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Accepted for/Published in: JMIR AI

Date Submitted: Nov 19, 2024
Date Accepted: Aug 8, 2025

The final, peer-reviewed published version of this preprint can be found here:

Standardizing and Scaffolding Health Care AI-Chatbot Evaluation: Systematic Review

Hua Y, Xia W, Bates D, Hartstein GL, Kim HT, Li M, Nelson BW, Stromeyer C IV, King D, Suh J, Zhou L, Torous J

Standardizing and Scaffolding Health Care AI-Chatbot Evaluation: Systematic Review

JMIR AI 2025;4:e69006

DOI: 10.2196/69006

PMID: 41202290

PMCID: 12639340

Warning: This is an author submission that is not peer-reviewed or edited.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.

Standardizing and Scaffolding Healthcare AI-Chatbot Evaluation

  • Yining Hua; 
  • Winna Xia; 
  • David Bates; 
  • George Luke Hartstein; 
  • Hyungjin Tom Kim; 
  • Michael Li; 
  • Benjamin W. Nelson; 
  • Charles Stromeyer IV; 
  • Darlene King; 
  • Jina Suh; 
  • Li Zhou; 
  • John Torous

ABSTRACT

Background:

The rapid rise of healthcare chatbots, valued at $787.1 million in 2022 and projected to grow at 23.9% annually through 2030, underscores the need for robust evaluation frameworks. Despite their potential, the absence of standardized evaluation criteria and rapid AI advancements complicate assessments.

Objective:

This study addresses these challenges by developing the first comprehensive evaluation framework inspired by health app regulations and integrating insights from diverse stakeholders.

Methods:

Following PRISMA guidelines, we reviewed 11 existing frameworks, refining 271 questions into a structured framework encompassing three priority constructs, 18 second-level constructs, and 60 third-level constructs.

Results:

Our framework emphasizes safety, privacy, trustworthiness, and usefulness, aligning with recent concerns about AI in healthcare.

Conclusions:

This adaptable framework aims to serve as the initial step in facilitating the responsible integration of chatbots into healthcare settings. Clinical Trial: NA


 Citation

Please cite as:

Hua Y, Xia W, Bates D, Hartstein GL, Kim HT, Li M, Nelson BW, Stromeyer C IV, King D, Suh J, Zhou L, Torous J

Standardizing and Scaffolding Health Care AI-Chatbot Evaluation: Systematic Review

JMIR AI 2025;4:e69006

DOI: 10.2196/69006

PMID: 41202290

PMCID: 12639340

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