Final Report

KOM2002

http://web4health.info/KOM2002/

30 August 2004

1. Table of Content

2. Project Description

2.1 Services Developed

2.2 Our Goals

2.3 Praise for our web site

3. Summary of Activities

3.1 User Requirements

3.2 Innovative Features

3.3 Reliable Content

3.4 Market Prospects

4. Dissemination and Awareness

5. Future Work and Exploitation Prospects

6. Further Information

2. Project Description

2.1 Services Developed

This project has developed a web site with medical information in the psychology/psychiatry area. The web site is available in multiple languages (German, Greek, English, Italian and Swedish). The web site provides the following services:

1. A collection of 800 answers (FAQs) to common questions on psychology, psychiatry, relations and healthy living.
2. Access to this collection through a taxonomy (hierarchical subject tree).
3. Access to this collection through a natural-language question-answering system.
4. An ask-the-expert service, where users can send individual, personal questions to medical experts.
5. A forum service, where users can discuss health issues with each other.

Figure 1: View when translating an FAQ from English to German (reduced size)

A content-management tool has been used which gives good support for multi-linguality. It is easy to see the same content in different languages, and to see two language versions, one to the left and one to the right, when translating content from one language to another. The content-managment system also has built-in facilities for chats and forums. A forum is automatically associated with each FAQ, where medical experts can discuss this FAQ.

The web site can be found at the web address: http://web4health.info/.

The web site was opened to the public in July 2003. During the first year (July 2003 to June 2004) the web site achieved more than 2 million hits and its number of visitors increase from about 40 000 visitors/month in September 2003 to about 80 000 visitors/month in July 2004.

Figure 2: Number of visitors at the Web4Health web site June 2003 to July 2004.

2.2 Project Goals

• Promote information about mental health and psychology in Europe.
• Fight against stigmatisation of mentally ill European citizens.
• Motivate people to seek professional help if our information is not enough to solve their problems.
• Give advice to promote healthy living and mental well being for patients and relatives.
• Demonstrate different psychological and medical treatment options.
• Evaluate the demand of information and the use of the Internet for Public Health topics (analysis of log files and "Ask-the-expert" questions).

2.3 Praise for our website

Our web site has received much praise. Examples:

• Alexa:
• B2BMine: Good ad useful help and advice.
• CureZone: Best Websites.
• Editor & Publisher: Forget the Pop Psychology. Get the Real Stuff at Web4Health. People who do know what they're talking about.
• The Kim Komando Site: Cool site of the day, 26 September 2003.
• Med411: Content of interest to healthcare professionals, tone and presentation maintained at a professional level, site structure, navgiation and graphic design executed at a professional level, a high level of integrity and credibilty.

3. Summary of activities

3.1 User requirements

Our web site aims at non-specialists, ordinary people who need help and information in the area of psychology/psychiatry. The texts should be easy to understand for a layman. It should be possible for a visitor to the web site to feel how the information relates to their own problems.

Our studies show that some visitors get to pages in our web site through Google and other search engines, other visitors prefer to click on links, sometimes never going back, just clicking onwards, other visitors use our natural-language question-answering system and the ask-the-expert service. Because of this, users should be able to find information using different methods, and we have specially worked at making the web site good for access using each user behaviour style. For example, to accommodate those users who just click on links, we have implemented a button below each FAQ with the text "Find a few related answers".

Figure 3: Bottom of an FAQ with "Find a few related answers" button.

Our studies also show that visitors more often will be able to use the information given in our FAQs, if they can feel "empathy", can understand and step into the shoes of a person, whose problem is described in the FAQ. Thus, simple factual FAQs will not have as much positive influence on user behaviour, as FAQs where the user can feel empathy with the problem described.

3.2 Innovative Features

1. A content management system with good support for managing the same information in multiple languages and for translation to multiple languages.
2. A natural-language question-answering system based on templates (mini-ontologies).
3. Cross-lingual facilities, so that classification for the natural-language question-answering in English will support searches also in other languages. This reduces the work of classifying the content very much, and means that the results of step-wise refinement in one language can be made available to the natural-language question-answering system in other languages.
4. A forum system which allows forum messages to be available in multiple languages.
5. An ask-the-expert area, based on the forum system, in which questions and answers can be translated to multiple languages, each user chooses which language version to see, but can also find other language versions if desired.

3.3 Reliable Content

• Every answer in Web4Health is written by a medical expert.
• The English translation of each answer is peer reviewed by another medical expert in another country.
• Translations to other languages are either written by or peer-reviewed by a medical expert in the target language.Source is specified where available, but sometimes the source is only specified as the clinical experience of the medical expert who wrote the answer.
• An e-mail address for comments and criticism is specified on each answers page, and letters to this addressed are reviewed by the project medical experts.
• Privacy policy and rules for users is described on a page linked from the home page.
• Encryption is used for secure registration and of users.

3.4 Market prospects

Cost Effectiveness of On-Line Health Information

The total cost of developing and running Web4Health, including both the EU funding and the funding by partners, will until 30 June 2005 be about 1.6 million Euro. A reasonable prognosis is that the site will by that time have had about 1.6 million visitors, so that the cost per visitor is about one Euro. (This does not include the planned extension of Web4Health to new languages, since we do not yet have funding for this.) According to several questionnaires, most visitors of Web4Health finds the site useful and many of them very useful. We do not know to what extent a visit to Web4Health will replace a visit to a doctor or psychotherapist. But since a visit to a specialist costs 50-100 Euro, even if only 25 % of all Web4Health visits replace a visitor to a doctor or psychotherapist, the saving will be 10-20 million Euro/year. The total cost, mostly in loss of productive work, for mental health in the EU is around 70 000 000 000 Euro/year. In some cases, Web4Health can even be better than a doctor or a psychotherapist, since we have such a complete collection of answers.

Within Web4Health, there is a function where visitors can send their question to a human specialist for answering. About 0,4 % of all our visitors use this function. The cost of answering such a question is in the same range as a visit to a doctor or psychotherapist. But since 99.6 % of our visitors are satisfied without asking such a question, the average cost per visitor is much less than that of giving an individually personalized answer to a each visistor.

Market: Medical information

There is so much good free medical information available on the Internet, that we do not believe we can charge for our information. We have at present 80 000 visitors per month at the Web4Health web site. If we started charging for information, the number of visitors would go down to perhaps one or two percent of what we have today. At present, the total cost for developing Web4Health, divided by the number of visitors, gives a cost of about one Euro per visitor. If we started charging, because the number of visitors would go down so steeply, the cost per visitors would increase to several hundred Euro. We do not believe that this is in the interest of European health. We therefore will continue to run the site without charges, in a very low-budget operation, financed by advertisements which give us at present about 300 Euro/month in income.

We may start to charge for ask-the-expert questions, since the cost for answering each such question is much higher than our other services.

Market: Content-Management

The KOM2002 content-management system has special features for easily producing the same web site translated to multiple languages. It might have a market in multi-national organisations and companies, who need to produce information in many languages.

Market: Natural-Language Question-Answering

Figure 4: The result page when asking a question to the natural-language question-answering system

The natural-language question-answering system used in Web4Health is already successfully marketed in Sweden by a company named Askology.

The cross-lingual natural-language question-answering which Web4Health has developed, will enable organizations and companies to easily set up web sites which can answer questions in multiple languages. This requires a combination with Systran machine-translation technology. We hope this has a market, but cannot yet predict, since we have not even taken it into production usage ourselves when this is written (August 2004).

The natural-language question-answering system in Web4Health gives much better results that traditional free text search engines. As an example, here is a comparison of the results with our query methods for the question "What causes eating disorders?"

Intelligent Natural-Language Question-Answering	Number of answers	Precision
Web4Health Natural-Language Question-Answering system	12 plus more via link to link page	100 %
Alkaline (conventional free text search engine, uses OR between search words)	939 answers	about 10 %
Alkaline query "+causes +eating +disorders"	82 answers	about 30 %
Google with "site:web4health.info"	90 answers	about 20 %
Google with no site restriction	437 000 answers	not measured

As this example shows, the Web4Health natural language question-answering system gives better precision than conventional free text search engines. It was also better in ordering the results with the most general overview answers first. People will thus much more often get direct links to highly relevant answers with our system.

Market: Machine-Translation

Machine-translation has a stable market.

The quality of translations can be acceptable if a special dictionary is developed for a special area. Thus, a web site providing information in a particular area may use machine-translation. However, for the area of psychology/psychiatry, which is a rather wide area, including almost all human activities, the quality is still not enough to allow us to use machine-translation for FAQs provided to users.

Machine-translation results are also more acceptable to people accustomed to using it, than to laymen without experience with machine-translation results.

Market: Combination

The combination of cross-lingual question-answering and machine-translation to provide a web site in multiple languages is a very interesting combination, which may have a large market. It is, however, not possible to predict this until we have tested the technology ourselves more than we have yet done.

The combination of the content-management system (KOM2002) with the natural-language question-answering system (QuickAsk) is another example of a valuable combination, which can be marketed to multi-national organisations and companies who need to produce web sites with information in multiple languages, and with easy access through a natural-language question-answering system.

4. Dissemination and awareness

We have presented our results at a number of medical and technical conferences and got much interest in our work. We were also selected as one of the 31 finalists in the eHealth contest, 2004, and as such demonstrated our web site at the eHealth conference in York in May 2004.

We have used Search Engine Optimization (SEO) technology to increase the number of visitors to our web site, and this is probably the major reason why our web site has so rapidly got so many visitors. In particular, we have used the WordTracker data base of actual search-engine queries, in order to make search engines find our pages for more commonly made queries.

5. Future work and exploitation prospects

See chapter Market Prospects above. We will continue to run the web site on a low budget until we succeed in getting alternative funding. Probably, future funding will be national rather than multi-national.

6 Further information

This final report is a short summary of a much more complete final report available at http://web4health.info/documentation/D-7-4-full-final-rep.pdf.

Deliverables are downloadable from http://web4health.info/KOM2002/docs.html.