AI Chatbots Versus Human Healthcare Professionals: A Systematic Review and Meta-Analysis of Empathy in Patient Care
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Background
Empathy is widely recognised for improving patient outcomes ranging from reduced pain and anxiety to improved patient satisfaction, and its absence can cause harm. Meanwhile, use of artificial intelligence (AI)–based chatbots in healthcare is rapidly expanding, with one in five general practitioners (GPs) using generative AI to assist with tasks such as writing letters. Several studies suggest that these AI-based technologies are sometimes more empathic than human healthcare professionals (HCPs). However, the evidence in this area is mixed and has not been synthesised.
Objective
To conduct a systematic review of studies that compare empathy of AI technologies with human HCP empathy.
Methods
We searched multiple databases for studies comparing AI chatbots using large language models (e.g., GPT-3.5, GPT-4) with human HCPs on empathy measures. We assessed risk of bias with ROBINS-I and synthesised findings using random-effects meta-analysis where feasible, whilst avoiding double counting.
Results
Our search identified 15 studies (2023–2024). Thirteen studies reported statistically significantly higher empathy ratings for AI, with only two studies situated in dermatology favouring human responses. Meta-analysis of 13 studies with data suitable for pooling, all utilising ChatGPT-3.5/4, showed a standardised mean difference (SMD) of 0.87 (95% CI, 0.54–1.20) favouring AI (p<0.00001).
Conclusion
Our findings indicate that, in text-only scenarios, AI chatbots are frequently perceived as more empathic than human HCPs – equivalent to an increase of approximately two points on a 10-point empathy scale. Future research should validate these findings with direct patient evaluations and assess whether emerging voice-enabled AI systems can deliver similar empathic advantages.
