Learning the Treatment Process in Radiotherapy Using an Artificial Intelligence–Assisted Chatbot: Development Study
Authors: Rebelo Nathanael , Sanders Leslie , Li Kay , Chow James C L 
Published: October 2022

Background
In knowledge transfer for educational purposes, most cancer hospital or center websites have existing information on cancer health. However, such information is usually a list of topics that are neither interactive nor customized to offer any personal touches to people facing dire health crisis and to attempt to understand the concerns of the users. Patients with cancer, their families, and the general public accessing the information are often in challenging, stressful situations, wanting to access accurate information as efficiently as possible. In addition, there is seldom any comprehensive information specifically on radiotherapy, despite the large number of older patients with cancer, to go through the treatment process. Therefore, having someone with professional knowledge who can listen to them and provide the medical information with good will and encouragement would help patients and families struggling with critical illness, particularly during the lingering pandemic.

Objective
This study created a novel virtual assistant, a chatbot that can explain the radiation treatment process to stakeholders comprehensively and accurately, in the absence of any similar software. This chatbot was created using the IBM Watson Assistant with artificial intelligence and machine learning features. The chatbot or bot was incorporated into a resource that can be easily accessed by the general public.

Methods
The radiation treatment process in a cancer hospital or center was described by the radiotherapy process: patient diagnosis, consultation, and prescription; patient positioning, immobilization, and simulation; 3D-imaging for treatment planning; target and organ contouring; radiation treatment planning; patient setup and plan verification; and treatment delivery. The bot was created using IBM Watson (IBM Corp) assistant. The natural language processing feature in the Watson platform allowed the bot to flow through a given conversation structure and recognize how the user responds based on recognition of similar given examples, referred to as intents during development. Therefore, the bot can be trained using the responses received, by recognizing similar responses from the user and analyzing using Watson natural language processing.

Results
The bot is hosted on a website by the Watson application programming interface. It is capable of guiding the user through the conversation structure and can respond to simple questions and provide resources for requests for information that was not directly programmed into the bot. The bot was tested by potential users, and the overall averages of the identified metrics are excellent. The bot can also acquire users’ feedback for further improvements in the routine update.

Conclusions
An artificial intelligence–assisted chatbot was created for knowledge transfer regarding radiation treatment process to the patients with cancer, their families, and the general public. The bot that is supported by machine learning was tested, and it was found that the bot can provide information about radiotherapy effectively.