Chatbot to Maximize Hereditary Cancer Genetic Risk Assessment

Weill Cornell Medicine (WCM)

Status: Enrolling

Conditions: Hereditary Cancer Syndrome; Gynecologic Cancer

Treatments: Other: Chatbot

Study type: Interventional

Funder types: Other

Identifiers

NCT05562778

21-11024123

Details and patient eligibility

About

In this study, the investigators aim to compare a mobile health platform, known as a 'chatbot,' that leverages artificial intelligence and natural language processing to scale communication, to 'usual care' that patients would receive. This comparison will enable the investigators to determine if the chatbot system can improve rates of recommendation for genetic testing among patients at elevated risk of harboring a familial cancer syndrome in an all-Medicaid gynecology clinic. Furthermore, the investigators aim to evaluate facilitators of inequity in regard to patient access to and utilization of genetic testing services.

Enrollment: 150 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• 8 years of age or older.
• Scheduled for a New Patient appointment in the gynecology clinic. Speaks and reads in English.
• Access to a telephone with texting capacity.
• Has not had prior genetic testing for hereditary cancer syndromes.

Exclusion criteria

• Under 18 years of age
• Has had previous genetic testing for hereditary cancer syndromes
• Does not read/speak in English
• Does not have access to a phone with texting capabilities

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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150 participants in 2 patient groups

Chatbot

Experimental group

Description:

Subjects will receive a text message initiating a chatbot conversation that relies on natural language processing to gather personal and family cancer. Subjects are identified by the chatbot as meeting National Comprehensive Cancer Network (NCCN) high-risk criteria. Next, subjects undergo pre-test genetic counseling via the chatbot and then clinicians are notified (via the chatbot portal) that the subject meets high-risk criteria. For subjects meeting high-risk criteria (based on the chatbot evaluation), the clinician will complete genetic counseling and recommend genetic testing during the visit. For subjects interested in genetic testing, the clinician will order genetic testing.

Treatment:

Other: Chatbot

Usual Care

No Intervention group

Description:

Personal and family cancer history will be collected by the clinician during the subject's visit. Clinicians will evaluate the patient's personal/family history according to National Comprehensive Cancer Network (NCCN) high-risk criteria. For subjects recognized by the clinician as meeting NCCN criteria, the clinician will complete genetic counseling and recommend genetic testing. For subjects interested in genetic testing, the clinician will order genetic testing.