Analysis of threats to research validity introduced by audio recording clinic visits: Selection bias, Hawthorne effect, both, or neither?

Stephen G Henry, Anthony F Jerant, Ana-Maria Iosif, Mitchell D. Feldman, Camille Cipri, Richard L Kravitz

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: To identify factors associated with participant consent to record visits; to estimate effects of recording on patient-clinician interactions. Methods: Secondary analysis of data from a randomized trial studying communication about depression; participants were asked for optional consent to audio record study visits. Multiple logistic regression was used to model likelihood of patient and clinician consent. Multivariable regression and propensity score analyses were used to estimate effects of audio recording on 6 dependent variables: discussion of depressive symptoms, preventive health, and depression diagnosis; depression treatment recommendations; visit length; visit difficulty. Results: Of 867 visits involving 135 primary care clinicians, 39% were recorded. For clinicians, only working in academic settings (P = 0.003) and having worked longer at their current practice (P = 0.02) were associated with increased likelihood of consent. For patients, white race (P = 0.002) and diabetes (P = 0.03) were associated with increased likelihood of consent. Neither multivariable regression nor propensity score analyses revealed any significant effects of recording on the variables examined. Conclusion: Few clinician or patient characteristics were significantly associated with consent. Audio recording had no significant effect on any of the 6 dependent variables examined. Practice implications: Benefits of recording clinic visits likely outweigh the risks of bias in this setting.

Original languageEnglish (US)
Pages (from-to)849-856
Number of pages8
JournalPatient Education and Counseling
Volume98
Issue number7
DOIs
StatePublished - Jul 1 2015

Fingerprint

Epidemiologic Effect Modifiers
Selection Bias
Ambulatory Care
Depression
Propensity Score
Research
Primary Health Care
Logistic Models
Communication
Health

Keywords

  • Audio recording
  • Consent
  • Depression
  • Hawthorne effect
  • Primary care
  • Selection bias

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{f4aa1ac3fb9e42c586f0dfe4c4b54a5f,
title = "Analysis of threats to research validity introduced by audio recording clinic visits: Selection bias, Hawthorne effect, both, or neither?",
abstract = "Objective: To identify factors associated with participant consent to record visits; to estimate effects of recording on patient-clinician interactions. Methods: Secondary analysis of data from a randomized trial studying communication about depression; participants were asked for optional consent to audio record study visits. Multiple logistic regression was used to model likelihood of patient and clinician consent. Multivariable regression and propensity score analyses were used to estimate effects of audio recording on 6 dependent variables: discussion of depressive symptoms, preventive health, and depression diagnosis; depression treatment recommendations; visit length; visit difficulty. Results: Of 867 visits involving 135 primary care clinicians, 39{\%} were recorded. For clinicians, only working in academic settings (P = 0.003) and having worked longer at their current practice (P = 0.02) were associated with increased likelihood of consent. For patients, white race (P = 0.002) and diabetes (P = 0.03) were associated with increased likelihood of consent. Neither multivariable regression nor propensity score analyses revealed any significant effects of recording on the variables examined. Conclusion: Few clinician or patient characteristics were significantly associated with consent. Audio recording had no significant effect on any of the 6 dependent variables examined. Practice implications: Benefits of recording clinic visits likely outweigh the risks of bias in this setting.",
keywords = "Audio recording, Consent, Depression, Hawthorne effect, Primary care, Selection bias",
author = "Henry, {Stephen G} and Jerant, {Anthony F} and Ana-Maria Iosif and Feldman, {Mitchell D.} and Camille Cipri and Kravitz, {Richard L}",
year = "2015",
month = "7",
day = "1",
doi = "10.1016/j.pec.2015.03.006",
language = "English (US)",
volume = "98",
pages = "849--856",
journal = "Patient Education and Counseling",
issn = "0738-3991",
publisher = "Elsevier Ireland Ltd",
number = "7",

}

TY - JOUR

T1 - Analysis of threats to research validity introduced by audio recording clinic visits

T2 - Selection bias, Hawthorne effect, both, or neither?

AU - Henry, Stephen G

AU - Jerant, Anthony F

AU - Iosif, Ana-Maria

AU - Feldman, Mitchell D.

AU - Cipri, Camille

AU - Kravitz, Richard L

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Objective: To identify factors associated with participant consent to record visits; to estimate effects of recording on patient-clinician interactions. Methods: Secondary analysis of data from a randomized trial studying communication about depression; participants were asked for optional consent to audio record study visits. Multiple logistic regression was used to model likelihood of patient and clinician consent. Multivariable regression and propensity score analyses were used to estimate effects of audio recording on 6 dependent variables: discussion of depressive symptoms, preventive health, and depression diagnosis; depression treatment recommendations; visit length; visit difficulty. Results: Of 867 visits involving 135 primary care clinicians, 39% were recorded. For clinicians, only working in academic settings (P = 0.003) and having worked longer at their current practice (P = 0.02) were associated with increased likelihood of consent. For patients, white race (P = 0.002) and diabetes (P = 0.03) were associated with increased likelihood of consent. Neither multivariable regression nor propensity score analyses revealed any significant effects of recording on the variables examined. Conclusion: Few clinician or patient characteristics were significantly associated with consent. Audio recording had no significant effect on any of the 6 dependent variables examined. Practice implications: Benefits of recording clinic visits likely outweigh the risks of bias in this setting.

AB - Objective: To identify factors associated with participant consent to record visits; to estimate effects of recording on patient-clinician interactions. Methods: Secondary analysis of data from a randomized trial studying communication about depression; participants were asked for optional consent to audio record study visits. Multiple logistic regression was used to model likelihood of patient and clinician consent. Multivariable regression and propensity score analyses were used to estimate effects of audio recording on 6 dependent variables: discussion of depressive symptoms, preventive health, and depression diagnosis; depression treatment recommendations; visit length; visit difficulty. Results: Of 867 visits involving 135 primary care clinicians, 39% were recorded. For clinicians, only working in academic settings (P = 0.003) and having worked longer at their current practice (P = 0.02) were associated with increased likelihood of consent. For patients, white race (P = 0.002) and diabetes (P = 0.03) were associated with increased likelihood of consent. Neither multivariable regression nor propensity score analyses revealed any significant effects of recording on the variables examined. Conclusion: Few clinician or patient characteristics were significantly associated with consent. Audio recording had no significant effect on any of the 6 dependent variables examined. Practice implications: Benefits of recording clinic visits likely outweigh the risks of bias in this setting.

KW - Audio recording

KW - Consent

KW - Depression

KW - Hawthorne effect

KW - Primary care

KW - Selection bias

UR - http://www.scopus.com/inward/record.url?scp=84929044114&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84929044114&partnerID=8YFLogxK

U2 - 10.1016/j.pec.2015.03.006

DO - 10.1016/j.pec.2015.03.006

M3 - Article

C2 - 25837372

AN - SCOPUS:84929044114

VL - 98

SP - 849

EP - 856

JO - Patient Education and Counseling

JF - Patient Education and Counseling

SN - 0738-3991

IS - 7

ER -