Usability and Credibility of a COVID-19 Vaccine Chatbot for Young Adults and Health Workers in the United States: Formative Mixed Methods Study.

BACKGROUND: The COVID-19 pandemic raised novel challenges in communicating reliable, continually changing health information to a broad and sometimes skeptical public, particularly around COVID-19 vaccines, which, despite being comprehensively studied, were the subject of viral misinformation. Chatbots are a promising technology to reach and engage populations during the pandemic. To inform and communicate effectively with users, chatbots must be highly usable and credible. OBJECTIVE: We sought to understand how young adults and health workers in the United States assessed the usability and credibility of a web-based chatbot called Vira, created by the Johns Hopkins Bloomberg School of Public Health and IBM Research using natural language processing technology. Using a mixed method approach, we sought to rapidly improve Vira's user experience to support vaccine decision-making during the peak of the COVID-19 pandemic. METHODS: We recruited racially and ethnically diverse young people and health workers, with both groups from urban areas of the United States. We used the validated Chatbot Usability Questionnaire to understand the tool's navigation, precision, and persona. We also conducted 11 interviews with health workers and young people to understand the user experience, whether they perceived the chatbot as confidential and trustworthy, and how they would use the chatbot. We coded and categorized emerging themes to understand the determining factors for participants' assessment of chatbot usability and credibility. RESULTS: In all, 58 participants completed a web-based usability questionnaire and 11 completed in-depth interviews. Most questionnaire respondents said the chatbot was "easy to navigate" (51/58, 88%) and "very easy to use" (50/58, 86%), and many (45/58, 78%) said its responses were relevant. The mean Chatbot Usability Questionnaire score was 70.2 (SD 12.1) and scores ranged from 40.6 to 95.3. Interview participants felt the chatbot achieved high usability due to its strong functionality, performance, and perceived confidentiality and that the chatbot could attain high credibility with a redesign of its cartoonish visual persona. Young people said they would use the chatbot to discuss vaccination with hesitant friends or family members, whereas health workers used or anticipated using the chatbot to support community outreach, save time, and stay up to date. CONCLUSIONS: This formative study conducted during the pandemic's peak provided user feedback for an iterative redesign of Vira. Using a mixed method approach provided multidimensional feedback, identifying how the chatbot worked well-being easy to use, answering questions appropriately, and using credible branding-while offering tangible steps to improve the product's visual design. Future studies should evaluate how chatbots support personal health decision-making, particularly in the context of a public health emergency, and whether such outreach tools can reduce staff burnout. Randomized studies should also be conducted to measure how chatbots countering health misinformation affect user knowledge, attitudes, and behavior.

Revisiting Sequential Information Bottleneck: New Implementation and Evaluation.

We introduce a modern, optimized, and publicly available implementation of the sequential Information Bottleneck clustering algorithm, which strikes a highly competitive balance between clustering quality and speed. We describe a set of optimizations that make the algorithm computation more efficient, particularly for the common case of sparse data representation. The results are substantiated by an extensive evaluation that compares the algorithm to commonly used alternatives, focusing on the practically important use case of text clustering. The evaluation covers a range of publicly available benchmark datasets and a set of clustering setups employing modern word and sentence embeddings obtained by state-of-the-art neural models. The results show that in spite of using the more basic Term-Frequency representation, the proposed implementation provides a highly attractive trade-off between quality and speed that outperforms the alternatives considered. This new release facilitates the use of the algorithm in real-world applications of text clustering.

Chatbot-Delivered COVID-19 Vaccine Communication Message Preferences of Young Adults and Public Health Workers in Urban American Communities: Qualitative Study.

BACKGROUND: Automated conversational agents, or chatbots, have a role in reinforcing evidence-based guidance delivered through other media and offer an accessible, individually tailored channel for public engagement. In early-to-mid 2021, young adults and minority populations disproportionately affected by COVID-19 in the United States were more likely to be hesitant toward COVID-19 vaccines, citing concerns regarding vaccine safety and effectiveness. Successful chatbot communication requires purposive understanding of user needs. OBJECTIVE: We aimed to review the acceptability of messages to be delivered by a chatbot named VIRA from Johns Hopkins University. The study investigated which message styles were preferred by young, urban-dwelling Americans as well as public health workers, since we anticipated that the chatbot would be used by the latter as a job aid. METHODS: We conducted 4 web-based focus groups with 20 racially and ethnically diverse young adults aged 18-28 years and public health workers aged 25-61 years living in or near eastern-US cities. We tested 6 message styles, asking participants to select a preferred response style for a chatbot answering common questions about COVID-19 vaccines. We transcribed, coded, and categorized emerging themes within the discussions of message content, style, and framing. RESULTS: Participants preferred messages that began with an empathetic reflection of a user concern and concluded with a straightforward, fact-supported response. Most participants disapproved of moralistic or reasoning-based appeals to get vaccinated, although public health workers felt that such strong statements appealing to communal responsibility were warranted. Responses tested with humor and testimonials did not appeal to the participants. CONCLUSIONS: To foster credibility, chatbots targeting young people with vaccine-related messaging should aim to build rapport with users by deploying empathic, reflective statements, followed by direct and comprehensive responses to user queries. Further studies are needed to inform the appropriate use of user-customized testimonials and humor in the context of chatbot communication.

An autonomous debating system.

Artificial intelligence (AI) is defined as the ability of machines to perform tasks that are usually associated with intelligent beings. Argument and debate are fundamental capabilities of human intelligence, essential for a wide range of human activities, and common to all human societies. The development of computational argumentation technologies is therefore an important emerging discipline in AI research1. Here we present Project Debater, an autonomous debating system that can engage in a competitive debate with humans. We provide a complete description of the system's architecture, a thorough and systematic evaluation of its operation across a wide range of debate topics, and a detailed account of the system's performance in its public debut against three expert human debaters. We also highlight the fundamental differences between debating with humans as opposed to challenging humans in game competitions, the latter being the focus of classical 'grand challenges' pursued by the AI research community over the past few decades. We suggest that such challenges lie in the 'comfort zone' of AI, whereas debating with humans lies in a different territory, in which humans still prevail, and for which novel paradigms are required to make substantial progress.

Adolescents in psychodynamic psychotherapy: changes in internal representations of relationships with parents.

This study explored whether and how internal representations of adolescents' relationship with their parents--a fundamental concept in psychodynamic theory--changed in the course of a year of treatment and whether the observed changes were related to changes in symptoms. Seventy two adolescents (ages 15-18; 30 in treatment and 42 in a non-treatment "community group") underwent Relationship Anecdote Paradigm (RAP) interviews according to the Core Conflictual Relationship Theme method (CCRT; Luborsky & Crits-Christoph, 1998) and completed outcome measures at two time points. A novel data-driven approach to clustering CCRT categories was used to characterize internal representations. The potential contribution of this approach to the CCRT method is discussed. The results indicate that adolescents' internal representations of their relationships with their parents changed significantly throughout treatment, and were related to changes in symptoms.

Automatic detection of inconsistencies between free text and coded data in Sarcoma discharge letters.

Discordance between data stored in Electronic Health Records (EHR) may have a harmful effect on patient care. Automatic identification of such situations is an important yet challenging task, especially when the discordance involves information stored in free text fields. Here we present a method to automatically detect inconsistencies between data stored in free text and related coded fields. Using EHR data we train an ensemble of classifiers to predict the value of coded fields from the free text fields. Cases in which the classifiers predict with high confidence a code different from the clinicians' choice are marked as potential inconsistencies. Experimental results over discharge letters of sarcoma patients, verified by a domain expert, demonstrate the validity of our method.

Knowledge-analytics synergy in Clinical Decision Support.

Clinical Decision Support (CDS) systems hold tremendous potential for improving patient care. Most existing systems are knowledge-based tools that rely on relatively simple rules. More recent approaches rely on analytics techniques to automatically mine EHR data to reveal meaningful insights. Here, we propose the Knowledge-Analytics Synergy paradigm for CDS, in which we synergistically combine existing relevant knowledge with analytics applied to EHR data. We propose a framework for implementing such a paradigm and demonstrate its principles over real-world clinical and genomic data of hypertensive patients.

Prognostic data-driven clinical decision support - formulation and implications.

Existing Clinical Decision Support Systems (CDSSs) typically rely on rule-based algorithms and focus on tasks like guidelines adherence and drug prescribing and monitoring. However, the increasing dominance of Electronic Health Record technologies and personalized medicine suggest great potential for prognostic data-driven CDSS. A major goal for such systems would be to accurately predict the outcome of patients' candidate treatments by statistical analysis of the clinical data stored at a Health Care Organization. We formally define the concepts involved in the development of such a system, highlight an inherent difficulty arising from bias in treatment allocation, and propose a general strategy to address this difficulty. Experiments over hypertension clinical data demonstrate the validity of our approach.

Glucose regulates transcription in yeast through a network of signaling pathways.

Addition of glucose to yeast cells increases their growth rate and results in a massive restructuring of their transcriptional output. We have used microarray analysis in conjunction with conditional mutations to obtain a systems view of the signaling network responsible for glucose-induced transcriptional changes. We found that several well-studied signaling pathways-such as Snf1 and Rgt-are responsible for specialized but limited responses to glucose. However, 90% of the glucose-induced changes can be recapitulated by the activation of protein kinase A (PKA) or by the induction of PKB (Sch9). Blocking signaling through Sch9 does not interfere with the glucose response, whereas blocking signaling through PKA does. We conclude that both Sch9 and PKA regulate a massive, nutrient-responsive transcriptional program promoting growth, but that they do so in response to different nutritional inputs. Moreover, activating PKA completely recapitulates the transcriptional growth program in the absence of any increase in growth or metabolism, demonstrating that activation of the growth program results solely from the cell's perception of its nutritional status.

A universal framework for regulatory element discovery across all genomes and data types.

Deciphering the noncoding regulatory genome has proved a formidable challenge. Despite the wealth of available gene expression data, there currently exists no broadly applicable method for characterizing the regulatory elements that shape the rich underlying dynamics. We present a general framework for detecting such regulatory DNA and RNA motifs that relies on directly assessing the mutual information between sequence and gene expression measurements. Our approach makes minimal assumptions about the background sequence model and the mechanisms by which elements affect gene expression. This provides a versatile motif discovery framework, across all data types and genomes, with exceptional sensitivity and near-zero false-positive rates. Applications from yeast to human uncover putative and established transcription-factor binding and miRNA target sites, revealing rich diversity in their spatial configurations, pervasive co-occurrences of DNA and RNA motifs, context-dependent selection for motif avoidance, and the strong impact of posttranscriptional processes on eukaryotic transcriptomes.

Multivariate information bottleneck.

The information bottleneck (IB) method is an unsupervised model independent data organization technique. Given a joint distribution, p(X, Y), this method constructs a new variable, T, that extracts partitions, or clusters, over the values of X that are informative about Y. Algorithms that are motivated by the IB method have already been applied to text classification, gene expression, neural code, and spectral analysis. Here, we introduce a general principled framework for multivariate extensions of the IB method. This allows us to consider multiple systems of data partitions that are interrelated. Our approach utilizes Bayesian networks for specifying the systems of clusters and which information terms should be maintained. We show that this construction provides insights about bottleneck variations and enables us to characterize the solutions of these variations. We also present four different algorithmic approaches that allow us to construct solutions in practice and apply them to several real-world problems.

Ab initio genotype-phenotype association reveals intrinsic modularity in genetic networks.

Microbial species express an astonishing diversity of phenotypic traits, behaviors, and metabolic capacities. However, our molecular understanding of these phenotypes is based almost entirely on studies in a handful of model organisms that together represent only a small fraction of this phenotypic diversity. Furthermore, many microbial species are not amenable to traditional laboratory analysis because of their exotic lifestyles and/or lack of suitable molecular genetic techniques. As an adjunct to experimental analysis, we have developed a computational information-theoretic framework that produces high-confidence gene-phenotype predictions using cross-species distributions of genes and phenotypes across 202 fully sequenced archaea and eubacteria. In addition to identifying the genetic basis of complex traits, our approach reveals the organization of these genes into generic preferentially co-inherited modules, many of which correspond directly to known enzymatic pathways, molecular complexes, signaling pathways, and molecular machines.

Information-based clustering.

In an age of increasingly large data sets, investigators in many different disciplines have turned to clustering as a tool for data analysis and exploration. Existing clustering methods, however, typically depend on several nontrivial assumptions about the structure of data. Here, we reformulate the clustering problem from an information theoretic perspective that avoids many of these assumptions. In particular, our formulation obviates the need for defining a cluster "prototype," does not require an a priori similarity metric, is invariant to changes in the representation of the data, and naturally captures nonlinear relations. We apply this approach to different domains and find that it consistently produces clusters that are more coherent than those extracted by existing algorithms. Finally, our approach provides a way of clustering based on collective notions of similarity rather than the traditional pairwise measures.