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Development of a measurement system for complex oral information transfer in medical consultations
BACKGROUND: Information exchange between physician and patient is crucial to achieve patient involvement, shared decision making and treatment adherence. No reliable method exists for measuring how much information physicians provide in a complex, unscripted medical conversation, nor how much of thi...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610985/ https://www.ncbi.nlm.nih.gov/pubmed/31272386 http://dx.doi.org/10.1186/s12874-019-0788-7 |
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author | Nordfalk, J. M. Gulbrandsen, P. Gerwing, J. Nylenna, M. Menichetti, J. |
author_facet | Nordfalk, J. M. Gulbrandsen, P. Gerwing, J. Nylenna, M. Menichetti, J. |
author_sort | Nordfalk, J. M. |
collection | PubMed |
description | BACKGROUND: Information exchange between physician and patient is crucial to achieve patient involvement, shared decision making and treatment adherence. No reliable method exists for measuring how much information physicians provide in a complex, unscripted medical conversation, nor how much of this information patients recall. This study aims to fill this gap by developing a measurement system designed to compare complex orally provided information to patient recall. METHODS: The development of the complex information transfer measurement system required nine methodological steps. Core activities were data collection, definition of information units and the first draft of a codebook, refinement through independent coding and consensus, and reliability testing. Videotapes of physician-patient consultations based on a standardized scenario and post-consultation interviews with patients constituted the data. The codebook was developed from verbatim transcriptions of the videotapes. Inter-rater reliability was calculated using a random selection of 10% of the statements in the transcriptions. RESULTS: Thirtyfour transcriptions of visits and interviews were collected. We developed a set of rules for defining a single unit of information, defined detailed criteria for exclusion and inclusion of relevant units of information, and outlined systematic counting procedures. In the refinement phase, we established a system for comparing the information provided by the physician with what the patient recalled. While linguistic and conceptual issues arose during the process, coders still achieved good inter-rater reliability, with intra-class correlation for patient recall: 0.723, and for doctors: 0.761. A full codebook is available as an appendix. CONCLUSIONS: A measurement system specifically aimed at quantifying complex unscripted information exchange may be a useful addition to the tools for evaluating the results of health communication training and randomized controlled trials. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12874-019-0788-7) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6610985 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66109852019-07-16 Development of a measurement system for complex oral information transfer in medical consultations Nordfalk, J. M. Gulbrandsen, P. Gerwing, J. Nylenna, M. Menichetti, J. BMC Med Res Methodol Research Article BACKGROUND: Information exchange between physician and patient is crucial to achieve patient involvement, shared decision making and treatment adherence. No reliable method exists for measuring how much information physicians provide in a complex, unscripted medical conversation, nor how much of this information patients recall. This study aims to fill this gap by developing a measurement system designed to compare complex orally provided information to patient recall. METHODS: The development of the complex information transfer measurement system required nine methodological steps. Core activities were data collection, definition of information units and the first draft of a codebook, refinement through independent coding and consensus, and reliability testing. Videotapes of physician-patient consultations based on a standardized scenario and post-consultation interviews with patients constituted the data. The codebook was developed from verbatim transcriptions of the videotapes. Inter-rater reliability was calculated using a random selection of 10% of the statements in the transcriptions. RESULTS: Thirtyfour transcriptions of visits and interviews were collected. We developed a set of rules for defining a single unit of information, defined detailed criteria for exclusion and inclusion of relevant units of information, and outlined systematic counting procedures. In the refinement phase, we established a system for comparing the information provided by the physician with what the patient recalled. While linguistic and conceptual issues arose during the process, coders still achieved good inter-rater reliability, with intra-class correlation for patient recall: 0.723, and for doctors: 0.761. A full codebook is available as an appendix. CONCLUSIONS: A measurement system specifically aimed at quantifying complex unscripted information exchange may be a useful addition to the tools for evaluating the results of health communication training and randomized controlled trials. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12874-019-0788-7) contains supplementary material, which is available to authorized users. BioMed Central 2019-07-04 /pmc/articles/PMC6610985/ /pubmed/31272386 http://dx.doi.org/10.1186/s12874-019-0788-7 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Nordfalk, J. M. Gulbrandsen, P. Gerwing, J. Nylenna, M. Menichetti, J. Development of a measurement system for complex oral information transfer in medical consultations |
title | Development of a measurement system for complex oral information transfer in medical consultations |
title_full | Development of a measurement system for complex oral information transfer in medical consultations |
title_fullStr | Development of a measurement system for complex oral information transfer in medical consultations |
title_full_unstemmed | Development of a measurement system for complex oral information transfer in medical consultations |
title_short | Development of a measurement system for complex oral information transfer in medical consultations |
title_sort | development of a measurement system for complex oral information transfer in medical consultations |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610985/ https://www.ncbi.nlm.nih.gov/pubmed/31272386 http://dx.doi.org/10.1186/s12874-019-0788-7 |
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