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Towards conversational assistants for health applications: using ChatGPT to generate conversations about heart failure (2505.03675v1)

Published 6 May 2025 in cs.CL

Abstract: We explore the potential of ChatGPT (3.5-turbo and 4) to generate conversations focused on self-care strategies for African-American heart failure patients -- a domain with limited specialized datasets. To simulate patient-health educator dialogues, we employed four prompting strategies: domain, African American Vernacular English (AAVE), Social Determinants of Health (SDOH), and SDOH-informed reasoning. Conversations were generated across key self-care domains of food, exercise, and fluid intake, with varying turn lengths (5, 10, 15) and incorporated patient-specific SDOH attributes such as age, gender, neighborhood, and socioeconomic status. Our findings show that effective prompt design is essential. While incorporating SDOH and reasoning improves dialogue quality, ChatGPT still lacks the empathy and engagement needed for meaningful healthcare communication.

Summary

Towards Conversational Assistants for Health Applications: Using ChatGPT to Generate Conversations About Heart Failure

The paper "Towards Conversational Assistants for Health Applications: Using ChatGPT to Generate Conversations About Heart Failure" presents an investigation into the potential application of advanced generative pretrained transformers (GPTs), specifically ChatGPT 3.5-turbo and GPT-4, in generating patient-health educator dialogues focused on heart failure, with an emphasis on self-care strategies for African-American communities. This exploration is noteworthy due to the scarcity of specialized datasets catering to the health communication needs of minorities, particularly African-American patients, who often face disparities in health outcomes due to a range of socio-economic factors.

Method and Approach

The paper is predicated on the development of a culturally sensitive conversational agent. The researchers employed four different prompting strategies: domain-specific prompting, the integration of African American Vernacular English (AAVE), consideration of Social Determinants of Health (SDOH), and SDOH-informed reasoning to generate synthetic conversations across critical self-care areas — food, exercise, and fluid intake. These conversations were varied by turn lengths and were personalized by incorporating patient-specific SDOH attributes such as age, gender, neighborhood, and socioeconomic status.

Key Findings and Challenges

The experimental findings highlight several critical insights and challenges:

  • Prompt Design and Relevance: Effective prompt design is essential for generating relevant conversations. It was noted that while domain-specific prompts could guide the conversation, there is a need for more contextual awareness and nuanced interaction to simulate realistic patient-health educator exchanges.
  • Integration of SDOH Features: The inclusion of SDOH features in conversation prompts led to varied levels of personalization. While ChatGPT could tailor its responses to include specific patient features, the depth of personalization was inconsistent and often lacked the sensitivity required for healthcare communication. This underscores the importance of integrating comprehensive patient data to enhance dialogue relevance and efficiency.
  • Empathy and Engagement: A significant observation was the machine's deficiency in expressing empathy, a cornerstone in effective healthcare communication. ChatGPT's outputs were often perceived as robotic, lacking the emotional depth necessary to engage patients genuinely. This limitation calls attention to the need for further development in LLMs to naturally incorporate empathy into conversations.
  • Efficacy of Reasoning in Dialogue Generation: The paper evaluated whether generating reasoning prior to conversation could improve output quality. While reasoning steps provided a framework to address patient inquiries thoroughly and consistently, the integration did not always translate into perceptibly enhanced dialogue engagement.

Implications and Future Prospects

The research offers valuable insights into the utilization of ChatGPT for health communications, suggesting feasible pathways in developing conversational agents tailored to the needs of underserved patient demographics. Practically, these findings highlight the potential of LLMs in facilitating patient education and self-care, particularly as digital healthcare solutions continue to evolve.

Theoretically, the paper stimulates discourse on the ethical and practical integration of AI in healthcare, urging the need for better models that can handle nuanced human interactions, accommodate cultural dynamics, and express empathy naturally.

Future Developments

Future research can look into refining prompt strategies and leveraging advanced AI techniques to achieve more context-aware, empathetic dialogue systems. There is also scope for incorporating richer datasets representing diverse SDOH characteristics to develop models capable of handling varied healthcare scenarios effectively. Collaborative efforts between AI researchers and healthcare professionals could propel innovations in AI-driven conversational tools, providing personalized and equitable patient care.

The paper's conclusions underscore the complexities of deploying AI in sensitive domains like healthcare, pointing to the ongoing need for interdisciplinary research and tailored technological solutions.

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