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Patient-provider communication while using a clinical decision support tool: explaining satisfaction with shared

Yan Liu1, Rachel Kornfield2, Ellie Fan Yang3

  • 1School of Journalism and Communication, Shanghai University, 149 Yanchang Drive, 1006 Xingjian Building, Shanghai, 200072, China. yliu680@shu.edu.cn.

BMC Medical Informatics and Decision Making
|December 8, 2022
PubMed
Summary

Provider use of quantitative language and repeated engagement with decision aids improved patient satisfaction in screening mammography decisions. Patient question-asking and excessive navigation without re-engagement decreased satisfaction.

Keywords:
Breast cancer screeningClinical decision support toolComputational text analysisDecisional satisfactionShared decision-making

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Area of Science:

  • Health Services Research
  • Medical Informatics
  • Communication Studies

Background:

  • Clinical decision aids can enhance shared decision-making for screening mammography.
  • Understanding the interplay between decision aid use and patient-provider communication is crucial for optimizing this process.

Purpose of the Study:

  • To investigate how patterns of using an Electronic Health Record (EHR)-integrated decision aid and verbal patient-provider communication influence decision-making satisfaction.
  • To identify specific communication and system usage factors that predict patient satisfaction with the shared decision-making process.

Main Methods:

  • Analysis of 51 patient visits involving a mammography decision aid.
  • Extraction of linguistic features from transcribed patient-provider communication and system logs of decision aid usage.
  • Statistical modeling (linear mixed effects models) to correlate communication patterns and decision aid navigation with patient-reported decisional satisfaction.

Main Results:

  • Provider use of quantitative language positively correlated with patient satisfaction, feeling informed, and values clarity.
  • Patient question-asking was negatively associated with overall satisfaction, values clarity, and certainty.
  • Repeatedly cycling through the decision aid ('looping') improved patient satisfaction, while high navigation clicks without 'looping' lowered it.

Conclusions:

  • Linguistic elements of communication and decision aid interaction patterns significantly predict patient satisfaction in shared decision-making for screening mammography.
  • Findings suggest implications for designing more effective decision aid tools and for clinician training to enhance shared decision-making processes.