Professional Studies, Northeastern University, Toronto, ON M5X 1E2, Canada.
  • Ankita Patel
    College of Professional Studies, Northeastern University, Toronto, ON M5X 1E2, Canada.
  • Janice M Li
    de Souza Institute, University Health Network, Toronto, ON M5G 2C4, Canada.
  • Denis Kwok
    de Souza Institute, University Health Network, Toronto, ON M5G 2C4, Canada.
  • Michelle B Nadler
    Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada.
  • Danielle Cuthbert
    Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada.
  • Philippe L Benard
    Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada.
  • Vikaash Kumar
    Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada.
  • Terry Cheng
    Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada.
  • Janet Papadakos
    Cancer Education Program, Princess Margaret Cancer Centre, Cancer Health Literacy Research Centre, Toronto, ON M5G 2M9, Canada.
  • Tina Papadakos
    Cancer Education Program, Princess Margaret Cancer Centre, Cancer Health Literacy Research Centre, Toronto, ON M5G 2M9, Canada.
  • Tran Truong
    Health Informatics Research, University Health Network, Toronto, ON Canada.
  • Mike Lovas
    Design and Innovation at Cancer Digital Intelligence, University Health Network, Toronto, ON M5G 2C4, Canada.
  • Jiahui Wong
    Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada.

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