arXiv:2611.00605v1 Announce Type: new Abstract: Conversational text-to-SQL interfaces could give healthcare professionals natural-language access to electronic health record (EHR) data, but evidence for their real-world usability remains limited: prior evaluations have relied largely on curated benchmarks with fully specified questions or on simulated users. We report a user study in which 14 physicians who regularly work with EHR data used both a single-turn and a conversational multi-turn text-to-SQL interface over the MIMIC-IV database in a within-subjects design; dialogue analyses additionally drew on interaction logs from 21 healthcare professionals across the main study and two pilot studies. The conversational interface was consistently favored: mean System Usability Scale scores rose from 68.2, near the industry average, to 85.9 (p<0.001), with significant advantages across technology-acceptance constructs including performance expectancy, effort expectancy, self-efficacy, and behavioral intention. In post-study forced-choice comparisons, 93% of participants reported greater overall satisfaction with the conversational interface, 86% preferred it for real-world adoption, and 71% trusted its results more; no participant preferred or trusted the single-turn interface more. Turn-level analysis of 425 logged user turns showed that freely composed queries triggered clarification requests in 24.8% of cases versus 1.8% for predefined, fully specified questions, and 64.3% of clarification episodes stemmed from EHR- or clinical-domain knowledge. Conversational interaction is a practical prerequisite, rather than a convenience, for natural-language EHR access. The frequent need for clarification in realistic clinical queries further underscores the importance of conversational interfaces, while benchmark-style evaluation can substantially underrepresent the ambiguity of real clinical use.
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