RESUMO
Over the last few years, dozens of healthcare surveys have shown a shortage of doctors and an alarming doctor-population ratio. With the motivation of assisting doctors and utilizing their time efficiently, automatic disease diagnosis using artificial intelligence is experiencing an ever-growing demand and popularity. Humans are known by the company they keep; similarly, symptoms also exhibit the association property, i.e., one symptom may strongly suggest another symptom's existence/non-existence, and their association provides crucial information about the suffering condition. The work investigates the role of symptom association in symptom investigation and disease diagnosis process. We propose and build a virtual assistant called Association guided Symptom Investigation and Diagnosis Assistant (A-SIDA) using hierarchical reinforcement learning. The proposed A-SIDDA converses with patients and extracts signs and symptoms as per patients' chief complaints and ongoing dialogue context. We infused association-based recommendations and critic into the assistant, which reinforces the assistant for conducting context-aware, symptom-association guided symptom investigation. Following the symptom investigation, the assistant diagnoses a disease based on the extracted signs and symptoms. The assistant then diagnoses a disease based on the extracted signs and symptoms. In addition to diagnosis accuracy, the relevance of inspected symptoms is critical to the usefulness of a diagnosis framework. We also propose a novel evaluation metric called Investigation Relevance Score (IReS), which measures the relevance of symptoms inspected during symptom investigation. The obtained improvements (Diagnosis success rate-5.36%, Dialogue length-1.16, Match rate-2.19%, Disease classifier-6.36%, IReS-0.3501, and Human score-0.66) over state-of-the-art methods firmly establish the crucial role of symptom association that gets uncovered by the virtual agent. Furthermore, we found that the association guided symptom investigation greatly increases human satisfaction, owing to its seamless topic (symptom) transition.
Assuntos
Inteligência Artificial , Aprendizado Profundo , HumanosRESUMO
With the advancement of internet communication and telemedicine, people are increasingly turning to the web for various healthcare activities. With an ever-increasing number of diseases and symptoms, diagnosing patients becomes challenging. In this work, we build a diagnosis assistant to assist doctors, which identifies diseases based on patient-doctor interaction. During diagnosis, doctors utilize both symptomatology knowledge and diagnostic experience to identify diseases accurately and efficiently. Inspired by this, we investigate the role of medical knowledge in disease diagnosis through doctor-patient interaction. We propose a two-channel, knowledge-infused, discourse-aware disease diagnosis model (KI-DDI), where the first channel encodes patient-doctor communication using a transformer-based encoder, while the other creates an embedding of symptom-disease using a graph attention network (GAT). In the next stage, the conversation and knowledge graph embeddings are infused together and fed to a deep neural network for disease identification. Furthermore, we first develop an empathetic conversational medical corpus comprising conversations between patients and doctors, annotated with intent and symptoms information. The proposed model demonstrates a significant improvement over the existing state-of-the-art models, establishing the crucial roles of (a) a doctor's effort for additional symptom extraction (in addition to patient self-report) and (b) infusing medical knowledge in identifying diseases effectively. Many times, patients also show their medical conditions, which acts as crucial evidence in diagnosis. Therefore, integrating visual sensory information would represent an effective avenue for enhancing the capabilities of diagnostic assistants.
Assuntos
Relações Médico-Paciente , Humanos , Telemedicina , Diagnóstico por Computador/métodos , Redes Neurais de Computação , ComunicaçãoRESUMO
PURPOSE: Existing task-oriented virtual agents can assist users with simple tasks like ticket booking, hotel reservations, etc. effectively and with high confidence. These virtual assistants, however, assume specific, predictable end-user behavior, such as predefined/servable objectives, which results in conversation failures in challenging situations, such as when goals are unavailable. METHODOLOGY: Inspired by the practice and its efficacy, we propose an end-to-end framework for task-oriented persuasive dialogue generation that combines pre-training and reinforcement learning for generating context-aware persuasive responses. We utilize four novel rewards to improve consistency and repetitiveness in generated responses. Additionally, a meta-learning strategy has also been utilized to make the model parameters better for domain adaptation. Furthermore, we also curate a personalized persuasive dialogue (PPD) corpus, which contains utterance-level intent, slot, sentiment, and persuasion strategy annotation. FINDINGS: The obtained results and detailed analysis firmly establish the effectiveness of the proposed persuasive virtual assistant over traditional task-oriented virtual assistants. The proposed framework considerably increases the quality of dialogue generation in terms of consistency and repetitiveness. Additionally, our experiment with a few shot and zero-shot settings proves that our meta-learned model learns to quickly adopt new domains with a few or even zero no. of training epochs. It outperforms the non-meta-learning-based approaches keeping the base model constant. ORIGINALITY: To the best of our knowledge, this is the first effort to improve a task-oriented virtual agent's persuasiveness and domain adaptation.
Assuntos
Aprendizagem , Comunicação Persuasiva , Reforço PsicológicoRESUMO
PURPOSE: Existing virtual agents (VAs) present in dialogue systems are either information retrieval based or static goal-driven. However, in real-world situations, end-users might not have a known and fixed goal beforehand for the task, i.e., they may upgrade/downgrade/update their goal components in real-time to maximize their utility values. Existing VAs are unable to handle such dynamic goal-oriented situations. METHODOLOGY: Due to the absence of any related dialogue dataset where such choice deviations are present, we have created a conversational dataset called Deviation adapted Virtual Agent(DevVA), with the manual annotation of its corresponding intents, slots, and sentiment labels. A Dynamic Goal Driven Dialogue Agent (DGDVA) has been developed by incorporating a Dynamic Goal Driven Module (GDM) on top of a deep reinforcement learning based dialogue manager. In the course of a conversation, the user sentiment provides grounded feedback about agent behavior, including goal serving action. User sentiment appears to be an appropriate indicator for goal discrepancy that guides the agent to complete the user's desired task with gratification. The negative sentiment expressed by the user about an aspect of the provided choice is treated as a discrepancy that is being resolved by the GDM depending upon the observed discrepancy and current dialogue state. The goal update capability and the VA's interactiveness trait enable end-users to accomplish their desired task satisfactorily. FINDINGS: The obtained experimental results illustrate that DGDVA can handle dynamic goals with maximum user satisfaction and a significantly higher success rate. The interaction drives the user to decide its final goal through the latent specification of possible choices and information retrieved and provided by the dialogue agent. Through the experimental results (qualitative and quantitative), we firmly conclude that the proposed sentiment-aware VA adapts users' dynamic behavior for its goal setting with substantial efficacy in terms of primary objective i.e., task success rate (0.88). PRACTICAL IMPLICATIONS: In real world, it can be argued that many people do not have a predefined and fixed goal for tasks such as online shopping, movie booking & restaurant booking, etc. They tend to explore the available options first which are aligned with their minimum requirements and then decide one amongst them. The DGDVA provides maximum user satisfaction as it enables them to accomplish a dynamic goal that leads to additional utilities along with the essential ones. ORIGINALITY: To the best of our knowledge, this is the first effort towards the development of A Dynamic Goal Adapted Task-Oriented Dialogue Agent that can serve user goals dynamically until the user is satisfied.