Department of Pharmacy, Uppsala University, Uppsala, Sweden.
Psychooncology. 2011 Sep;20(9):992-1000. doi: 10.1002/pon.1808. Epub 2010 Jul 28.
The aim was to assess the feasibility and reliability of Velikova's Content Analysis System (VCAS) and the Medical Interaction Process System (MIPS) global scale for evaluation of communication in oncology care.
Seventy routine physician consultations with gastro-intestinal (GI) cancer patients were audio-recorded. Two coders applied VCAS and MIPS global scale to the consultations. VCAS captures aspects of communication like symptoms, side effects, functional issues (e.g. emotional, social, physical), health-related quality of life and medical decision making. MIPS global scale measures the total impression of the consultation, e.g. patient centredness and psychosocial focus.
In total, 61 of 70 consultations were coded. The coding took twice the consultations' actual durations in minutes for VCAS. The time for coding MIPS global scale equalled the consultations length. However, the coder had then listened to the consultation twice before, coding for VCAS. Cohen's kappa for all aspects measured by VCAS varied between 0.20 and 1, mean 0.80. One category (Info on test) had a kappa of 0.20, the other categories were all above 0.60. Weighted Kappa for MIPS global scale varied between 0.25 and 0.73, mean 0.42.
VCAS and MIPS global scale is a feasible combination of tools for evaluating patient-physician communication regarding content, medical decision making and global aspects of communication. VCAS showed high reliability. The MIPS global scale showed lower reliability, due to its sensitivity to the individual coders' unique values, common for all global scales. Further development of the combination of content and global instruments would be valuable.
评估 Velikova 的内容分析系统（VCAS）和医学互动过程系统（MIPS）全球量表用于评估肿瘤护理中沟通的可行性和可靠性。
对 70 例胃肠道（GI）癌症患者的常规医生咨询进行音频记录。两名编码员将 VCAS 和 MIPS 全球量表应用于咨询。VCAS 捕捉沟通的各个方面，如症状、副作用、功能问题（如情绪、社会、身体）、健康相关生活质量和医疗决策。MIPS 全球量表衡量咨询的总体印象，如以患者为中心和社会心理焦点。
总共对 70 次咨询中的 61 次进行了编码。VCAS 的编码时间是咨询实际持续时间的两倍。编码 MIPS 全球量表的时间与咨询时间相等。但是，在编码 VCAS 之前，编码员已经听了两次咨询。VCAS 测量的所有方面的 Cohen's kappa 介于 0.20 到 1 之间，平均值为 0.80。一个类别（测试信息）的 kappa 值为 0.20，其他类别均高于 0.60。MIPS 全球量表的加权 Kappa 介于 0.25 和 0.73 之间，平均值为 0.42。
VCAS 和 MIPS 全球量表是评估医患沟通内容、医疗决策和沟通全局方面的可行工具组合。VCAS 具有很高的可靠性。MIPS 全球量表的可靠性较低，因为它对每个编码员独特价值观的敏感性，这对所有全球量表都很常见。进一步开发内容和全球工具的组合将是有价值的。
