Natural Language Processing–Based Virtual Cofacilitator for Online Cancer Support Groups: Protocol for an Algorithm Development and Validation Study

March 9, 2021 |

Natural Language Processing–Based Virtual Cofacilitator for Online Cancer Support Groups: Protocol for an Algorithm Development and Validation Study

  • Authors: Yvonne W Leung, PhD; Elise Wouterloot, MA; Achini Adikari, BSc; Graeme Hirst, PhD; Daswin de Silva, PhD; Jiahui Wong, PhD; Jacqueline L Bender, PhD; Mathew Gancarz, MMSc; David Gratzer, MD; Damminda Alahakoon, PhD; Mary Jane Esplen, PhD
  • Published in: JMIR Research Protocols, Volume 10, Number 1, 2021, DOI: 10.2196/21453
  • Funding Source: Ontario Institute for Cancer Research Cancer Care Ontario Health Services Research Network

Cancer and its treatment can significantly impact the short- and long-term psychological well-being of patients and families. Emotional distress and depressive symptomatology are often associated with poor treatment adherence, reduced quality of life, and higher mortality. Cancer support groups, especially those led by health care professionals, provide a safe place for participants to discuss fear, normalize stress reactions, share solidarity, and learn about effective strategies to build resilience and enhance coping. However, in-person support groups may not always be accessible to individuals; geographic distance is one of the barriers for access, and compromised physical condition (eg, fatigue, pain) is another. Emerging evidence supports the effectiveness of online support groups in reducing access barriers.

Text-based and professional-led online support groups have been offered by Cancer Chat Canada. Participants join the group discussion using text in real time. However, therapist leaders report some challenges leading text-based online support groups in the absence of visual cues, particularly in tracking participant distress. With multiple participants typing at the same time, the nuances of the text messages or red flags for distress can sometimes be missed. Recent advances in artificial intelligence such as deep learning–based natural language processing offer potential solutions. This technology can be used to analyze online support group text data to track participants’ expressed emotional distress, including fear, sadness, and hopelessness. Artificial intelligence allows session activities to be monitored in real time and alerts the therapist to participant disengagement.

We have developed and are evaluating an artificial intelligence–based cofacilitator prototype to track and monitor online support group participants’ distress through real-time analysis of text-based messages posted during synchronous sessions.

This study received ethics approval in August 2019. Phase 1, development of an artificial intelligence–based cofacilitator, was completed in January 2020. As of December 2020, phase 2 is underway. The study is expected to be completed by September 2021.

Oncology Nursing Day 2020 Message

April 7, 2020 |

Every year on the first Tuesday in April, we celebrate the work of oncology nurses across the country. Oncology nurses play a pivotal role in the care of individuals and their families living with cancer and have an immense impact on their quality of life throughout the cancer journey.

In this unprecedented time of COVID-19 pandemic, we are seeing first-hand the dedication of oncology nurses as they rise to the challenge and continue to provide critical care to patients and families, helping them manage difficulties associated with cancer and cancer treatments while addressing their fear of infection. We at de Souza, want to thank and acknowledge these nurses for their brave and selfless work. To those on the frontlines, we applaud you and stand with you.

Stay safe and take good care,
de Souza Institute

Course Extension Due to COVID-19

March 17, 2020 |

Dear colleagues,

Many of our learners are health professionals working at the front line and we express our gratitude for your dedication in providing care for patients and families. We are fully in support of this tremendous effort and will stand with you in this trying time. In light of the challenge to control the spread and impact of COVID-19, we recognize that many clinicians will be focusing their time and effort exclusively to direct care.

Course extension: All active de Souza courses that started before May 6, 2020 were extended for one additional month from the course close date. This extension is to give learners additional time to complete course requirements, including assignments and final exams. This includes all facilitator-led courses and self-directed courses. The course extensions do no apply to courses that start in June or later.

For O-PREP learners in Alberta, all de Souza courses on the Learning Pathway will have extended deadlines, including the AHS Cohort Chemo/Bio Maintenance.
There are two exceptions in Alberta for deadlines:

  1. O-PREP ASCB – Provincial Standardized Chemotherapy and Biotherapy: Communication has been distributed to learners via the course News Forum and details will continue to be updated on the course as a plan is determined.
  2. O-PREP Foundations Part 1 & 2, learners are expected to complete modules as outlined by their educators for initial orientation.

This applies to any courses that started up until May 6, 2020 and we will reassess the situation throughout May. We will also be evaluating each course and determining an appropriate approach that will allow for suitable course completion, including exams, where applicable. As there is not a “one-size-fits all” approach in this situation, we will be reaching out directly to you with specific plans for the course(s) you are enrolled in. For the time being, online courses will continue as planned.

de Souza Support Line 416-581-7887: Because all our non-clinical staff will start to work from home this week, our main support line will have no staff to answer your call live, but will accept voicemails. Our team will be checking these voicemails on an hourly basis during business hours and will answer your message within one business day. Our support email is attended to promptly so feel free to contact us by email at

Our emails have sometimes been incorrectly flagged as spam in some cases, so please double check your spam folder if you do not see a reply from us within one business day.

Thank you everyone, take care, and be safe.
de Souza Institute

WHO Year of the Nurse – de Souza Nightingale Series – Janny Proba

February 4, 2020 |

2020 marks the 200th anniversary of Florence Nightingale’s birth. Her legacy as the founder of modern nursing continues to influence nurses and improve patient care worldwide. To celebrate this anniversary the World Health Organization has declared 2020 as the Year of the Nurse and the Midwife. Taking inspiration from her moniker as The Lady with … Read more

2020 New Year’s Message

January 7, 2020 |

A year can be described as being 12 months, 52 weeks or 365 days, but a New Year can be described as a celebration, a fresh start or an opportunity. 2020 can be all of that and more. More, because this leap year we are given an extra day to do something new, bold or … Read more

Warm Holiday Wishes from de Souza Institute

December 19, 2019 |

As the days pass and we bring a close to 2019, the end of the year gives us an opportunity to pause and reflect on all our partnerships and interactions with our learners, faculty and staff. 2019 was a remarkable year with many advancements in treatment and hard work on our courses to roll out … Read more