Natural Language Processing–Based Virtual Cofacilitator for Online Cancer Support Groups: Protocol for an Algorithm Development and Validation Study
Authors: Leung Yvonne W , Wouterloot Elise , Adikari Achini , Hirst Graeme , de Silva Daswin , Wong Jiahui , Bender Jacqueline L , Gancarz Mathew , Gratzer David , Alahakoon Damminda , Esplen Mary Jane 
Published: January 2021

BackgroundCancer and its treatment can significantly impact the short- and long-term psychological well-being of patients and families. Emotional distress and depressive symptomatology are often associated with poor treatment adherence, reduced quality of life, and higher mortality. Cancer support groups, especially those led by health care professionals, provide a safe place for participants to discuss fear, normalize stress reactions, share solidarity, and learn about effective strategies to build resilience and enhance coping. However, in-person support groups may not always be accessible to individuals; geographic distance is one of the barriers for access, and compromised physical condition (eg, fatigue, pain) is another. Emerging evidence supports the effectiveness of online support groups in reducing access barriers. Text-based and professional-led online support groups have been offered by Cancer Chat Canada. Participants join the group discussion using text in real time. However, therapist leaders report some challenges leading text-based online support groups in the absence of visual cues, particularly in tracking participant distress. With multiple participants typing at the same time, the nuances of the text messages or red flags for distress can sometimes be missed. Recent advances in artificial intelligence such as deep learning–based natural language processing offer potential solutions. This technology can be used to analyze online support group text data to track participants’ expressed emotional distress, including fear, sadness, and hopelessness. Artificial intelligence allows session activities to be monitored in real time and alerts the therapist to participant disengagement.ObjectiveWe aim to develop and evaluate an artificial intelligence–based cofacilitator prototype to track and monitor online support group participants’ distress through real-time analysis of text-based messages posted during synchronous sessions.MethodsAn artificial intelligence–based cofacilitator will be developed to identify participants who are at-risk for increased emotional distress and track participant engagement and in-session group cohesion levels, providing real-time alerts for therapist to follow-up; generate postsession participant profiles that contain discussion content keywords and emotion profiles for each session; and automatically suggest tailored resources to participants according to their needs. The study is designed to be conducted in 4 phases consisting of (1) development based on a subset of data and an existing natural language processing framework, (2) performance evaluation using human scoring, (3) beta testing, and (4) user experience evaluation.ResultsThis study received ethics approval in August 2019. Phase 1, development of an artificial intelligence–based cofacilitator, was completed in January 2020. As of December 2020, phase 2 is underway. The study is expected to be completed by September 2021.ConclusionsAn artificial intelligence–based cofacilitator offers a promising new mode of delivery of person-centered online support groups tailored to individual needs.International Registered Report Identifier (IRRID)DERR1-10.2196/21453