Topic analysis: an objective measure of the consultation and its application to computer assisted consultations.

Abstract

A simple method has been developed to classify the verbal interaction during medical consultations in terms of the relative proportions of medical and social content and the initiator of conversational topics discussed. The method has been applied to video tape recordings of three doctors' consultations with and without a computer present to classify and compare the items discussed. Actual computer use has been shown to have a medical effect on the consultations (p less than 0.05) and to increase the proportion of topics initiated by the doctor (p less than 0.001). Although this was largely accounted for by the massive increase in doctor initiated medical items resulting directly from computer use, there was evidence that, for two of the doctors, these topics were replacing some of the normal social and patient initiated medical exchanges.

Has general practitioner computing made a difference to patient care? A systematic review of published reports

“…Six examined the effects on the consultation process21 22 23 24 25 26 (see table II), 21 evaluated effects on clinicians' performance of tasks21 22 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 (see table III), and only three measured the impact on patient outcome47 48 49 50 (see table IV). Two studies examined more than one topic (consultation process and doctors' performance)21 22 and are included in both relevant tables (II and III).…”