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

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.