all you can really do is build muscle memory on how many times you have to click for dialogues and hope for the best. thats what i do anyways
as of now i think the only way to get a sub 21 would be a tas or auto/scroll clicking (which wouldnt even be a valid run), the only way to shorten times outside of mouse placement is to increase cps which gets capped quite low due to only 2 keys being useable (space + m1/2) plus theres probably no way to speed/skip through think sections from my knowledge which is kinda sad as sub 21 and even sub 20 runs are made very difficult/impossible from it
also what would the run category fall into? im thinking any% or something else but i wouldnt know as im pretty new to the speedrunning scene myself
i'd probably reckon that speedruns would be locked to the default settings w/o any assists, that tends to be the norm for speedrunning games and so i would assume it applies here