Exploring differences in interpretation of words essential in medical expert-patient communication

In the context of cancer treatment and surgery, quality of life assessment is a crucial part of determining treatment success and viability. In order to assess it, patient-completed questionnaires which employ words to capture aspects of patients’ well-being are the norm. As the results of these questionnaires are often used to assess patient progress and to determine future treatment options, it is important to establish that the words used are interpreted in the same way by both patients and medical professionals. In this paper, we capture and model patients’ perceptions and associated uncertainty about the words used to describe the level of their physical function used in the highly common (in Sarcoma Services) Toronto Extremity Salvage Score (TESS) questionnaire. The paper provides detail about the interval-valued data capture as well as the subsequent modelling of the data using fuzzy sets. Based on an initial sample of participants, we use Jaccard similarity on the resulting words models to show that there may be considerable differences in the interpretation of commonly used questionnaire terms, thus presenting a very real risk of miscommunication between patients and medical professionals as well as within the group of medical professionals

Exploring differences in interpretation of words essential in medical expert-patient communication

In the context of cancer treatment and surgery, quality of life assessment is a crucial part of determining treatment success and viability. In order to assess it, patient-completed questionnaires which employ words to capture aspects of patients’ well-being are the norm. As the results of these questionnaires are often used to assess patient progress and to determine future treatment options, it is important to establish that the words used are interpreted in the same way by both patients and medical professionals. In this paper, we capture and model patients’ perceptions and associated uncertainty about the words used to describe the level of their physical function used in the highly common (in Sarcoma Services) Toronto Extremity Salvage Score (TESS) questionnaire. The paper provides detail about the interval-valued data capture as well as the subsequent modelling of the data using fuzzy sets. Based on an initial sample of participants, we use Jaccard similarity on the resulting words models to show that there may be considerable differences in the interpretation of commonly used questionnaire terms, thus presenting a very real risk of miscommunication between patients and medical professionals as well as within the group of medical professionals

Words

No abstract available

Sensitivity analysis in a scoping review on police accountability : assessing the feasibility of reporting criteria in mixed studies reviews

In this paper, we report on the findings of a sensitivity analysis that was carried out within a previously conducted scoping review, hoping to contribute to the ongoing debate about how to assess the quality of research in mixed methods reviews. Previous sensitivity analyses mainly concluded that the exclusion of inadequately reported or lower quality studies did not have a significant effect on the results of the synthesis. In this study, we conducted a sensitivity analysis on the basis of reporting criteria with the aims of analysing its impact on the synthesis results and assessing its feasibility. Contrary to some previous studies, our analysis showed that the exclusion of inadequately reported studies had an impact on the results of the thematic synthesis. Initially, we also sought to propose a refinement of reporting criteria based on the literature and our own experiences. In this way, we aimed to facilitate the assessment of reporting criteria and enhance its consistency. However, based on the results of our sensitivity analysis, we opted not to make such a refinement since many publications included in this analysis did not sufficiently report on the methodology. As such, a refinement would not be useful considering that researchers would be unable to assess these (sub-)criteria

'I've used the word cancer but it's actually good news' : discursive performativity of cancer and the identity of urological cancer services

© 2015 Foundation for the Sociology of Health & Illness. Acknowledgements We are grateful to the patients and staff who took part in the study, and to two anonymous reviewers whose thoughtful comments helped refine our thinking. This research was supported by a grant from the Big Lottery Fund. The views expressed here are the authors’and do not necessarily reflect those of the funding bodies or any other organisation.Peer reviewedPostprin

Technology for large-scale translation of clinical practice guidelines : a pilot study of the performance of a hybrid human and computer-assisted approach

Background: The construction of EBMPracticeNet, a national electronic point-of-care information platform in Belgium, was initiated in 2011 to optimize quality of care by promoting evidence-based decision-making. The project involved, among other tasks, the translation of 940 EBM Guidelines of Duodecim Medical Publications from English into Dutch and French. Considering the scale of the translation process, it was decided to make use of computer-aided translation performed by certificated translators with limited expertise in medical translation. Our consortium used a hybrid approach, involving a human translator supported by a translation memory (using SDL Trados Studio), terminology recognition (using SDL Multiterm termbases) from medical termbases and support from online machine translation. This has resulted in a validated translation memory which is now in use for the translation of new and updated guidelines. Objective: The objective of this study was to evaluate the performance of the hybrid human and computer-assisted approach in comparison with translation unsupported by translation memory and terminology recognition. A comparison was also made with the translation efficiency of an expert medical translator. Methods: We conducted a pilot trial in which two sets of 30 new and 30 updated guidelines were randomized to one of three groups. Comparable guidelines were translated (a) by certificated junior translators without medical specialization using the hybrid method (b) by an experienced medical translator without this support and (c) by the same junior translators without the support of the validated translation memory. A medical proofreader who was blinded for the translation procedure, evaluated the translated guidelines for acceptability and adequacy. Translation speed was measured by recording translation and post-editing time. The Human Translation Edit Rate was calculated as a metric to evaluate the quality of the translation. A further evaluation was made of translation acceptability and adequacy. Results: The average number of words per guideline was 1,195 and the mean total translation time was 100.2 min/1,000 words. No meaningful differences were found in the translation speed for new guidelines. The translation of updated guidelines was 59 min/1,000 words faster (95% CI 2-115; P=.044) in the computer-aided group. Revisions due to terminology accounted for one third of the overall revisions by the medical proofreader. Conclusions: Use of the hybrid human and computer-aided translation by a non-expert translator makes the translation of updates of clinical practice guidelines faster and cheaper because of the benefits of translation memory. For the translation of new guidelines there was no apparent benefit in comparison with the efficiency of translation unsupported by translation memory (whether by an expert or non-expert translator

Improving Quality and Achieving Equity: A Guide for Hospital Leaders

Outlines the need to address racial/ethnic disparities in health care, highlights model practices, and makes step-by-step recommendations on creating a committee, collecting data, setting quality measures, evaluating, and implementing new strategies

Exploring entertainment medicine and professionalization of self-care : interview study among doctors on the potential effects of digital self-tracking

Background: Nowadays, digital self-tracking devices offer a plethora of possibilities to both healthy and chronically ill users who want to closely examine their body. This study suggests that self-tracking in a private setting will lead to shifting understandings in professional care. To provide more insight into these shifts, this paper seeks to lay bare the promises and challenges of self-tracking while staying close to the everyday professional experience of the physician. Objective: The aim of this study was to (1) offer an analysis of how medical doctors evaluate self-tracking methods in their practice and (2) explore the anticipated shifts that digital self-care will bring about in relation to our findings and those of other studies. Methods: A total of 12 in-depth semistructured interviews with general practitioners (GPs) and cardiologists were conducted in Flanders, Belgium, from November 2015 to November 2016. Thematic analysis was applied to examine the transcripts in an iterative process. Results: Four major themes arose in our body of data: (1) the patient as health manager, (2) health obsession and medicalization, (3) information management, and (4) shifting roles of the doctors and impact on the health care organization. Our research findings show a nuanced understanding of the potentials and pitfalls of different forms of self-tracking. The necessity of contextualization of self-tracking data and a professionalization of self-care through digital devices come to the fore as important overarching concepts. Conclusions: This interview study with Belgian doctors examines the potentials and challenges of self-monitoring while focusing on the everyday professional experience of the physician. The dialogue between our dataset and the existing literature affords a fine-grained image of digital self-care and its current meaning in a medical-professional landscape