A Linguistic Examination Of Information Framing In Physician-Patient Conversations

Fridman, I, Fagerlin, A, Scherr, K, Scherer, L, Kanze, D and Huffstetler, H (2020) A Linguistic Examination Of Information Framing In Physician-Patient Conversations. In: 41st Annual Meeting of the Society for Medical Decision Making Portland,, October 20-23, 2019, Portland, Oregon.

Abstract

Purpose: When discussing risks and benefits with cancer patients, physicians could focus on losses such as mortality rates and recurrence or, alternatively, gains such as survival rates and curing cancer. Previous research has shown that the way health information is framed influences individuals’ preferences and choices 1. We developed dictionaries for automated text analysis and ran exploratory analysis investigating whether and when framing manifests in actual physician-patient conversations and how often only one (gain) or another (loss) frame dominates the conversation.

Methods: We analyzed transcribed consultations with patients who had low- or intermediate-risk prostate cancer. Using Linguistic Inquiry and Word Count (LIWC) software, we calculated the number of words describing gains or losses. We ran a regression analysis exploring framing in the communications.

Results: Our analysis revealed that on average, physicians use more words related to gains than losses. Furthermore, we found that the frame of the conversation shifts depending on the type of recommendation the physician offered during the consultation. Physicians who recommended immediate active treatment for prostate cancer (versus active surveillance) used marginally fewer loss words and significantly fewer words related to death. Exploratory analyses showed that words associated with losses and death were correlated with patient choice of active treatment (versus active surveillance).

Conclusion: The frequency of loss words in physicians’ explanations was correlated with physicians’ recommendations and patients choices. We discuss theoretical implications and suggest directions for further research.