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Mary Catherine Beach - One of the best experts on this subject based on the ideXlab platform.
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Impact of Physician Race on Patient Decision-Making and Ratings of Physicians: a Randomized Experiment Using Video Vignettes
Journal of General Internal Medicine, 2020Co-Authors: Somnath Saha, Mary Catherine BeachAbstract:Background Studies suggest that black Patients have better interactions, on average, with physicians of their own race. Whether this reflects greater “cultural competence” in race-concordant relationships, or other effects of race unrelated to physician behavior, is unclear. It is also unclear if physician race influences Patient Decision-Making. Objective To determine whether physician race affects Patients’ ratings of physicians and Decision-Making, independent of physician behavior. Design Randomized study using standardized video vignettes. Participants Primary care Patients with coronary risk factors or disease. Interventions Each participant viewed one of 16 vignettes depicting a physician reviewing cardiac catheterization results and recommending coronary artery bypass graft (CABG) surgery. Vignettes varied only in terms of physicians’ race, gender, age, and communication style (high vs. low Patient-centeredness). Main Measures Participants rated the video physician’s communication, interpersonal style, competence, trustworthiness, likability, and overall performance (0–4 Likert scales). They also rated the necessity of CABG (0–5 scale) and whether they would undergo CABG or obtain a second opinion if they were the video Patient (0–3 scales). Key Results Participants included 107 black and 131 white Patients (72% participation rate). Black participants viewing a black (vs. white) video physician gave higher ratings on all physician attributes (e.g., overall rating 3.22 vs. 2.34, p
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Impact of Physician Race on Patient Decision-Making and Ratings of Physicians: a Randomized Experiment Using Video Vignettes.
Journal of general internal medicine, 2020Co-Authors: Somnath Saha, Mary Catherine BeachAbstract:Studies suggest that black Patients have better interactions, on average, with physicians of their own race. Whether this reflects greater “cultural competence” in race-concordant relationships, or other effects of race unrelated to physician behavior, is unclear. It is also unclear if physician race influences Patient Decision-Making. To determine whether physician race affects Patients’ ratings of physicians and Decision-Making, independent of physician behavior. Randomized study using standardized video vignettes. Primary care Patients with coronary risk factors or disease. Each participant viewed one of 16 vignettes depicting a physician reviewing cardiac catheterization results and recommending coronary artery bypass graft (CABG) surgery. Vignettes varied only in terms of physicians’ race, gender, age, and communication style (high vs. low Patient-centeredness). Participants rated the video physician’s communication, interpersonal style, competence, trustworthiness, likability, and overall performance (0–4 Likert scales). They also rated the necessity of CABG (0–5 scale) and whether they would undergo CABG or obtain a second opinion if they were the video Patient (0–3 scales). Participants included 107 black and 131 white Patients (72% participation rate). Black participants viewing a black (vs. white) video physician gave higher ratings on all physician attributes (e.g., overall rating 3.22 vs. 2.34, p
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impact of physician race on Patient Decision Making and ratings of physicians a randomized experiment using video vignettes
Journal of General Internal Medicine, 2020Co-Authors: Somnath Saha, Mary Catherine BeachAbstract:Studies suggest that black Patients have better interactions, on average, with physicians of their own race. Whether this reflects greater “cultural competence” in race-concordant relationships, or other effects of race unrelated to physician behavior, is unclear. It is also unclear if physician race influences Patient Decision-Making. To determine whether physician race affects Patients’ ratings of physicians and Decision-Making, independent of physician behavior. Randomized study using standardized video vignettes. Primary care Patients with coronary risk factors or disease. Each participant viewed one of 16 vignettes depicting a physician reviewing cardiac catheterization results and recommending coronary artery bypass graft (CABG) surgery. Vignettes varied only in terms of physicians’ race, gender, age, and communication style (high vs. low Patient-centeredness). Participants rated the video physician’s communication, interpersonal style, competence, trustworthiness, likability, and overall performance (0–4 Likert scales). They also rated the necessity of CABG (0–5 scale) and whether they would undergo CABG or obtain a second opinion if they were the video Patient (0–3 scales). Participants included 107 black and 131 white Patients (72% participation rate). Black participants viewing a black (vs. white) video physician gave higher ratings on all physician attributes (e.g., overall rating 3.22 vs. 2.34, p < 0.001) and were more likely to perceive CABG as necessary (4.05 vs. 3.72, p = 0.03) and say they would undergo CABG if they were the video Patient (2.43 vs. 2.09, p = 0.004). Patient-centered communication style reduced, but did not eliminate, the impact of race concordance. Physician race was not associated with any outcomes among white Patients. Black Patients viewed the doctor in a scripted vignette more positively, and were more receptive to the same recommendation, communicated in the same way, with a black vs. white physician. Patient-centered communication reduced but did not eliminate the effect of physician race.
Steven R Brown - One of the best experts on this subject based on the ideXlab platform.
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A systematic review of online resources to support Patient Decision-Making for full-thickness rectal prolapse surgery.
Techniques in coloproctology, 2017Co-Authors: George E Fowler, D. Baker, Matthew Lee, Steven R BrownAbstract:The internet is becoming an increasingly popular resource to support Patient Decision-Making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support Patient Decision-Making for full-thickness rectal prolapse surgery. This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist Decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch–Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0). Overall, 95 sources were from Google and the specialist Decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch–Kincaid Reading Ease score was higher than recommended for Patient education materials (48.8 ± 15.6, range 25.2–85.3). Overall quality of sources supporting Patient Decision-Making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1–5). No sources met minimum Decision-Making standards (median IPDASi score 5/12 ± 2.01, range 1–8). Currently, easily accessible online health information to support Patient Decision-Making for rectal surgery is of poor quality, difficult to read and does not support shared Decision-Making. It is recommended that professional bodies and medical professionals seek to develop Decision aids to support Decision-Making for full-thickness rectal prolapse surgery.
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A systematic review of online resources to support Patient Decision-Making for full-thickness rectal prolapse surgery
Techniques in Coloproctology, 2017Co-Authors: George E Fowler, D. M. Baker, M. J. Lee, Steven R BrownAbstract:Background The internet is becoming an increasingly popular resource to support Patient Decision-Making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support Patient Decision-Making for full-thickness rectal prolapse surgery. Methods This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist Decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch–Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0). Results Overall, 95 sources were from Google and the specialist Decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch–Kincaid Reading Ease score was higher than recommended for Patient education materials (48.8 ± 15.6, range 25.2–85.3). Overall quality of sources supporting Patient Decision-Making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1–5). No sources met minimum Decision-Making standards (median IPDASi score 5/12 ± 2.01, range 1–8). Conclusions Currently, easily accessible online health information to support Patient Decision-Making for rectal surgery is of poor quality, difficult to read and does not support shared Decision-Making. It is recommended that professional bodies and medical professionals seek to develop Decision aids to support Decision-Making for full-thickness rectal prolapse surgery.
Somnath Saha - One of the best experts on this subject based on the ideXlab platform.
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Impact of Physician Race on Patient Decision-Making and Ratings of Physicians: a Randomized Experiment Using Video Vignettes
Journal of General Internal Medicine, 2020Co-Authors: Somnath Saha, Mary Catherine BeachAbstract:Background Studies suggest that black Patients have better interactions, on average, with physicians of their own race. Whether this reflects greater “cultural competence” in race-concordant relationships, or other effects of race unrelated to physician behavior, is unclear. It is also unclear if physician race influences Patient Decision-Making. Objective To determine whether physician race affects Patients’ ratings of physicians and Decision-Making, independent of physician behavior. Design Randomized study using standardized video vignettes. Participants Primary care Patients with coronary risk factors or disease. Interventions Each participant viewed one of 16 vignettes depicting a physician reviewing cardiac catheterization results and recommending coronary artery bypass graft (CABG) surgery. Vignettes varied only in terms of physicians’ race, gender, age, and communication style (high vs. low Patient-centeredness). Main Measures Participants rated the video physician’s communication, interpersonal style, competence, trustworthiness, likability, and overall performance (0–4 Likert scales). They also rated the necessity of CABG (0–5 scale) and whether they would undergo CABG or obtain a second opinion if they were the video Patient (0–3 scales). Key Results Participants included 107 black and 131 white Patients (72% participation rate). Black participants viewing a black (vs. white) video physician gave higher ratings on all physician attributes (e.g., overall rating 3.22 vs. 2.34, p
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Impact of Physician Race on Patient Decision-Making and Ratings of Physicians: a Randomized Experiment Using Video Vignettes.
Journal of general internal medicine, 2020Co-Authors: Somnath Saha, Mary Catherine BeachAbstract:Studies suggest that black Patients have better interactions, on average, with physicians of their own race. Whether this reflects greater “cultural competence” in race-concordant relationships, or other effects of race unrelated to physician behavior, is unclear. It is also unclear if physician race influences Patient Decision-Making. To determine whether physician race affects Patients’ ratings of physicians and Decision-Making, independent of physician behavior. Randomized study using standardized video vignettes. Primary care Patients with coronary risk factors or disease. Each participant viewed one of 16 vignettes depicting a physician reviewing cardiac catheterization results and recommending coronary artery bypass graft (CABG) surgery. Vignettes varied only in terms of physicians’ race, gender, age, and communication style (high vs. low Patient-centeredness). Participants rated the video physician’s communication, interpersonal style, competence, trustworthiness, likability, and overall performance (0–4 Likert scales). They also rated the necessity of CABG (0–5 scale) and whether they would undergo CABG or obtain a second opinion if they were the video Patient (0–3 scales). Participants included 107 black and 131 white Patients (72% participation rate). Black participants viewing a black (vs. white) video physician gave higher ratings on all physician attributes (e.g., overall rating 3.22 vs. 2.34, p
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impact of physician race on Patient Decision Making and ratings of physicians a randomized experiment using video vignettes
Journal of General Internal Medicine, 2020Co-Authors: Somnath Saha, Mary Catherine BeachAbstract:Studies suggest that black Patients have better interactions, on average, with physicians of their own race. Whether this reflects greater “cultural competence” in race-concordant relationships, or other effects of race unrelated to physician behavior, is unclear. It is also unclear if physician race influences Patient Decision-Making. To determine whether physician race affects Patients’ ratings of physicians and Decision-Making, independent of physician behavior. Randomized study using standardized video vignettes. Primary care Patients with coronary risk factors or disease. Each participant viewed one of 16 vignettes depicting a physician reviewing cardiac catheterization results and recommending coronary artery bypass graft (CABG) surgery. Vignettes varied only in terms of physicians’ race, gender, age, and communication style (high vs. low Patient-centeredness). Participants rated the video physician’s communication, interpersonal style, competence, trustworthiness, likability, and overall performance (0–4 Likert scales). They also rated the necessity of CABG (0–5 scale) and whether they would undergo CABG or obtain a second opinion if they were the video Patient (0–3 scales). Participants included 107 black and 131 white Patients (72% participation rate). Black participants viewing a black (vs. white) video physician gave higher ratings on all physician attributes (e.g., overall rating 3.22 vs. 2.34, p < 0.001) and were more likely to perceive CABG as necessary (4.05 vs. 3.72, p = 0.03) and say they would undergo CABG if they were the video Patient (2.43 vs. 2.09, p = 0.004). Patient-centered communication style reduced, but did not eliminate, the impact of race concordance. Physician race was not associated with any outcomes among white Patients. Black Patients viewed the doctor in a scripted vignette more positively, and were more receptive to the same recommendation, communicated in the same way, with a black vs. white physician. Patient-centered communication reduced but did not eliminate the effect of physician race.
George E Fowler - One of the best experts on this subject based on the ideXlab platform.
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A systematic review of online resources to support Patient Decision-Making for full-thickness rectal prolapse surgery.
Techniques in coloproctology, 2017Co-Authors: George E Fowler, D. Baker, Matthew Lee, Steven R BrownAbstract:The internet is becoming an increasingly popular resource to support Patient Decision-Making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support Patient Decision-Making for full-thickness rectal prolapse surgery. This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist Decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch–Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0). Overall, 95 sources were from Google and the specialist Decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch–Kincaid Reading Ease score was higher than recommended for Patient education materials (48.8 ± 15.6, range 25.2–85.3). Overall quality of sources supporting Patient Decision-Making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1–5). No sources met minimum Decision-Making standards (median IPDASi score 5/12 ± 2.01, range 1–8). Currently, easily accessible online health information to support Patient Decision-Making for rectal surgery is of poor quality, difficult to read and does not support shared Decision-Making. It is recommended that professional bodies and medical professionals seek to develop Decision aids to support Decision-Making for full-thickness rectal prolapse surgery.
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A systematic review of online resources to support Patient Decision-Making for full-thickness rectal prolapse surgery
Techniques in Coloproctology, 2017Co-Authors: George E Fowler, D. M. Baker, M. J. Lee, Steven R BrownAbstract:Background The internet is becoming an increasingly popular resource to support Patient Decision-Making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support Patient Decision-Making for full-thickness rectal prolapse surgery. Methods This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist Decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch–Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0). Results Overall, 95 sources were from Google and the specialist Decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch–Kincaid Reading Ease score was higher than recommended for Patient education materials (48.8 ± 15.6, range 25.2–85.3). Overall quality of sources supporting Patient Decision-Making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1–5). No sources met minimum Decision-Making standards (median IPDASi score 5/12 ± 2.01, range 1–8). Conclusions Currently, easily accessible online health information to support Patient Decision-Making for rectal surgery is of poor quality, difficult to read and does not support shared Decision-Making. It is recommended that professional bodies and medical professionals seek to develop Decision aids to support Decision-Making for full-thickness rectal prolapse surgery.
D. M. Baker - One of the best experts on this subject based on the ideXlab platform.
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A systematic review of online resources to support Patient Decision-Making for full-thickness rectal prolapse surgery
Techniques in Coloproctology, 2017Co-Authors: George E Fowler, D. M. Baker, M. J. Lee, Steven R BrownAbstract:Background The internet is becoming an increasingly popular resource to support Patient Decision-Making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support Patient Decision-Making for full-thickness rectal prolapse surgery. Methods This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist Decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch–Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0). Results Overall, 95 sources were from Google and the specialist Decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch–Kincaid Reading Ease score was higher than recommended for Patient education materials (48.8 ± 15.6, range 25.2–85.3). Overall quality of sources supporting Patient Decision-Making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1–5). No sources met minimum Decision-Making standards (median IPDASi score 5/12 ± 2.01, range 1–8). Conclusions Currently, easily accessible online health information to support Patient Decision-Making for rectal surgery is of poor quality, difficult to read and does not support shared Decision-Making. It is recommended that professional bodies and medical professionals seek to develop Decision aids to support Decision-Making for full-thickness rectal prolapse surgery.
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Assessing internet-based information used to aid Patient Decision-Making about surgery for perianal Crohn’s fistula
Techniques in Coloproctology, 2017Co-Authors: J. H. Marshall, D. M. Baker, G. L. Jones, A. J. Lobo, S. R. BrownAbstract:Background Decision-Making in perianal Crohn’s fistula (pCD) is preference sensitive. Patients use the internet to access healthcare information. The aim of this study was to assess the online information and Patient Decision aids relating to surgery for pCD. Methods A search of Google™ and the Decision Aids Library Inventory (DALI) was performed using a predefined search strategy. Patient-focussed sources providing information about pCD surgery were included in the analysis. Written health information was assessed using the International Patient Decision Aids Standards (IPDAS) and DISCERN criteria. The readability of the source content was assessed using the Flesch–Kincaid score. Results Of the 201 sources found, 187 were excluded, leaving 14 sources for analysis. Three sources were dedicated to pCD, and six sources mentioned pCD-specific outcomes. The most common surgical intervention reported was seton insertion ( n = 13). The least common surgical intervention reported was proctectomy ( n = 1). The mean IPDAS and DISCERN scores were 4.43 ± 1.65 out of 12 (range = 2–8) and 2.93 ± 0.73 out of 5 (range = 1–5), respectively. The mean reading ease was US college standard. Conclusions We found no Patient Decision aids relating to surgery for pCD. The online sources relating to surgery for pCD are few, and their quality is poor, as seen in the low IPDAS and DISCERN scores. Less than half of the sources mentioned pCD-specific outcomes, and three sources were solely dedicated to providing information on pCD. Healthcare professionals should look to create a Patient tool to assist Decision-Making in pCD.