Good communication is critical to good healthcare. Clinical dialogue is a conversation between health practitioners and their patients, with the explicit goal of obtaining and sharing medical information. This information contributes to medical decision-making regarding the patient and plays a crucial role in their healthcare journey. The reliance on note taking and manual scribing processes are extremely inefficient and leads to manual transcription errors when digitizing notes. Automatic Speech Recognition (ASR) plays a significant role in speech-to-text applications, and can be directly used as a text generator in conversational applications. However, recording clinical dialogue presents a number of general and domain-specific challenges. In this paper, we present a seq2seq learning approach for ASR transcription error correction of clinical dialogues. We introduce a new Gastrointestinal Clinical Dialogue (GCD) Dataset which was gathered by healthcare professionals from a NHS Inflammatory Bowel Disease clinic and use this in a comparative study with four commercial ASR systems. Using self-supervision strategies, we fine-tune a seq2seq model on a mask-filling task using a domain-specific PubMed dataset which we have shared publicly for future research. The BART model fine-tuned for mask-filling was able to correct transcription errors and achieve lower word error rates for three out of four commercial ASR outputs.
Counterfactual explanations focus on "actionable knowledge" to help end-users understand how a machine learning outcome could be changed to a more desirable outcome. For this purpose a counterfactual explainer needs to discover input dependencies that relate to outcome changes. Identifying the minimum subset of feature changes needed to action an output change in the decision is an interesting challenge for counterfactual explainers. The DisCERN algorithm introduced in this paper is a case-based counter-factual explainer. Here counterfactuals are formed by replacing feature values from a nearest unlike neighbour (NUN) until an actionable change is observed. We show how widely adopted feature relevance-based explainers (i.e. LIME, SHAP), can inform DisCERN to identify the minimum subset of "actionable features". We demonstrate our DisCERN algorithm on five datasets in a comparative study with the widely used optimisation-based counterfactual approach DiCE. Our results demonstrate that DisCERN is an effective strategy to minimise actionable changes necessary to create good counterfactual explanations.
Delivery of digital behaviour change interventions which encourage physical activity has been tried in many forms. Most often interventions are delivered as text notifications, but these do not promote interaction. Advances in conversational AI have improved natural language understanding and generation, allowing AI chatbots to provide an engaging experience with the user. For this reason, chatbots have recently been seen in healthcare delivering digital interventions through free text or choice selection. In this work, we explore the use of voice-based AI chatbots as a novel mode of intervention delivery, specifically targeting older adults to encourage physical activity. We co-created "FitChat", an AI chatbot, with older adults and we evaluate the first prototype using Think Aloud Sessions. Our thematic evaluation suggests that older adults prefer voice-based chat over text notifications or free text entry and that voice is a powerful mode for encouraging motivation.