Evidence map›Paper›PMID 37115595›Full record

SynthesisJournal of medical Internet research2023

Conversational Agent Interventions for Mental Health Problems: Systematic Review and Meta-analysis of Randomized Controlled Trials.

Yuhao He, Li Yang, Chunlian Qian, Tong Li, Zhengyuan Su, Qiang Zhang, Xiangqing Hou

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of medical Internet research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 12 syntheses or guidelines pooled it.

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20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Yuhao HeInstitute of Applied Psychology, College of Education, Tianjin University, Tianjin, China.ORCID 0000-0003-3969-7530
Li YangInstitute of Applied Psychology, College of Education, Tianjin University, Tianjin, China.ORCID 0000-0002-7947-0392
Chunlian QianInstitute of Applied Psychology, College of Education, Tianjin University, Tianjin, China.ORCID 0000-0001-7389-092X
Tong LiInstitute of Applied Psychology, College of Education, Tianjin University, Tianjin, China.ORCID 0009-0002-3789-6827
Zhengyuan SuInstitute of Applied Psychology, College of Education, Tianjin University, Tianjin, China.ORCID 0009-0001-3664-0953
Qiang ZhangShenzhen School, Sun Yat-sen University, Shenzhen, China.ORCID 0009-0009-3167-4052
Xiangqing HouInstitute of Applied Psychology, College of Education, Tianjin University, Tianjin, China.ORCID 0000-0002-7142-3583

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMental health problems are a crucial global public health concern. Owing to their cost-effectiveness and accessibility, conversational agent interventions (CAIs) are promising in the field of mental health care.

objectiveThis study aims to present a thorough summary of the traits of CAIs available for a range of mental health problems, find evidence of efficacy, and analyze the statistically significant moderators of efficacy via a meta-analysis of randomized controlled trial.

methodsWeb-based databases (Embase, MEDLINE, PsycINFO, CINAHL, Web of Science, and Cochrane) were systematically searched dated from the establishment of the database to October 30, 2021, and updated to May 1, 2022. Randomized controlled trials comparing CAIs with any other type of control condition in improving depressive symptoms, generalized anxiety symptoms, specific anxiety symptoms, quality of life or well-being, general distress, stress, mental disorder symptoms, psychosomatic disease symptoms, and positive and negative affect were considered eligible. This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Data were extracted by 2 independent reviewers, checked by a third reviewer, and pooled using both random effect models and fixed effects models. Hedges g was chosen as the effect size.

resultsOf the 6900 identified records, a total of 32 studies were included, involving 6089 participants. CAIs showed statistically significant short-term effects compared with control conditions in improving depressive symptoms (g=0.29, 95% CI 0.20-0.38), generalized anxiety symptoms (g=0.29, 95% CI 0.21-0.36), specific anxiety symptoms (g=0.47, 95% CI 0.07-0.86), quality of life or well-being (g=0.27, 95% CI 0.16-0.39), general distress (g=0.33, 95% CI 0.20-0.45), stress (g=0.24, 95% CI 0.08-0.41), mental disorder symptoms (g=0.36, 95% CI 0.17-0.54), psychosomatic disease symptoms (g=0.62, 95% CI 0.14-1.11), and negative affect (g=0.28, 95% CI 0.05-0.51). However, the long-term effects of CAIs for the most mental health outcomes were not statistically significant (g=-0.04 to 0.39). Personalization and empathic response were 2 critical facilitators of efficacy. The longer duration of interaction with conversational agents was associated with the larger pooled effect sizes.

conclusionsThe findings show that CAIs are research-proven interventions that ought to be implemented more widely in mental health care. CAIs are effective and easily acceptable for those with mental health problems. The clinical application of this novel digital technology will conserve human health resources and optimize the allocation of mental health services.

trial registrationPROSPERO CRD42022350130; https://tinyurl.com/mvhk6w9p.

Indexed as

Mental HealthQuality of LifeAnxietyHumansRandomized Controlled Trials as Topicanxietychatbot and conversational agentdepressiondigital medicinemental healthmeta-analysismeta-regressionmHealthmobile healthmobile phonequality of lifestress

Identifiers

PMID37115595
PMCPMC10182468

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.