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Related Experiment Videos

Development and validation of the Davis Observation Code.

E J Callahan1, K D Bertakis

  • 1Department of Family Practice, University of California, Davis 95817.

Family Medicine
|January 1, 1991
PubMed
Summary
This summary is machine-generated.

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Direct observation using the Davis Observation Code (DOC) is reliable for measuring physician behaviors. However, chart audits underreport these behaviors, indicating lower validity for chart review in health care research.

Area of Science:

  • Medical Sociology
  • Health Services Research
  • Clinical Observation

Background:

  • Direct observation is a powerful tool for measuring human behavior.
  • Various direct methodologies are used to study physician-patient interactions.
  • The Davis Observation Code (DOC) is a new scale for direct observation of physician-patient interactions.

Purpose of the Study:

  • To develop and evaluate the Davis Observation Code (DOC) for physician-patient interactions.
  • To compare the rates of key physician behaviors measured by direct observation (DOC) versus chart audit.
  • To assess the reliability and concurrent validity of the DOC compared to chart audit.

Main Methods:

  • Developed and evaluated the 20-item Davis Observation Code (DOC).
  • Analyzed 49 videotaped physician-patient interactions using the DOC.

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  • Reviewed the medical record (chart audit) for each interaction.
  • Assessed inter-rater reliability and conducted nonparametric correlation analyses.

    • Main Results:

    • Inter-rater reliability was acceptable for both direct observation and chart audit.
    • Rates of physician behaviors (disease prevention, health education, health promotion, compliance checking) were lower with chart audit.
    • Concurrent validity (phi values .12–.49) was low, primarily due to underreporting in charts.

    Conclusions:

    • The DOC is a reliable method for observing physician behaviors.
    • Chart audit is less valid than direct observation due to underreporting.
    • Findings have implications for improving health care delivery research methods.