Conceptual metonymy and emotive-affective meaning at the interface: Examples from online medical consultations

Background Measuring shared decision making (SDM) in clinical practice is important to improve the quality of health care. Measurement can be done by trained observers and by people participating in the clinical encounter, namely, patients. This study aimed to describe the correlations between patients’ and observers’ ratings of SDM using 2 validated and 2 nonvalidated SDM measures in clinical consultations. Methods In this cross-sectional study, we recruited 238 complete dyads of health professionals and patients in 5 university-affiliated family medicine clinics in Canada. Participants completed self-administered questionnaires before and after audio-recorded medical consultations. Observers rated the occurrence of SDM during medical consultations using both the validated OPTION-5 (the 5-item “observing patient involvement” score) and binary questions on risk communication and values clarification (RCVC-observer). Patients rated SDM using both the 9-item Shared Decision-Making Questionnaire (SDM-Q9) and binary questions on risk communication and values clarification (RCVC-patient). Results Agreement was low between observers’ and patients’ ratings of SDM using validated OPTION-5 and SDM-Q9, respectively (ρ = 0.07; P = 0.38). Observers’ ratings using RCVC-observer were correlated to patients’ ratings using either SDM-Q9 ( rpb = −0.16; P = 0.01) or RCVC-patients ( rpb = 0.24; P = 0.03). Observers’ OPTION-5 scores and patients’ ratings using RCVC-questions were moderately correlated ( rφ = 0.33; P = 0.04). Conclusion There was moderate to no alignment between observers’ and patients’ ratings of SDM using both validated and nonvalidated measures. This lack of strong correlation emphasizes that observer and patient perspectives are not interchangeable. When assessing the presence, absence, or extent of SDM, it is important to clearly state whose perspectives are reflected.

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A multimodal corpus of simulated consultations between a patient and multiple healthcare professionals

Language Resources and Evaluation ◽

10.1007/s10579-020-09526-0 ◽

2021 ◽

Author(s):

Mark Snaith ◽

Nicholas Conway ◽

Tessa Beinema ◽

Dominic De Franco ◽

Alison Pease ◽

...

Keyword(s):

Healthcare Professionals ◽

Ethical Issues ◽

Upper Body ◽

Language Resources ◽

Close Analysis ◽

Medical Consultations ◽

Multimodal Corpus ◽

Clear Identification ◽

Patient Consultation ◽

Design Construction

AbstractLanguage resources for studying doctor–patient interaction are rare, primarily due to the ethical issues related to recording real medical consultations. Rarer still are resources that involve more than one healthcare professional in consultation with a patient, despite many chronic conditions requiring multiple areas of expertise for effective treatment. In this paper, we present the design, construction and output of the Patient Consultation Corpus, a multimodal corpus of simulated consultations between a patient portrayed by an actor, and at least two healthcare professionals with different areas of expertise. As well as the transcribed text from each consultation, the corpus also contains audio and video where for each consultation: the audio consists of individual tracks for each participant, allowing for clear identification of speakers; the video consists of two framings for each participant—upper-body and face—allowing for close analysis of behaviours and gestures. Having presented the design and construction of the corpus, we then go on to briefly describe how the multi-modal nature of the corpus allows it to be analysed from several different perspectives.

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