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The validity of using analogue patients in practitioner-patient communication research: systematic review and meta-analysis.

van Vliet LM, van der Wall E, Albada A, Spreeuwenberg PM, Verheul W, Bensing JM - J Gen Intern Med (2012)

Bottom Line: Thirty-four studies were included, comprising both scripted and clinical studies, of average-to-superior quality.The meta-analysis revealed that analogue patients' evaluations of practitioners' communication are not subject to ceiling effects.Analogue patients' evaluations of communication equaled clinical patients' perceptions, while overcoming ceiling effects.

View Article: PubMed Central - PubMed

Affiliation: NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BN, Utrecht, The Netherlands. l.vanvliet@nivel.nl

ABSTRACT
When studying the patient perspective on communication, some studies rely on analogue patients (patients and healthy subjects) who rate videotaped medical consultations while putting themselves in the shoes of the video-patient. To describe the rationales, methodology, and outcomes of studies using video-vignette designs in which videotaped medical consultations are watched and judged by analogue patients. Pubmed, Embase, Psychinfo and CINAHL databases were systematically searched up to February 2012. Data was extracted on: study characteristics and quality, design, rationales, internal and external validity, limitations and analogue patients' perceptions of studied communication. A meta-analysis was conducted on the distribution of analogue patients' evaluations of communication. Thirty-four studies were included, comprising both scripted and clinical studies, of average-to-superior quality. Studies provided unspecific, ethical as well as methodological rationales for conducting video-vignette studies with analogue patients. Scripted studies provided the most specific methodological rationales and tried the most to increase and test internal validity (e.g. by performing manipulation checks) and external validity (e.g. by determining identification with video-patient). Analogue patients' perceptions of communication largely overlap with clinical patients' perceptions. The meta-analysis revealed that analogue patients' evaluations of practitioners' communication are not subject to ceiling effects. Analogue patients' evaluations of communication equaled clinical patients' perceptions, while overcoming ceiling effects. This implies that analogue patients can be included as proxies for clinical patients in studies on communication, taken some described precautions into account. Insights from this review may ease decisions about including analogue patients in video-vignette studies, improve the quality of these studies and increase knowledge on communication from the patient perspective.

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PRISMA flowchart of the inclusion procedure.
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Related In: Results  -  Collection


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Fig1: PRISMA flowchart of the inclusion procedure.

Mentions: The 2950 references initially found were reviewed on title/abstract (and if necessary on full-text) to determine whether they: a) were about communication, b) used a video-vignette design, c) included APs. A random 10 % of the articles were independently checked on these criteria by two authors (LV and JB); interrater agreement exceeded 95 %. Thirty-four articles met these criteria and a forward- and backward reference search was performed. Four hundred and fifty-two new articles were reviewed in the aforementioned manner, resulting in 32 additional articles. These 66 articles were explored full-text on the final criteria: a) a focus on doctor/nurse-patient communication, b) inclusion of APs who viewed videos and judged the communication. Thirty-four articles met all criteria. Their references were hand-searched, resulting in four extra articles. Accordingly, 38 articles were included (see Fig. 1) that were based on 34 studies; some studies produced multiple articles.21–28Figure 1.


The validity of using analogue patients in practitioner-patient communication research: systematic review and meta-analysis.

van Vliet LM, van der Wall E, Albada A, Spreeuwenberg PM, Verheul W, Bensing JM - J Gen Intern Med (2012)

PRISMA flowchart of the inclusion procedure.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3475831&req=5

Fig1: PRISMA flowchart of the inclusion procedure.
Mentions: The 2950 references initially found were reviewed on title/abstract (and if necessary on full-text) to determine whether they: a) were about communication, b) used a video-vignette design, c) included APs. A random 10 % of the articles were independently checked on these criteria by two authors (LV and JB); interrater agreement exceeded 95 %. Thirty-four articles met these criteria and a forward- and backward reference search was performed. Four hundred and fifty-two new articles were reviewed in the aforementioned manner, resulting in 32 additional articles. These 66 articles were explored full-text on the final criteria: a) a focus on doctor/nurse-patient communication, b) inclusion of APs who viewed videos and judged the communication. Thirty-four articles met all criteria. Their references were hand-searched, resulting in four extra articles. Accordingly, 38 articles were included (see Fig. 1) that were based on 34 studies; some studies produced multiple articles.21–28Figure 1.

Bottom Line: Thirty-four studies were included, comprising both scripted and clinical studies, of average-to-superior quality.The meta-analysis revealed that analogue patients' evaluations of practitioners' communication are not subject to ceiling effects.Analogue patients' evaluations of communication equaled clinical patients' perceptions, while overcoming ceiling effects.

View Article: PubMed Central - PubMed

Affiliation: NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BN, Utrecht, The Netherlands. l.vanvliet@nivel.nl

ABSTRACT
When studying the patient perspective on communication, some studies rely on analogue patients (patients and healthy subjects) who rate videotaped medical consultations while putting themselves in the shoes of the video-patient. To describe the rationales, methodology, and outcomes of studies using video-vignette designs in which videotaped medical consultations are watched and judged by analogue patients. Pubmed, Embase, Psychinfo and CINAHL databases were systematically searched up to February 2012. Data was extracted on: study characteristics and quality, design, rationales, internal and external validity, limitations and analogue patients' perceptions of studied communication. A meta-analysis was conducted on the distribution of analogue patients' evaluations of communication. Thirty-four studies were included, comprising both scripted and clinical studies, of average-to-superior quality. Studies provided unspecific, ethical as well as methodological rationales for conducting video-vignette studies with analogue patients. Scripted studies provided the most specific methodological rationales and tried the most to increase and test internal validity (e.g. by performing manipulation checks) and external validity (e.g. by determining identification with video-patient). Analogue patients' perceptions of communication largely overlap with clinical patients' perceptions. The meta-analysis revealed that analogue patients' evaluations of practitioners' communication are not subject to ceiling effects. Analogue patients' evaluations of communication equaled clinical patients' perceptions, while overcoming ceiling effects. This implies that analogue patients can be included as proxies for clinical patients in studies on communication, taken some described precautions into account. Insights from this review may ease decisions about including analogue patients in video-vignette studies, improve the quality of these studies and increase knowledge on communication from the patient perspective.

Show MeSH