Study of a Chatbot to Improve Genetic Risk Assessment for Hereditary Cancer in Gynecology Patients

What this Trial Is About

Researchers are evaluating a mobile health platform called a chatbot that uses artificial intelligence and natural language processing to communicate with patients at an all-Medicaid gynecology clinic. The study aims to compare this chatbot system to usual care to see if it improves recommendations for genetic testing among patients at high risk for familial cancer syndromes. The study also seeks to understand factors that affect patient access to and use of genetic testing services, focusing on inequities. Participants will be assigned to one of two groups. In the chatbot group, patients receive a text message to start a chatbot conversation that collects personal and family cancer history and identifies high-risk patients based on National Comprehensive Cancer Network criteria. The chatbot provides pre-test genetic counseling and notifies clinicians about high-risk patients, who then complete counseling and recommend genetic testing if appropriate. In the usual care group, clinicians collect personal and family cancer history during visits and evaluate risk according to guidelines before counseling and recommending testing. Genetic testing is ordered for interested patients meeting criteria. Participants will be monitored over two years to measure outcomes such as the proportion of patients recommended for genetic testing and the proportion completing testing. The study also assesses patient satisfaction, distress levels, decision satisfaction, facilitators and barriers to genetic testing, and other scales related to inequity in utilization of genetic services. These evaluations include questionnaires and surveys to understand patient experiences and access to care during the study period.

Chatbot to Maximize Hereditary Cancer Genetic Risk Assessment