| Title: |
Artificial intelligence-generated feedback on social signals in patient–provider communication: technical performance, feedback usability, and impact |
| Authors: |
Bedmutha, Manas Satish; Bascom, Emily; Sladek, Kimberly R; Tobar, Kelly; Casanova-Perez, Reggie; Andreiu, Alexandra; Bhat, Amrit; Mangal, Sabrina; Wood, Brian R; Sabin, Janice; Pratt, Wanda; Weibel, Nadir; Hartzler, Andrea L |
| Source: |
JAMIA Open, vol 7, iss 4 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2024 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
4203 Health Services and Systems (for-2020); 42 Health Sciences (for-2020); Behavioral and Social Science (rcdc); Machine Learning and Artificial Intelligence (rcdc); Networking and Information Technology R&D (NITRD) (rcdc); Clinical Research (rcdc); Health Services (rcdc); Health Disparities (rcdc); 3 Good Health and Well Being (sdg); nonverbal communication; social interaction; interpersonal relations; primary health care/patient-centered care; artificial intelligence; |
| Description: |
Objectives: Implicit bias perpetuates health care inequities and manifests in patient-provider interactions, particularly nonverbal social cues like dominance. We investigated the use of artificial intelligence (AI) for automated communication assessment and feedback during primary care visits to raise clinician awareness of bias in patient interactions. Materials and Methods: (1) Assessed the technical performance of our AI models by building a machine-learning pipeline that automatically detects social signals in patient-provider interactions from 145 primary care visits. (2) Engaged 24 clinicians to design usable AI-generated communication feedback for their workflow. (3) Evaluated the impact of our AI-based approach in a prospective cohort of 108 primary care visits. Results: Findings demonstrate the feasibility of AI models to identify social signals, such as dominance, warmth, engagement, and interactivity, in nonverbal patient-provider communication. Although engaged clinicians preferred feedback delivered in personalized dashboards, they found nonverbal cues difficult to interpret, motivating social signals as an alternative feedback mechanism. Impact evaluation demonstrated fairness in all AI models with better generalizability of provider dominance, provider engagement, and patient warmth. Stronger clinician implicit race bias was associated with less provider dominance and warmth. Although clinicians expressed overall interest in our AI approach, they recommended improvements to enhance acceptability, feasibility, and implementation in telehealth and medical education contexts. Discussion and Conclusion: Findings demonstrate promise for AI-driven communication assessment and feedback systems focused on social signals. Future work should improve the performance of this approach, personalize models, and contextualize feedback, and investigate system implementation in educational workflows. This work exemplifies a systematic, multistage approach for evaluating AI tools designed to raise clinician ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt4vd8c4cd; https://escholarship.org/uc/item/4vd8c4cd; https://escholarship.org/content/qt4vd8c4cd/qt4vd8c4cd.pdf |
| DOI: |
10.1093/jamiaopen/ooae106 |
| Availability: |
https://escholarship.org/uc/item/4vd8c4cd; https://escholarship.org/content/qt4vd8c4cd/qt4vd8c4cd.pdf; https://doi.org/10.1093/jamiaopen/ooae106 |
| Rights: |
CC-BY-NC |
| Accession Number: |
edsbas.A003E8FA |
| Database: |
BASE |