Using Natural Language Processing to Explore Patient Perspectives on AI Avatars in Support Materials for Patients With Breast Cancer: Survey Study

Background: Having well-informed patients iscrucial to enhancing patientsatisfaction, quality of life, and health outcomes, which in turn optimizes health care use. Traditional methods of delivering information, such as booklets and leaflets, are often ineffective and can overwhelm patients. Educational videos represent a promising alternative; however, their production typically requires significant time and financial resources. Videoproduction using generative artificial intelligence (AI) technology may provide a solution to this problem. Objective: This study aimed to use natural language processing (NLP) to understand free-text patient feedback on 1 of 7 AI-generated patient educational videos created in collaboration with Roche UK and the Hull University Teaching Hospitals NHS Trust breast cancer team, titled "Breast Cancer Follow Up Programme." Methods: A survey was sent to 400 patients who had completed the breast cancer treatment pathway, and 98 (24.5%) free-text responses were received for the question "Any comments or suggestions to improve its [the video's] contents?" We applied and evaluated different NLP machine learning techniques to draw insights from these unstructured data, namely sentiment analysis, topic modeling, summarization, and term frequency-inverse document frequency word clouds. Results: Sentiment analysis showed that 81% (79/98) of the responses were positive or neutral, while negative comments were predominantly related to the AI avatar. Topic modeling using BERTopic with k-means clustering was found to be the most effective model and identified 4 key topics: the breast cancer treatment pathway, video content, the digital avatar or narrator, and short responses with little or no content. Theterm frequency-inverse document frequency word clouds indicated positive sentiment about thetreatment pathway (eg, "reassured" and "faultless") and video content (eg, "informative" and "clear"), whereas the AI avatar was often described negatively (eg, "impersonal"). Summarization using the text-to-text transfer transformer model effectively created summaries of the responses by topic. Conclusions:This study demonstratesthe success of NLP techniques in efficiently generating insights into patient feedback related to generative AI educational content. Combining NLP methods resulted in clear visuals and insights, enhancing the understanding of patient feedback. Analysis of free-text responses provided clinicians at Hull University Teaching Hospitals NHS Trust with deeper insights than those obtained from quantitative Likert scale responses alone. Importantly, the results validate the use of generative AI in creating patient educational videos, highlighting its potential to address the challenges of costly video production and the limitations of traditional, often overwhelming educational leaflets. Despite the positive overall feedback, negative comments focused on the technical aspects of theAI avatar, indicating areas for improvement. We advocate that patients who receive AI avatar explanations are counseled that this technology is intended to supplement, not replace, human health care interactions. Future investigations are needed to confirm the ongoing effectiveness of these educational tools.