ABSTRACT
BACKGROUND: The potential of chatbots for screening and monitoring COVID-19 was envisioned since the outbreak of the disease. Chatbots can help disseminate up-to-date and trustworthy information, promote healthy social behavior, and support the provision of health care services safely and at scale. In this scenario and in view of its far-reaching postpandemic impact, it is important to evaluate user experience with this kind of application. OBJECTIVE: We aimed to evaluate the quality of user experience with a COVID-19 chatbot designed by a large telehealth service in Brazil, focusing on the usability of real users and the exploration of strengths and shortcomings of the chatbot, as revealed in reports by participants in simulated scenarios. METHODS: We examined a chatbot developed by a multidisciplinary team and used it as a component within the workflow of a local public health care service. The chatbot had 2 core functionalities: assisting web-based screening of COVID-19 symptom severity and providing evidence-based information to the population. From October 2020 to January 2021, we conducted a mixed methods approach and performed a 2-fold evaluation of user experience with our chatbot by following 2 methods: a posttask usability Likert-scale survey presented to all users after concluding their interaction with the bot and an interview with volunteer participants who engaged in a simulated interaction with the bot guided by the interviewer. RESULTS: Usability assessment with 63 users revealed very good scores for chatbot usefulness (4.57), likelihood of being recommended (4.48), ease of use (4.44), and user satisfaction (4.38). Interviews with 15 volunteers provided insights into the strengths and shortcomings of our bot. Comments on the positive aspects and problems reported by users were analyzed in terms of recurrent themes. We identified 6 positive aspects and 15 issues organized in 2 categories: usability of the chatbot and health support offered by it, the former referring to usability of the chatbot and how users can interact with it and the latter referring to the chatbot's goal in supporting people during the pandemic through the screening process and education to users through informative content. We found 6 themes accounting for what people liked most about our chatbot and why they found it useful-3 themes pertaining to the usability domain and 3 themes regarding health support. Our findings also identified 15 types of problems producing a negative impact on users-10 of them related to the usability of the chatbot and 5 related to the health support it provides. CONCLUSIONS: Our results indicate that users had an overall positive experience with the chatbot and found the health support relevant. Nonetheless, qualitative evaluation of the chatbot indicated challenges and directions to be pursued in improving not only our COVID-19 chatbot but also health chatbots in general.
ABSTRACT
As sequelas das lesões traumáticas da espinal medula representam um elevado prejuízo pessoal, familiar e social. Desde 1984, foi investigado e proposto o tratamento com succinato sódico metilprednisolona em altas doses, como forma de reverter ou prevenir o agravamento dessas lesões. Apresentamos uma revisão da literatura sobre essa temática. Sabe-se que essa terapêutica tem uma elevada taxa de complicações, mas, acerca das suas vantagens e real eficácia, não existe concordância entre autores de trabalhos. Enquanto uns a defendem, outros chegam a considerar provada a sua total contraindicação nessa patologia. Já existem, em nível mundial, alguns centros que não fazem a sua administração. Em Portugal é prática generalizada a sua utilização. Não o fazer poderia mesmo ser difícil de defender em situação de litígio. Mas será que estamos mesmo a ajudar os nossos doentes?.
Sequelae of the traumatic injuries to the spinal cord represent a high personal, family and social damage. Since 1984, it has been investigated and considered that the treatment with sodium succinate methylprednisolone in high doses was a solution to revert or to prevent the aggravation of such injuries. We present a revision of literature on this subject. It is well established that this therapeutic has a high rate of complications, but concerning its advantages and real effectiveness, there is no agreement between paper authors. While some defend it, others state that this is a total contraindication in this pathology. There are already some medical centers worldwide that do not use it. In Portugal, the practice of its administration is generalized. Not to do it could be difficult to defend in a litigation situation. But are we really helping our patients with it?.
Las secuelas de las lesiones traumáticas de la médula espinal representan una gran pérdida personal, familiar y social. Desde el 1984, se investigó y se ofreció tratamiento con succinato sódico de metilprednisolona en altas dosis, como una forma de revertir o prevenir el empeoramiento de estas lesiones. Los autores presentan una revisión de la literatura sobre este tema. Se sabe que esta terapia tiene un alto índice de complicaciones. Sin embargo, sobre sus ventajas y eficacia real, no hay acuerdo entre las publicaciones. Mientras que algunas la defienden y otros llegan a tomar como prueba de su contraindicación total en esta patología.Ahora, existen en todo el mundo, algunos centros que no hacen su administración. En Portugal, se encuentra en uso generalizado. No hacerlo sería difícil de defender en situaciones de conflicto. ¿Pero, es esto una real ayuda a nuestros pacientes?.
