UnBIASED: Understanding Biased patient-provider Interaction And Supporting Enhanced Discourse

项目摘要/摘要 这个项目通过研究一种新的计算方法来解决健康差距，这种方法使隐含的、 因此，隐藏的，偏见是可见的。医疗保健偏见，基于患者的种族、性别、社会经济地位、性别 取向和其他特征导致健康差距。这种偏见往往是无意的和隐藏的。 在临床医生和患者之间的沟通中。尽管医疗保健偏向需要广泛的共识 为了更好地理解、评估和缓解，传统的临床沟通培训和评估是 从实际的患者与提供者之间的互动中剔除偏见。为了缩小健康差距，我们建议 社交信号处理(SSP)技术，可在患者就诊期间自动评估隐藏的偏见。 SSP涉及对细微提示(例如，通话时间、中断、身体移动)的机器分析和反馈， 反映沟通的质量。这项技术将自动捕获非语言、语言和 在患者与提供者的互动中提供情感暗示，然后提供改进反馈，设计于 与患者和提供者合作。在以人为本的设计指导下，我们将从事低收入、种族 不同的患者和他们的提供者告知设计SSP评估的视觉反馈，然后 评估这项新技术在模拟和真实世界遭遇中的效果。利用我们的 我们的两个调查地点--华盛顿大学和 加州大学圣地亚哥分校，我们将与这两个地点的学术和社区卫生诊所合作 让服务不足的患者和提供者参与三个具体目标：建立具有以下特点的SSP模式 临床医生和健康差距患者之间的沟通质量(目标1)，设计SSP反馈，传达 隐藏对患者和提供者的偏见(目标2)，并评估SSP技术在受控和真实中的效果 世界临床环境(目标3)。这些发现将带来对与隐藏的偏见相关的社会信号的洞察， 可以在患者访问期间自动检测，为两者提供有效的SSP反馈设计建议 提供者和患者，以及SSP技术改进的技术有效性和有效性的证据 患者和提供者体验以患者为中心的护理。为了缩小健康差距，患者和提供者 需要无偏见的互动。该项目将贡献一种使用SSP的新计算范例，它将带来 以人为中心对医疗沟通中显露并导致健康的隐性偏见的可见性 差距。新的SSP将推进生物医学信息学和健康差异研究 面向下一代医疗保健提供者和教育工作者的方法，增强健康差距患者的能力，以及 促进医疗质量和公平。通过以人为中心的SSP带来隐藏的偏见的可见性 重大承诺，特别是在以患者为中心的沟通对建立融洽关系至关重要的医疗保健领域， 建立值得信赖的患者-提供者关系，促进公平，并最终缩小健康差距。

PROJECT SUMMARY/ABSTRACT This project addresses health disparities by investigating a novel computational approach that makes implicit, thus hidden, bias visible. Healthcare bias, based on patients’ race, gender, socioeconomic status, sexual orientation, and other characteristics lead to health disparities. Such biases are often unintentional and hidden in communication among clinicians and patients. Although there is broad agreement that healthcare biases need to be better understood, assessed and mitigated, traditional clinical communication training and assessment is removed from actual patient-provider interactions in which bias hides. To mitigate health disparities, we propose social signal processing (SSP) technology that automatically assesses hidden bias during patient encounters. SSP involves machine analysis and feedback on subtle cues (e.g., talk time, interruptions, body movement) that reflect the quality of communication. This technology will automatically capture nonverbal, linguistic, and affective, cues in patient-provider interactions and then provide feedback for improvement, designed in collaboration with patients and providers. Guided by human-centered design, we will engage low income, racially diverse patients and their providers to inform the design of visual feedback from SSP assessment, and then evaluate the efficacy of this novel technology in both simulated and real world encounters. Leveraging our preliminary work and multidisciplinary expertise from our two investigative sites, University of Washington and University of California San Diego, we will partner with academic and community health clinics at both sites to engage underserved patients and providers in three specific aims to: build an SSP model that characterizes communication quality among clinicians and health disparity patients (Aim 1), design SSP feedback that conveys hidden bias to patients and providers (Aim 2), and evaluate the efficacy of SSP technology in controlled and real world clinical settings (Aim 3). Findings will bring insight into social signals associated with hidden bias that we can automatically detect during patient visits, design recommendations for effective SSP feedback for both providers and patients, and evidence on the technical validity and efficacy of SSP technology for improving patient and provider experience of patient-centered care. To mitigate health disparities, patients and providers need unbiased interactions. This project will contribute a novel computational paradigm using SSP that brings human-centered visibility to implicit biases that manifest in healthcare communication and lead to health disparities. Findings will advance biomedical informatics and health disparities research with a novel SSP approach for the next generation of healthcare providers and educators, empower health disparity patients, and promote healthcare quality and equity. Bringing visibility to hidden bias though human-centered SSP has significant promise, particularly in healthcare where patient-centered communication is critical to building rapport, establishing trusted patient-provider relationships, promoting equity, and ultimately mitigating health disparities.