智能问答系统在老年患者健康教育中的应用研究

Older adults commonly experience chronic conditions such as pain and sleep disturbances and may consider cannabidiol for symptom management. Safe use requires appropriate dosing, careful titration, and awareness of drug interactions, yet stigma and limited health literacy often limit understanding. Conversational artificial intelligence systems based on large language models and retrieval-augmented generation may support cannabidiol education, but their safety and reliability remain insufficiently evaluated. This study developed a retrieval-augmented large language model framework that combines structured prompt engineering with curated cannabidiol evidence to generate context-aware guidance for older adults, including those with cognitive impairment. We also proposed an automated, annotation-free evaluation framework to benchmark leading standalone and retrieval-augmented models in the absence of standardized benchmarks. Sixty-four diverse user scenarios were generated by varying symptoms, preferences, cognitive status, demographics, comorbidities, medications, cannabis history, and caregiver support. Multiple state-of-the-art models were evaluated, including a novel ensemble retrieval architecture that integrates multiple retrieval systems. Across three automated evaluation strategies, retrieval-augmented models consistently produced more cautious and guideline-aligned recommendations than standalone models, with the ensemble approach performing best. These findings demonstrate that structured retrieval improves the reliability and safety of AI-driven cannabidiol education and provide a reproducible framework for evaluating AI tools used in sensitive health contexts.

While Artificial Intelligence (AI) shows promise in healthcare applications, existing conversational systems often falter in complex and sensitive medical domains such as Sexual and Reproductive Health (SRH). These systems frequently struggle with hallucination and lack the specialized knowledge required, particularly for sensitive SRH topics. Furthermore, current AI approaches in healthcare tend to prioritize diagnostic capabilities over comprehensive patient care and education. Addressing these gaps, this work at the UNC School of Nursing introduces SARHAchat, a proof-of-concept Large Language Model (LLM)-based chatbot. SARHAchat is designed as a reliable, user-centered system integrating medical expertise with empathetic communication to enhance SRH care delivery. Our evaluation demonstrates SARHAchat's ability to provide accurate and contextually appropriate contraceptive counseling while maintaining a natural conversational flow. The demo is available at https://sarhachat.com/}{https://sarhachat.com/.

Asthma-related deaths in the UK are the highest in Europe, and only 30% of patients access basic care. There is a need for alternative approaches to reaching people with asthma in order to provide health education, self-management support and bridges to care. Automated conversational agents (specifically, mobile chatbots) present opportunities for providing alternative and individually tailored access to health education, self-management support and risk self-assessment. But would patients engage with a chatbot, and what factors influence engagement? We present results from a patient survey (N=1257) devised by a team of asthma clinicians, patients, and technology developers, conducted to identify optimal factors for efficacy, value and engagement for a chatbot. Results indicate that most adults with asthma (53%) are interested in using a chatbot and the patients most likely to do so are those who believe their asthma is more serious and who are less confident about self-management. Results also indicate enthusiasm for 24/7 access, personalisation, and for WhatsApp as the preferred access method (compared to app, voice assistant, SMS or website). Obstacles to uptake include security/privacy concerns and skepticism of technological capabilities. We present detailed findings and consolidate these into 7 recommendations for developers for optimising efficacy of chatbot-based health support.