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The ENGAGE study: evaluation of a conversational virtual agent that provides tailored pre-test genetic education to cancer patients

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Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

Novel approaches are needed to ensure all patients with cancer have access to quality genetic education before genetic testing to enable informed treatment decisions. The purpose of this study was to test the use of an artificial intelligence (AI) intervention for the delivery of genetic education by non-genetic providers to patients with cancer undergoing active treatment.

Methods

A conversational AI-based application was developed on the HealthFAX platform to provide tailored genetic education to patients with cancer and tested at Johns Hopkins Hospital between April 2021 and Feb 2022. Patients’ responses around the adoption, use, and experience of the AI application were assessed.

Results

Out of 64 individuals who consented to the study, 51 accessed the tool. The responding participants had a mean age of 61 years (ranging from 30–90 years) with 39 individuals undergoing active treatment for breast cancer and 12 for advanced prostate cancer. All patients chose to complete the tool at home. The median time between study enrollment and AI application initiation was 1 day, and the median time to complete the application was 24 min. All participants in their survey responses felt that the tool was secure, easy to use, liked the convenience of viewing it at home, and felt it provided valuable information. Eighteen percent of participants viewed the application with a family member. Ninety-eight percent of the participants completed their genetic education prior to receiving their test results. In 16%, a pathogenic variant was identified.

Conclusions

The 51 patients who adopted the AI application were highly satisfied with its usability and convenience. Our results support the continued evaluation of this cost-effective AI application in a large-scale study.

Implications for Cancer Survivors

Tailored pre-test genetic education can be successfully delivered to patients with cancer undergoing active treatment via an AI application at their convenience.

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Data availability

The data generated and analyzed during the study are available from the corresponding author upon reasonable request.

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Funding

The clinical study was supported by funding from Maryland Cigarrette Restitution Fund and the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center Support Grant (P30CA006973).

Author information

Authors and Affiliations

  1. Johns Hopkins School of Medicine and Bloomberg School of Public Health, #E6142 615 N. Wolfe Street, Baltimore, MD, 21231, USA

    Kala Visvanathan

  2. Johns Hopkins School of Medicine, Baltimore, MD, USA

    Dana Petry, Catherine A. Klein, Angelisa Johnson, Melissa Camp, Channing J. Paller, Rima Couzi, Mary Wilkinson, Lisa Jacobs, Julie Lange, Danijela Jelovac, Michael A. Carducci & Mehran Habibi

  3. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Michelle S. McCullough, Betty May & Gisselle Killian

  4. Goodwin College of Business, Benedictine University, Lisle, IL, USA

    Ramkrishnan Tenkasi

  5. Optra Health, San Jose, CA, USA

    Nitin Sharma, Gauri Naik & Ashwin Kotwaliwale

Authors
  1. Kala Visvanathan
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  2. Dana Petry
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  15. Julie Lange
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Contributions

Development of tool: K.V., D.P., B.M., N.S., G.N., and A.K. Conception and design of clinical study: K.V., B.M., M.M., and R.T. Financial support for the clinical study: K.V. Provision of study materials or patients: K.V., M.M., B.M., C.A.K., A.J., G.K., M.C., C.J.P., R.C., M.W., L.J., J.L., D.J., M.A.C., and M.H. Collection and assembly of the data: K.V., M.M., and B.M. Data analysis and interpretation: K.V., D.P., M.M., G.K., R.T. Manuscript writing: K.V. Final approval of manuscript: all authors read and approved the final manuscript.

Corresponding author

Correspondence to Kala Visvanathan.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval

This study was approved by the Institutional Review Board of Johns Hopkins University Bloomberg School of Public Health.

Consent to participate

Informed consent was obtained from all participants included in the study.

Consent for publication

This manuscript does not include individual participants’ data.

Conflict of interest

The authors declare no competing interests.

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Visvanathan, K., Petry, D., McCullough, M.S. et al. The ENGAGE study: evaluation of a conversational virtual agent that provides tailored pre-test genetic education to cancer patients. J Cancer Surviv (2023). https://doi.org/10.1007/s11764-023-01495-x

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