10 XII December 2022

https://doi.org/10.22214/ijraset.2022.48322
 International Journal for Research in Applied Science & Engineering Technology (IJRASET)
ISSN: 2321-9653; IC Value: 45.98; SJ Impact Factor: 7.538
Volume 10 Issue XII Dec 2022- Available at www.ijraset.com

A Deep Learning Enabled Chatbot Approach for

Self-Diagnosis
Soumiki Chattopadhyay1, Souti Chattopadhyay2
1
Department of Computer Science and Engineering, Institute of Engineering and Management (IEM), Kolkata, India
2
Department of Computer Science, University of Southern California, Los Angeles, California

Abstract: Healthcare is an essential need that is often inaccessible or unavailable. With rising populations and deadly viruses,
the load on healthcare workers is the highest, while the ratio of healthcare workers per person has hit an all time low. This
extreme demand for assistance in the face of unavailability has opened up avenues for computer assisted healthcare. In this
paper, we propose an approach to use advancements in computer assisted healthcare in two directions. We employ machine
learning algorithms to predict the disease correctly. We used Random Forest and XGBoost as this system's core classifiers that
gave an accuracy of 100% and 99.0% correspondingly. The chatbot is used to trigger the appropriate function for the disease
prediction concluding from the conversation with the user. It has an accuracy of 97.22%. Overall our chatbot has the potential
to provide immediate assistance to those who are in need, and in turn, reduce the burden on healthcare workers.
Keywords: Machine Learning, Deep Learning, Healthcare, Chatbot

I. INTRODUCTION
Medical care is one of the most essential services for people, and governments take on responsibility to provide accessible and
affordable healthcare to their people. However, governments around the world fail to provide functional healthcare access due to
varying reasons like costly medical supply and care provider systems in the United States [1]. or the lack of resources to provide for
a huge population in India. While high costs of medical care are driven by the economic strategies and policies, lack of resources
and shortage of healthcare is a global problem across all developing nations [2]. WHO estimates a projected shortfall of 10 million
health workers by 2030, mostly in low- and lower-middle income countries [3]. A 2011 study estimated that India has roughly 20
health workers per 10,000 population [4] [5]. The World Health Organization (WHO) has said India faces an "enormous challenge"
to train enough health personnel to meet the needs of a burgeoning, ageing population [6]. With the recent COVID 19 pandemic,
even affluent countries like the US are facing healthcare worker shortage [7].
The lack of personnel creates a crisis on an upward trend in the lack of accessibility and affordability of healthcare. A study reports
that in rural areas in India, only 37% of people were able to access in-patient facilities within a 5 km distance, and 68% were able to
access out-patient facilities [8]. Less than half of Africa’s citizens (52%) – some 615 million people – have access to the healthcare
they need[9]. Due to the lack of accessibility, private sectors often carry the burden to provide healthcare to exponentially increasing
the cost of healthcare, with healthcare expenditure as high as 70% in Africa and 75% in India coming from the private sector [4, 10].
While the world is focused on improving national and international policies, supply chains, and training ground forces to cope with
the ever increasing demand for healthcare, especially, in the face one of the biggest pandemics faced by mankind, the gap between
demand and accessibility of healthcare seems unlikely to be resolved by simply personnel or policies. The WHO reports that the
demand for physicians is projected to grow in the US by 17% percent by 2025 [11], and the Indian Ministry of Health and Family
Welfare puts the same estimate for India to grow by nearly 50% by 2025 [12]. This has caused governments and industry to
examine computer mediation in healthcare, investigating how digital procurement and localisation can be used to improve access
and make healthcare more affordable [13].
One such computer mediated approach is using computers to assist with diagnosis, popularly, in the form of medical chatbots. These
chatbots have advantages that most automated systems bring like unlimited availability, learn, and disseminate critical information
faster than people having to consult primary care or search for valid medical articles [14]. Chatbots are popularly used to provide
automated assistance with booking appointments, building a community who share similar health experiences, or collect patient data
[15]. However, most chatbots don't perform diagnosis, identifying the health issue from the patients' conversations. When chatbots
have the ability to diagnose and identify what kind of health support the patient needs, they can make an impact by contributing to
the healthcare workforce and making healthcare more accessible.

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 International Journal for Research in Applied Science & Engineering Technology (IJRASET)
ISSN: 2321-9653; IC Value: 45.98; SJ Impact Factor: 7.538
Volume 10 Issue XII Dec 2022- Available at www.ijraset.com

In this paper, we implement a diagnostic assistant that can predict specific diseases the patients are suffering from by asking for
information, and then provide additional assistance or temporary relief. Our chatbot uses Deep Learning to learn with time and
answer more detailed questions and provide personalised assistance. Our chatbot uses ML algorithms to predict heart and kidney
diseases with 99.02% and 100% accuracy. And if the patient is diagnosed with a disease, the chatbot follows up with potential
assistance. We posit, our chatbot will be useful in scenarios where people want a confirmed diagnosis to identify which specialist or
doctors to contact. Since the chatbot uses minimal computation power, and can be hosted from a server, the chatbot will improve
accessibility to healthcare or alleviate immediate concerns. Eventually, it will lower the cost associated with healthcare.

II. BACKGROUND AND RELATED WORK

Our approach marries two threads of advancements in computer aided healthcare—predicting diseases accurately from health data,
and using chatbots to provide medical assistance. In this section, we talk about how our approach builds upon the existing work and
adds functionality to make a practically usable chatbot.

A. Predicting Diseases using Machine Learning

Researchers have explored various Machine Learning models and their powers to predict diseases based on existing medical data.
The UCI Machine learning repository [16] serves as the benchmark dataset to explore and evaluate algorithms. In recent years,
authors have compiled the performances of the algorithms by various other researchers to understand the need and scope for
improvement [17]. Other authors have explicitly compared the performances of various algorithms to predict heart diseases [18].
They found that researchers most frequently used Support Vector Machine (SVM). Some papers have also built hybrid algorithms to
improve the performance on heart disease prediction [19]. Various papers have documented the performance of algorithms on
different classes of diseases like heart, breast cancer etc. available from the repository [20].
Machine Learning algorithms are well documented to perform good prediction of diseases, however, the algorithms alone are not
usable by the general users. The predictors are used by expert healthcare officials or for various stimulated drug trials. In this paper,
we propose an approach where the disease predictor algorithms are made available directly to the users through a chatbot interface

B. Chatbots in Healthcare
Chatbots have been implemented in various capacities in the field of healthcare. Some of them are trained and able to answer
questions like “how to treat a cut?” “how to cure a fever?” developed the application using the N-gram, TF-IDF for extracting the
keyword from the user query [21]. Each keyword is weighed down to obtain the proper answer for the query. The authors also
implemented a web interface developed for the users, to the input query.The application uses n-gram for text compression using
bigram and trigram for faster execution of the query. The N-gram, TF-IDF, and cosine similarity to convey the answers to the
users. Other authors like Prayitno et. al. [22] builds a chatbot using Cosine Similarity, ID3 Decision Tree, and Natural Language
Processing. It is designed to make therapeutic suggestions depending on the disease the user describes. The cosine similarity is used
to find the similarities between the query words or the questions that are asked by the user and the documents, then return the
answers of the document with the highest similarity. The chatbot can successfully diagnose user illness with approximately 87%
accuracy.
Some authors have used fully trained neural networks as the core for chatbots. For instance, Reshmanth et. al. [23] built a chatbot
based on natural language processing and trained using RNN. The accuracy of the chatbot is 100% and is programmed to answer
questions like "how to treat dog bite?", "how to treat fever?", "how to handle the cold?". The dataset comprises these general
problems and their solutions. Finally, they used Flask to create a UI for the chatbot. The large number of chatbots have been
surveyed and studied by some authors to understand the use cases for the chatbots. Detailed study of various research papers related
to chatbots and analyse the different tools, algorithms, software and platforms that are utilised. The study of the papers included
comparison of their chatbots, the methodologies they used, advantages, disadvantages, dataset, domain, accuracy, and whether the
chatbot is voice or text activated [24].
Authors have also worked to make the chatbots multilingual, for example, some papers used five classification algorithms SVM,
KNN, Decision Tree, MNB, Random Forest Classifier for disease prediction [25]. The Random Forest Classifier produces the best
results and gives an accuracy of 98.43%. The chatbot uses TF-IDF and cosine similarity to respond to users and also supports
speech to text and text to speech conversion so that the user can also communicate using voice in three languages: English, Hindi,
and Gujarati to make it suitable for use in rural areas.

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 International Journal for Research in Applied Science & Engineering Technology (IJRASET)
ISSN: 2321-9653; IC Value: 45.98; SJ Impact Factor: 7.538
Volume 10 Issue XII Dec 2022- Available at www.ijraset.com

In our approach, we devised a chatbot that will diagnose the disease of the user through conversational flow and utilise databases
through the forms filled up by the user to detect what type of disease the user has, if any. Further, it can also provide aid for
temporary relief. The chatbot is trained using LSTM with an accuracy of 97.22%, and the disease detection is performed using
XGBoost or Random Forest. It utilises the concept of natural language processing to parse and understand the intents file which was
created by wielding various resources.

III. METHODOLOGY
Our approach marries the two threads of using machine learning to predict diseases from users' symptoms and using a chatbot to
identify symptoms. We explain the design choices of these components, and then describe how we combined the two components to
work together as a system.

A. Using ML Algorithms to Predict Diseases

We used data from the UCI machine learning repository [16]. For this paper, we will demonstrate the approach with two datasets ,
heart disease dataset and chronic kidney disease dataset. Both the detests are multivariate and designed to classify the diseases with
various metabolic measurements. To make our approach more generalizable, the two datasets were merged and passed on to the data
preprocessing stage. To broaden the approach, datasets for different diseases can be merged at this stage.

1) Data Processing
The data preprocessing stage took place within two functions : Heart and Kidney.
a) Heart Function: When the chatbot detects the user has a possibility of heart disease (See Section 3.2), the chatbot asks the
patient to fill up the heart disease form. The form collects the variable measures used for the classification and passes the form
data to the heart function.
b) Kidney Function: If the chatbot detects that the user might have kidney disease (See Section 3.2) from the conversation flow, it
prompts the user to fill up the kidney form. Then sends the form data to the kidney function which only works with the kidney
classification related variable values from the merged dataset. Since the kidney dataset has categorical values and null values,
we used label encoder to encode the categorical values to allow us to perform numerical operations. Also drop the rows with
null values.

2) Model Training and Prediction

The processed data then invoked the algorithms, and the best performing algorithm for the specific data is then used to predict the
disease on the new patient data. The model training and prediction also occurs within the specific disease functions.
a) Heart Disease Prediction: The heart function only subsets the heart disease related data features from the merged dataset and
uses the best performing model for heart data, XGBoost model. Then uses the trained model to predict whether the user has
heart disease. The results of the prediction are then shown to the user in the "result" portion of the form. The result is a
dichotomous, and the form returns the result of 0 or 1.
b) Kidney Disease Prediction: The Kidney function uses random forest to train the model, and then uses the trained model on the
user provided form data to predict whether the user has CKD (Chronic Kidney Disease). The prediction result is dichotomous,
and the model returns 2 or 3 to the form for the user to see.

B. Building the Chatbot

Chatbots are virtual conversational agents that stimulate conversation with the users. There are mainly three types of chatbots: rule-
based, learning enabled, and hybrid. Rule-based chatbots have predefined conversational paths and do not respond accurately if the
user says anything outside the predefined path. Deep learning enables chatbots to improve themselves over time with more training
and learns to mimic the human brain and stimulate human-like conversations. Hybrid chatbots are a combination of these two.
Rule based chatbots follow a predefined conversational path. If the user says something beyond the predefined path, the chatbot
can't attach semantic meanings to the user conversations. This makes the user interaction with the chatbot not conversational. To
avoid this limitation, in this paper, we are using a Deep Learning trained chatbot approach to build an intelligent conversational
agent which, over time and training, learns the patterns of human conversations and eventually mimics the way humans talk. This
allows the chatbot to provide meaningful responses even if a user asks something beyond the scope of the conversation.

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 International Journal for Research in Applied Science & Engineering Technology (IJRASET)
ISSN: 2321-9653; IC Value: 45.98; SJ Impact Factor: 7.538
Volume 10 Issue XII Dec 2022- Available at www.ijraset.com

Since Deep Learning chatbots are powered by Natural Language Processing, rather than using keywords to answer, they try to
understand the intent of the user. The hidden layers in the neural network captures the underlying trends and improves with training.
This allows the chatbot to handle variations in user conversations.
In Figure 1, we demonstrate the components and workflow of the chatbot. First, we compiled a set of user intents for interacting
with the chatbot. The tags, responses, and patterns were stored in separate lists correspondingly. Then, we applied Tokenization on
patterns or user inputs to split them into smaller, understandable units. Table 1 provides some examples of intents from our
database.
Table 1. Intents-based data
Tag Patterns in User Conversation Responses
greeting “just going to say hi”, “heya”, “hello”, “hi”, “Hello! This is Doctor Bot, how can I
“hey”, “hi”, “need help” help you?”
pain “i am having chest pain”, “pain”, “chest “Alright. What is your age?”
pain”, “heart pain”, “heart ache”, “pain in
my chest”
chestpainshortn “Chest pain while resting”, “Sudden chest “Alright. An ideal BMI is in the 18.5 to
essbreath pain”, “Shortness of breath”, “Fast or 24.9 range for adults. What is your
Shallow breathing” BMI?”

bmi “i dont know”, “my bmi is 24.6”, “my bmi “Okay. Ideal blood pressure is
is 36.0”, “57.1”, “20.2”, “dont know”, considered to be between 90/60mmHg
“dont know bmi” and 120/80mmHg. What is your blood
pressure?”

Table 1. User intents in the conversations. The Tag is automatically generated, then the patterns are detected based on the tag, and
corresponding responses from the chatbot.

Next, we performed Padding to convert all inputs to the same size and store them in the features data. The corresponding list of tags
was the label data that the model has to learn to predict. These training data (the features dataset and the training dataset) were then
passed to the Deep Learning (LSTM) model. The model used softmax activation function, sparse categorical cross entropy for loss
function, and Adam optimizer to perform the training. The model was trained for a total of 320 epochs and resulted in an accuracy
of 97.22%.

Figure 1. Chatbot architecture demonstrating the steps taken within the chatbot to build the conversation model with users.

C. Tool Design: Merging the Disease Predictor and Chatbot

The chatbot uses deep learning while the disease prediction is done using machine learning models we implemented through
functions. The user starts having a conversation with the chatbot and there are two ways the conversation could flow. If the user
mentions the pain around the chest area, the chatbot asks more questions related to heart disease symptoms. However, if the user
mentions pain around the stomach area, the chatbot asks more questions based on symptoms a kidney disease patient could have.
Once the chatbot is assured, it suggests the user to fill the kidney disease form or heart disease form accordingly. Figure 2
demonstrates the entire workflow of the system.

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 International Journal for Research in Applied Science & Engineering Technology (IJRASET)
ISSN: 2321-9653; IC Value: 45.98; SJ Impact Factor: 7.538
Volume 10 Issue XII Dec 2022- Available at www.ijraset.com

When the user fills out the form, the data is sent to the corresponding algorithm for kidney or heart disease. The algorithm then uses
the trained model to predict whether the user has a disease. The heart disease prediction form returns a value of 0 or 1, and the
kidney disease form returns 2 or 3. After the prediction value is returned, the chatbot asks the user for the value, and interprets what
the value means in terms of the disease and provides assistance with tips for immediate relief until the user can consult a specialist
(e.g. when the user gets the value 0, the chatbot responds ``you don't have a high probability of a disease, but if would you like to
receive further assistance about temporary relief?").

Figure 2. System architecture. The left part of the figure shows the component exchange and interaction of the chatbot and user.
The right side shows the interaction between the chatbot and the disease predictor.

IV. RESULTS
The evaluation of our approach is based on the performance of the two components of the system–the predicting algorithms and the
chatbot.

A. Evaluating Prediction Performance

First, we ran 8 classifications algorithms with the two datasets separately to determine the optimal model. The accuracy table for the
heart disease dataset is Figure 3.b. It shows Decision Tree, Random Forest and XGBoost gave the highest accuracies. To determine
which is the best among these three models, we further performed cross validation with 10 folds. XGBoost gave the highest
accuracy of 99.02%.

Figure 3.a. Bar Graph representing accuracies of different models evaluated on heart data. XGBoost shows the best accuracy among
the models after performing cross validation.

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 International Journal for Research in Applied Science & Engineering Technology (IJRASET)
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Volume 10 Issue XII Dec 2022- Available at www.ijraset.com

Figure 3.b. Accuracies of different models evaluated on heart data

Similarly, for the kidney disease prediction, we ran the same models to find out the optimal model. According to Figure 4.b.,
Random Forest, GaussianNB, BernoulliNB, and XGBoost have an accuracy of 100%. We applied hyper-parameter tuning to these
models to improve models' predictive accuracy. Although the other models' accuracies reduced to some extent, Random Forest
stayed consistent with a 100%. This could be possible due to overfitting. We conducted a post-hoc inspection to overrule the
possibility of overfitting, and additionally, triangulated with other findings who report that 100% accuracy is a valid outcome when
using Random forest [26]. Random forest is an ensemble algorithm. It combines multiple trees and each tree is grown to the greatest
extent, there is no pruning, and it decides on majority vote rule. So, it is quite common for Random forest to get a 100% accuracy.

Figure 4.a. Bar Graph representing accuracies of different models evaluated on kidney data. Random Forest shows the best accuracy
among the models.

Figure 4.b. Accuracies of different models evaluated on kidney data.

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 International Journal for Research in Applied Science & Engineering Technology (IJRASET)
ISSN: 2321-9653; IC Value: 45.98; SJ Impact Factor: 7.538
Volume 10 Issue XII Dec 2022- Available at www.ijraset.com

B. Evaluating Chatbot Performance

The goal of the chatbot was to engage the user with conversation that will lead to the diagnosis of the disease by matching
symptoms that the user mentioned. Hence, the chatbot needed to be adaptive to various natural language conversations. This is
suitable for an LSTM model, as LSTM thrives on sequential input like natural language where the meaning of a word depends on
the ones that preceded it.
The model consisted of an Input layer, an Embedding Layer, LSTM with ten hidden layers, a Flatten layer, and a Dense layer with
Softmax activation. The loss function used was sparse categorical cross entropy, and Adam optimizer to perform the training. The
best stable accuracy was obtained when trained for 320 epochs and where the model reached a maximum accuracy of 97.22% with a
learning rate lambda of 0.001.

V. DISCUSSION AND IMPLICATIONS

The performance of the components of the system indicate that the approach is usable and applicable to reduce the time to reach a
diagnosis and the pressure on healthcare workers. Using the two underlying functionalities, we can allow users to get immediate
feedback. With the vast amount of articles available to people to search their symptoms, the searches often lead to a spiral of
gradually worse diseases that the articles relate with the symptoms. Users looking for a possible correlation for a symptom like mild
chest pain can get articles that diagnose it with heartburn and indigestion, while the other articles would associate the same
symptoms to blockage of vessels near the heart, or cardiac arrest. However, with no one to chat with and no way of getting an initial
confirmation of the disease, the extreme range in the diagnosis often puts users in panic going down a spiral of information search
leading to more and more serious diagnosis.
Our approach can be used to intervene in this process, saving patients from feeling drowned in information and spooked by
rumoured diagnosis, by providing immediate confirmation on whether certain serious diseases like heart failure or chronic kidney
disease occurs. By making this diagnostic confirmation more accessible and available to the users, the chatbot can also save them
time from worrying about a serious disease they don't have and focus on what might be the true cause of their symptoms.
Additionally, the prediction is often the first step in the healthcare process. Predicting a possible disease requires patients to go
through testing their blood and measuring biophysical data. The process of getting the measurements and tests itself requires
multiple visits to various doctors who then refer the patients to the clinics. Using our approach, users will be receiving a form with
the names of various measures and tests they need to perform. This approach saves the time to initiate the diagnosis and also reduces
the burden on healthcare workers which in turn makes healthcare more available to critical patient needs.

VI. FUTURE WORK

For future work, we target to build a web application with the same chatbot integrated on a user-friendly and visually enticing
platform. This paper only works with two diseases so we will increase the types of diseases that can be diagnosed by adding more
data. This would need us to further add models that can also accommodate other disease data. In the future, we also plan to train the
chatbot on a larger corpus of conversational cues, and enable the chatbot to be trained with LLMs like GPT3, that can parse existing
information on the web and learn to explain and respond to humans.

A. Deploying The Chatbot To Increase Healthcare Accessibility

We plan to develop a full stack web application with the chatbot integrated. It will require customers to make accounts, and store
their data and information in a database for future references. The database will also have patients' history that will include past
diagnosis, medical records, medicines prescribed for the chatbot to utilise. It will be secure as there is no third-party intervention. To
make the system available to everyone, the entire application will be deployed via a cloud service.

B. Enhancing Chatbot Functionality To Connect To Medical Assistance Networks

If the user feels the need to take medicines even after being diagnosed of not having any disease, the user can use the chatbot to get
prescriptions or refill prescriptions, the chatbot can identify if the desired medicine is safe and adequate for the diagnosis and
prescribe it to the patient.
We also wish to utilise location services and integrate with care provider network data, so the chatbot can identify closest
doctor/clinic/specialist and eventually schedule appointments by sharing patient's information and initial diagnosis result from the
chatbot. If a user needs urgent medical attention while in a foreign region, this will be incredibly helpful.

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 International Journal for Research in Applied Science & Engineering Technology (IJRASET)
ISSN: 2321-9653; IC Value: 45.98; SJ Impact Factor: 7.538
Volume 10 Issue XII Dec 2022- Available at www.ijraset.com

C. Integrating Chatbot with Automated Scheduling Systems

Lastly, we target to function the chatbot to schedule automated appointments for tests, check-ups, and other facilities. The chatbot
can be modified to have access to a database containing information about general clinics and pharmacies within the various
networks, the doctors affiliated with those clinics, and their scheduling systems. Using this data, the chatbot can be integrated with a
scheduling assistant module to allow users to directly book appointments with clinics and pharmacies based on the diagnosis. This
module can also be refined to make distinction between low acuity medical needs like ear infection or cavity, and more serious and
immediate needs like detecting lung cancer or renal failure. The chatbot can then schedule initial visits and surgeries for serious
disease requiring such procedures.

VII. CONCLUSION
Healthcare is an important resource that is often not available or accessible to users. Especially since the pandemic, the number of
healthcare workers have drastically reduced making it difficult to access immediate care for millions of people. In this paper, we
proposed an approach to merge the two capabilities of machine learning algorithms to help with this problem. We use ML to predict
the presence of diseases in a user, and use a DL trained chatbot to converse with the patient to detect cues that can trigger the
prediction algorithm. Our algorithms performed with high accuracy, and overall we envision that our approach can help users get
immediate access to healthcare and in turn reduce the burden on healthcare workers.

VIII. ACKNOWLEDGEMENTS
We would like to thank the members of the ACE Lab for their feedback that helped shape the results.

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©IJRASET: All Rights are Reserved | SJ Impact Factor 7.538 | ISRA Journal Impact Factor 7.894 | 1817
 International Journal for Research in Applied Science & Engineering Technology (IJRASET)
ISSN: 2321-9653; IC Value: 45.98; SJ Impact Factor: 7.538
Volume 10 Issue XII Dec 2022- Available at www.ijraset.com

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AUTHORS

Soumiki Chattopadhyay is a student of Institute of Engineering and Management, currently in her final year of B.Tech in Computer
Science and Engineering.

Souti Chattopadhyay is a professor of computer science at the University of Southern California. She works at the intersection of
human-computer interaction & software engineering. Her work has been awarded by IEEE, and other prominent research bodies.

©IJRASET: All Rights are Reserved | SJ Impact Factor 7.538 | ISRA Journal Impact Factor 7.894 | 1818