Conversational agents for depression screening: A systematic review.

OBJECTIVE: This work explores the advances in conversational agents aimed at the detection of mental health disorders, and specifically the screening of depression. The focus is put on those based on voice interaction, but other approaches are also tackled, such as text-based interaction or embodied avatars. METHODS: PRISMA was selected as the systematic methodology for the analysis of existing literature, which was retrieved from Scopus, PubMed, IEEE Xplore, APA PsycINFO, Cochrane, and Web of Science. Relevant research addresses the detection of depression using conversational agents, and the selection criteria utilized include their effectiveness, usability, personalization, and psychometric properties. RESULTS: Of the 993 references initially retrieved, 36 were finally included in our work. The analysis of these studies allowed us to identify 30 conversational agents that claim to detect depression, specifically or in combination with other disorders such as anxiety or stress disorders. As a general approach, screening was implemented in the conversational agents taking as a reference standardized or psychometrically validated clinical tests, which were also utilized as a golden standard for their validation. The implementation of questionnaires such as Patient Health Questionnaire or the Beck Depression Inventory, which are used in 65% of the articles analyzed, stand out. CONCLUSIONS: The usefulness of intelligent conversational agents allows screening to be administered to different types of profiles, such as patients (33% of relevant proposals) and caregivers (11%), although in many cases a target profile is not clearly of (66% of solutions analyzed). This study found 30 standalone conversational agents, but some proposals were explored that combine several approaches for a more enriching data acquisition. The interaction implemented in most relevant conversational agents is text-based, although the evolution is clearly towards voice integration, which in turns enhances their psychometric characteristics, as voice interaction is perceived as more natural and less invasive.

Smart conversational agents for the detection of neuropsychiatric disorders: A systematic review.

OBJECTIVE: To determine whether smart conversational agents can be used for detection of neuropsychiatric disorders. Therefore, we reviewed the technologies used, targeted mental disorders and validation procedures of relevant proposals in this field. METHODS: We searched Scopus, PubMed, Pro-Quest, IEEE Xplore, Web of Science, CINAHL and the Cochrane Library using a predefined search strategy. Studies were included if they focused on neuropsychiatric disorders and involved conversational data for detection and diagnosis. They were assessed for eligibility by independent reviewers and ultimately included if a consensus was reached about their relevance. RESULTS: 2356 references were initially retrieved. Eventually, 17 articles - referring 9 smart conversational agents - met the inclusion criteria. Out of the selected studies, 7 are targeted at neurocognitive disorders, 7 at depression and 3 at other conditions. They apply diverse technological solutions and analysis techniques (82.4% use Artificial Intelligence), and they usually rely on gold standard tests for criterion validity assessment. Acceptability, reliability and other aspects of validity were rarely addressed. CONCLUSION: The use of smart conversational agents for the detection of neuropsychiatric disorders is an emerging and promising field of research, with a broad coverage of mental disorders and extended use of AI. However, the few published studies did not undergo robust psychometric validation processes. Future research in this field would benefit from more rigorous validation mechanisms and standardized software and hardware platforms.

Heuristic Evaluation of an IoMT System for Remote Health Monitoring in Senior Care.

This paper presents the usability assessment of the design of an Internet of Medical Things (IoMT) system for older adults; the evaluation, using heuristics, was held early on the design process to assess potential problems with the system and was found to be an efficient method to find issues with the application design and led to significant usability improvements on the IoMT platform.

An IoT System for Remote Health Monitoring in Elderly Adults Through a Wearable Device and Mobile Application.

With the increase in global life expectancy and the advance of technology, the creation of age-friendly environments is a priority in the design of new products for elderly people healthcare. This paper presents a proposal for a real-time health monitoring system of older adults living in geriatric residences. This system was developed to help caregivers to have a better control in monitoring the health of their patients and have closer communication with their patients' family members. To validate the feasibility and effectiveness of this proposal, a prototype was built, using a biometric bracelet connected to a mobile application, which allows real-time visualization of all the information generated by the sensors (heart rate, body temperature, and blood oxygenation) in the bracelet. Using these data, caregivers can make decisions about the health status of their patients. The evaluation found that the users perceived the system to be easy to learn and use, providing initial evidence that our proposal could improve the quality of the adult's healthcare.

Learning to Detect Cognitive Impairment through Digital Games and Machine Learning Techniques.

OBJECTIVE: Alzheimer's disease (AD) is one of the most prevalent diseases among the adult population. The early detection of Mild Cognitive Impairment (MCI), which may trigger AD, is essential to slow down the cognitive decline process. METHODS: This paper presents a suit of serious games that aims at detecting AD and MCI overcoming the limitations of traditional tests, as they are time-consuming, affected by confounding factors that distort the result and usually administered when symptoms are evident and it is too late for preventive measures. The battery, named Panoramix, assesses the main early cognitive markers (i.e., memory, executive functions, attention and gnosias). Regarding its validation, it has been tested with a cohort study of 16 seniors, including AD, MCI and healthy individuals. RESULTS: This first pilot study offered initial evidence about psychometric validity, and more specifically about construct, criterion and external validity. After an analysis using machine learning techniques, findings show a promising 100% rate of success in classification abilities using a subset of three games in the battery. Thus, results are encouraging as all healthy subjects were correctly discriminated from those already suffering AD or MCI. CONCLUSIONS: The solid potential of digital serious games and machine learning for the early detection of dementia processes is demonstrated. Such a promising performance encourages further research to eventually introduce this technique for the clinical diagnosis of cognitive impairment.

A Bag of Concepts Approach for Biomedical Document Classification Using Wikipedia Knowledge*. Spanish-English Cross-language Case Study.

OBJECTIVES: The ability to efficiently review the existing literature is essential for the rapid progress of research. This paper describes a classifier of text documents, represented as vectors in spaces of Wikipedia concepts, and analyses its suitability for classification of Spanish biomedical documents when only English documents are available for training. We propose the cross-language concept matching (CLCM) technique, which relies on Wikipedia interlanguage links to convert concept vectors from the Spanish to the English space. METHODS: The performance of the classifier is compared to several baselines: a classifier based on machine translation, a classifier that represents documents after performing Explicit Semantic Analysis (ESA), and a classifier that uses a domain-specific semantic annotator (MetaMap). The corpus used for the experiments (Cross-Language UVigoMED) was purpose-built for this study, and it is composed of 12,832 English and 2,184 Spanish MEDLINE abstracts. RESULTS: The performance of our approach is superior to any other state-of-the art classifier in the benchmark, with performance increases up to: 124% over classical machine translation, 332% over MetaMap, and 60 times over the classifier based on ESA. The results have statistical significance, showing p-values < 0.0001. CONCLUSION: Using knowledge mined from Wikipedia to represent documents as vectors in a space of Wikipedia concepts and translating vectors between language-specific concept spaces, a cross-language classifier can be built, and it performs better than several state-of-the-art classifiers.

The Technology Acceptance of a TV Platform for the Elderly Living Alone or in Public Nursing Homes.

In Mexico, many seniors are alone for most of the day or live in public nursing homes. Simple interaction with computer systems is required for older people. This is why we propose the exploration of a medium well known by seniors, such as the television (TV). The primary objective of this study is to improve the quality of life of seniors through an easier reminder system, using the television set. A technological platform was designed based on interactive television, through which seniors and their caregivers can have a better way to track their daily activities. Finally, an evaluation of the technology adoption was performed with 50 seniors living in two public nursing homes. The evaluation found that the elderly perceived the system as useful, easy to use, and they had a positive attitude and good intention to use it. This helped to generate initial evidence that the system supported them in achieving a better quality of life, by reminding them to take their medications and increasing their rate of attendance to their medical appointments.

An Open Architecture to Support Social and Health Services in a Smart TV Environment.

OBJECTIVE: To design, implement, and test a solution to provide social and health services for the elderly at home based on smart TV technologies and access to all services. METHODS: The architecture proposed is based on an open software platform and standard personal computing hardware. This provides great flexibility to develop new applications over the underlying infrastructure or to integrate new devices, for instance to monitor a broad range of vital signs in those cases where home monitoring is required. RESULTS: An actual system as a proof-of-concept was designed, implemented, and deployed. Applications range from social network clients to vital signs monitoring; from interactive TV contests to conventional online care applications such as medication reminders or telemedicine. CONCLUSION: In both cases, the results have been very positive, confirming the initial perception of the TV as a convenient, easy-to-use technology to provide social and health care. The TV set is a much more familiar computing interface for most senior users, and as a consequence, smart TVs become a most convenient solution for the design and implementation of applications and services targeted to this user group. SIGNIFICANCE: This proposal has been tested in real setting with 62 senior people at their homes. Users included both individuals with experience using computers and others reluctant to them.

Biomedical literature classification using encyclopedic knowledge: a Wikipedia-based bag-of-concepts approach.

Automatic classification of text documents into a set of categories has a lot of applications. Among those applications, the automatic classification of biomedical literature stands out as an important application for automatic document classification strategies. Biomedical staff and researchers have to deal with a lot of literature in their daily activities, so it would be useful a system that allows for accessing to documents of interest in a simple and effective way; thus, it is necessary that these documents are sorted based on some criteria-that is to say, they have to be classified. Documents to classify are usually represented following the bag-of-words (BoW) paradigm. Features are words in the text-thus suffering from synonymy and polysemy-and their weights are just based on their frequency of occurrence. This paper presents an empirical study of the efficiency of a classifier that leverages encyclopedic background knowledge-concretely Wikipedia-in order to create bag-of-concepts (BoC) representations of documents, understanding concept as "unit of meaning", and thus tackling synonymy and polysemy. Besides, the weighting of concepts is based on their semantic relevance in the text. For the evaluation of the proposal, empirical experiments have been conducted with one of the commonly used corpora for evaluating classification and retrieval of biomedical information, OHSUMED, and also with a purpose-built corpus of MEDLINE biomedical abstracts, UVigoMED. Results obtained show that the Wikipedia-based bag-of-concepts representation outperforms the classical bag-of-words representation up to 157% in the single-label classification problem and up to 100% in the multi-label problem for OHSUMED corpus, and up to 122% in the single-label classification problem and up to 155% in the multi-label problem for UVigoMED corpus.