Scott R Vrana1, Dylan T Vrana2, Louis A Penner3, Susan Eggly4, Richard B Slatcher5, Nao Hagiwara6. 1. Department of Psychology, 806 W. Franklin St. Box 84-2018, Virginia Commonwealth University, Richmond, VA 23284, USA. Electronic address: srvrana@vcu.edu. 2. Ray and Stephanie Lane Center for Computational Biology, Carnegie Mellon University, 5000 Forbes Ave Suite 7725, Pittsburgh, PA 15213, USA. Electronic address: dtv@andrew.cmu.edu. 3. Wayne State University, Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI 48201, USA. Electronic address: pennerl@karmanos.org. 4. Department of Oncology, Karmanos Cancer Institute/Wayne State University, 4100 John R, MM03CB, Detroit, MI 48201, USA. Electronic address: egglys@karmanos.org. 5. Department of Psychology, Wayne State University, 5057 Woodward Ave., Detroit, MI 48202, USA. Electronic address: slatcher@wayne.edu. 6. Department of Psychology, 806 W. Franklin St. Box 84-2018, Virginia Commonwealth University, Richmond, VA 23284, USA. Electronic address: nhagiwara@vcu.edu.
Abstract
RATIONALE: Patient-physician communication plays an essential role in a variety of patient outcomes; however, it is often difficult to operationalize positive patient-physician communication objectively, and the existing evaluation tools are generally time-consuming. OBJECTIVE: This study proposes semantic similarity of the patient's and physician's language in a medical interaction as a measure of patient-physician communication. Latent semantic analysis (LSA), a mathematical method for modeling semantic meaning, was employed to assess similarity in language during clinical interactions between physicians and patients. METHODS: Participants were 132 Black/African American patients (76% women, Mage = 43.8, range = 18-82) who participated in clinical interactions with 17 physicians (53% women, Mage = 27.1, range = 26-35) in a primary care clinic in a large city in the Midwestern United States. RESULTS: LSA captured reliable information about patient-physician communication: The mean correlation indicating similarity between the transcripts of a physician and patient in a clinical interaction was 0.142, significantly greater than zero; the mean correlation between a patient's transcript and transcripts of their physician during interactions with other patients was not different from zero. Physicians differed significantly in the semantic similarity between their language and that of their patients, and these differences were related to physician ethnicity and gender. Female patients exhibited greater communication similarity with their physicians than did male patients. Finally, greater communication similarity was predicted by less patient trust in physicians prior to the interaction and greater patient trust after the interaction. CONCLUSION: LSA is a potentially important tool in patient-physician communication research. Methodological considerations in applying LSA to address research questions in patient-physician communication are discussed.
RATIONALE: Patient-physician communication plays an essential role in a variety of patient outcomes; however, it is often difficult to operationalize positive patient-physician communication objectively, and the existing evaluation tools are generally time-consuming. OBJECTIVE: This study proposes semantic similarity of the patient's and physician's language in a medical interaction as a measure of patient-physician communication. Latent semantic analysis (LSA), a mathematical method for modeling semantic meaning, was employed to assess similarity in language during clinical interactions between physicians and patients. METHODS:Participants were 132 Black/African American patients (76% women, Mage = 43.8, range = 18-82) who participated in clinical interactions with 17 physicians (53% women, Mage = 27.1, range = 26-35) in a primary care clinic in a large city in the Midwestern United States. RESULTS: LSA captured reliable information about patient-physician communication: The mean correlation indicating similarity between the transcripts of a physician and patient in a clinical interaction was 0.142, significantly greater than zero; the mean correlation between a patient's transcript and transcripts of their physician during interactions with other patients was not different from zero. Physicians differed significantly in the semantic similarity between their language and that of their patients, and these differences were related to physician ethnicity and gender. Female patients exhibited greater communication similarity with their physicians than did male patients. Finally, greater communication similarity was predicted by less patient trust in physicians prior to the interaction and greater patient trust after the interaction. CONCLUSION: LSA is a potentially important tool in patient-physician communication research. Methodological considerations in applying LSA to address research questions in patient-physician communication are discussed.
Authors: Louis A Penner; John F Dovidio; Donald Edmondson; Rhonda K Dailey; Tsveti Markova; Terrance L Albrecht; Samuel L Gaertner Journal: J Black Psychol Date: 2009-05-01