Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 1, 2020
Date Accepted: Jul 2, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
“Alexa, does the HPV vaccine cause autism?”: Evaluating smart assistant responses for accuracy and misinformation
ABSTRACT
Background:
Almost half (46%) of Americans have used a smart assistant (SA) of some kind (e.g., Apple’s Siri) and 25% have used a stand-alone SA (e.g., Amazon Echo). This positions SAs as potentially useful modalities for retrieving health-related information; however, the accuracy of SA responses lacks rigorous evaluation.
Objective:
We evaluated the levels of accuracy, misinformation, and sentiment provided by SAs in response to human papillomavirus (HPV) vaccination-related questions.
Methods:
We systematically examined responses to questions about the HPV vaccine from the 4 most popular SAs: Apple’s Siri, Google’s Assistant, Amazon’s Alexa, and Microsoft’s Cortana. One team member posed 10 questions to each SA and recorded all queries and responses. Two raters independently coded all responses (kappa=0.85). We then assessed differences between the 4 SAs on measures of response accuracy, presence of misinformation, and sentiment regarding the HPV vaccine.
Results:
A total of 103 responses resulted from the 10 questions posed across the 4 SAs. Over half (62%) of SA responses were accurate. We found statistical differences across the SAs, χ2 (2, N = 103) = 7.807, p < .05, with Cortana yielding the greatest proportion of misinformation. Siri returned the greatest proportion of accurate responses (72%), whereas Cortana yielded the lowest proportion of accurate responses (54%). Most response sentiments across SAs were positive (63%) or neutral (18%), but Cortana’s responses yielded the largest proportion of negative sentiments (12%).
Conclusions:
SAs appear to be average-quality sources, regarding HPV vaccination information, with Alexa responding most reliably. Cortana returned the largest proportion of inaccurate responses, most misinformation, and the greatest proportion of results with negative sentiments. More collaboration between tech companies and public health entities is necessary to improve the retrieval of accurate health information via SAs.
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