Beyond readability: investigating coherence of clinical text for consumers.
Beyond readability: investigating coherence of clinical text for consumers.
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DOI：
10.2196/jmir.1842
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发表时间：
2011-12-02
影响因子：
7.4
通讯作者：
Keselman A
中科院分区：
文献类型：
--
作者：
Smith CA;Hetzel S;Dalrymple P;Keselman A
消费者健康信息学的一个基本原则是，可理解的健康资源赋予公众权力。文本理解具有很大的希望，有助于描述消费者在理解健康文本方面的问题。需要有效的方法来评估面向消费者的健康文本和计算支持的工具的可用性，使我们探索各种文本特征对读者理解健康文本的影响，以及开发新的方法来评估这些特征。本研究的目的是比较两种不同的方法，以提高可读性的影响，和三种干预措施，对个人的理解简短，复杂的健康文本的段落。参与者是80名大学工作人员，教师或学生。每个参与者被要求“复述”两篇健康文章的内容：一篇是糖尿病领域的临床试验，另一篇是典型的访问记录。将这些文本转换为研究的干预组。两项干预措施通过（1）标准词典或（2）语境化词汇定义提供术语支持。第三项干预措施改善了一致性。我们通过命题分析、开放式问卷和错误数量分析来评估参与者对临床文本的理解。对于临床试验文本，文本条件的影响在任何比较中都不显着，这表明尽管支持程度不同，但回忆没有差异（P = 0.84）。然而，对于访视记录，连贯和（原始+词典）条件之间回忆的中位总命题的差异是显著的（P = .04）。这表明，在连贯条件下的参与者回忆起更多的原始访问笔记的内容比参与者在原始和字典条件的总和。然而，在（原文+词典）和词汇（P = .36）以及连贯和词汇（P = .62）之间没有发现差异。在开放式问卷（临床试验：P = .86，访视说明：P = .20）或错误率（临床试验：P = .47，访视说明：P = .25）中，未发现任何文件转换的统计学显著影响。然而，事后功效分析表明，每种条件增加约6名参与者的样本量将导致访视记录出现显着差异，但临床试验文本不会出现显着差异。从统计学上看，本研究的结果证明，提高连贯性对消费者理解临床文本的影响很小，但这项任务是非常劳动密集型的，不可扩展。需要进一步的研究，使用文本从更多样化的临床领域和更异质的参与者，包括实际的病人。由于临床文本的可理解性似乎很难自动化，信息学支持工具可能最有效地支持医疗保健专业人员的任务是使患者能够理解临床信息。
A basic tenet of consumer health informatics is that understandable health resources empower the public. Text comprehension holds great promise for helping to characterize consumer problems in understanding health texts. The need for efficient ways to assess consumer-oriented health texts and the availability of computationally supported tools led us to explore the effect of various text characteristics on readers’ understanding of health texts, as well as to develop novel approaches to assessing these characteristics. The goal of this study was to compare the impact of two different approaches to enhancing readability, and three interventions, on individuals’ comprehension of short, complex passages of health text. Participants were 80 university staff, faculty, or students. Each participant was asked to “retell” the content of two health texts: one a clinical trial in the domain of diabetes mellitus, and the other typical Visit Notes. These texts were transformed for the intervention arms of the study. Two interventions provided terminology support via (1) standard dictionary or (2) contextualized vocabulary definitions. The third intervention provided coherence improvement. We assessed participants’ comprehension of the clinical texts through propositional analysis, an open-ended questionnaire, and analysis of the number of errors made. For the clinical trial text, the effect of text condition was not significant in any of the comparisons, suggesting no differences in recall, despite the varying levels of support (P = .84). For the Visit Note, however, the difference in the median total propositions recalled between the Coherent and the (Original + Dictionary) conditions was significant (P = .04). This suggests that participants in the Coherent condition recalled more of the original Visit Notes content than did participants in the Original and the Dictionary conditions combined. However, no difference was seen between (Original + Dictionary) and Vocabulary (P = .36) nor Coherent and Vocabulary (P = .62). No statistically significant effect of any document transformation was found either in the open-ended questionnaire (clinical trial: P = .86, Visit Note: P = .20) or in the error rate (clinical trial: P = .47, Visit Note: P = .25). However, post hoc power analysis suggested that increasing the sample size by approximately 6 participants per condition would result in a significant difference for the Visit Note, but not for the clinical trial text. Statistically, the results of this study attest that improving coherence has a small effect on consumer comprehension of clinical text, but the task is extremely labor intensive and not scalable. Further research is needed using texts from more diverse clinical domains and more heterogeneous participants, including actual patients. Since comprehensibility of clinical text appears difficult to automate, informatics support tools may most productively support the health care professionals tasked with making clinical information understandable to patients.
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影响因子：
4.9
作者：
BRITTON, BK;GULGOZ, S
通讯作者：
GULGOZ, S
DOI：
10.1016/s0738-3991(80)80022-x
发表时间：
1980-01-01
期刊：
PATIENT COUNSELLING AND HEALTH EDUCATION
影响因子：
--
作者：
FISCHBACH, RL;SIONELOBAYOG, A;DELBANCO, TL
通讯作者：
DELBANCO, TL
影响因子：
3.3
作者：
Linderholm, T;Everson, MG;Samuels, J
通讯作者：
Samuels, J
DOI：
10.1197/jamia.m2599
发表时间：
2008-07-01
影响因子：
6.4
作者：
Keselman, Alla;Smith, Catherine Arnott;Zeng-Treitler, Qing
通讯作者：
Zeng-Treitler, Qing
影响因子：
2.2
作者：
McNamara, Danielle S.;Louwerse, Max M.;Graesser, Arthur C.
通讯作者：
Graesser, Arthur C.