de Lusignan Simon, Wilson Eben, Dyble Andy, Grant Tristan, Theadom Alice, Chan Tom
Primary Care Informatics, Department of Community Health Sciences, Hunter Wing, St George's Hospital Medical School, London, SW17 ORE, UK.
BMC Med Inform Decis Mak. 2003 Nov 26;3:12. doi: 10.1186/1472-6947-3-12.
A key feature of a good general practice consultation is that it is patient-centred. A number of verbal and non-verbal behaviours have been identified as important to establish a good relationship with the patient. However, the use of the computer detracts the doctor's attention away from the patient, compromising these essential elements of the consultation. Current methods to assess the consultation and the influence of the computer on them are time consuming and subjective. If it were possible to measure these quantitatively, it could provide the basis for the first truly objective way of studying the influence of the computer on the consultation. The aim was to assess whether pattern recognition software could be used to measure the influence and pattern of computer use in the consultation. If this proved possible it would provide, for the first time, an objective quantitative measure of computer use and a measure of the attention and responsiveness of the general practitioner towards the patient.
A feasibility study using pattern recognition software to analyse a consultation was conducted. A web camera, linked to a data-gathering node was used to film a simulated consultation in a standard office. Members of the research team enacted the role of the doctor and the patient, using pattern recognition software to try and capture patient-centred, non-verbal behaviour. As this was a feasibility study detailed results of the analysis are not presented.
It was revealed that pattern recognition software could be used to analyse certain aspects of a simulated consultation. For example, trigger lines enabled the number of times the clinician's hand covered the keyboard to be counted and wrapping recorded the number of times the clinician nodded his head. It was also possible to measure time sequences and whether the movement was brief or lingering.
Pattern recognition software enables movements associated with patient-centredness to be recorded. Pattern recognition software has the potential to provide an objective, quantitative measure of the influence of the computer on the consultation.
一次良好的全科医疗咨询的关键特征是以患者为中心。一些言语和非言语行为已被确定为与患者建立良好关系的重要因素。然而，使用电脑会分散医生对患者的注意力，损害咨询的这些基本要素。目前评估咨询以及电脑对其影响的方法既耗时又主观。如果能够对这些进行量化测量，就可以为首次真正客观地研究电脑对咨询的影响提供依据。目的是评估模式识别软件是否可用于测量咨询中电脑的使用影响和模式。如果证明可行，它将首次提供电脑使用的客观量化指标以及全科医生对患者的关注度和反应能力的指标。
开展了一项使用模式识别软件分析咨询的可行性研究。一个与数据收集节点相连的网络摄像头被用于在标准办公室拍摄一次模拟咨询。研究团队成员扮演医生和患者的角色，使用模式识别软件尝试捕捉以患者为中心的非言语行为。由于这是一项可行性研究，未展示详细的分析结果。
结果表明，模式识别软件可用于分析模拟咨询的某些方面。例如，触发线可以统计临床医生的手覆盖键盘的次数，而包裹功能记录临床医生点头的次数。还可以测量时间序列以及动作是短暂的还是持续的。
模式识别软件能够记录与以患者为中心相关的动作。模式识别软件有可能提供电脑对咨询影响的客观、量化指标。
