Toward Automated Detection of Biased Social Signals from the Content of Clinical Conversations.

Journal: AMIA ... Annual Symposium proceedings. AMIA Symposium
Published Date:

Abstract

Implicit bias can impede patient-provider interactions and lead to inequities in care. Raising awareness is key to reducing such bias, but its manifestations in the social dynamics of patient-provider communication are difficult to detect. In this study, we used automated speech recognition (ASR) and natural language processing (NLP) to identify social signals in patient-provider interactions. We built an automated pipeline to predict social signals from audio recordings of 782 primary care visits that achieved 90.1% average accuracy across codes, and exhibited fairness in its predictions for white and non-white patients. Applying this pipeline, we identified statistically significant differences in provider communication behavior toward white versus non-white patients. In particular, providers expressed more patient-centered behaviors towards white patients including more warmth, engagement, and attentiveness. Our study underscores the potential of automated tools in identifying subtle communication signals that may be linked with bias and impact healthcare quality and equity.

Authors

  • Feng Chen
    Department of Integrated Care Management Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
  • Manas Satish Bedmutha
    University of California San Diego, La Jolla, CA.
  • Ray-Yuan Chung
    University of Washington, Seattle, WA.
  • Janice Sabin
    University of Washington, Seattle, WA.
  • Wanda Pratt
    Biomedical Informatics & Medical Education, University of Washington, Seattle, WA; Information School, University of Washington, Seattle, WA.
  • Brian R Wood
    Department of Medicine, University of Washington, Seattle, WA 98195, United States.
  • Nadir Weibel
    University of California San Diego, La Jolla, CA.
  • Andrea L Hartzler
    Group Health Research Institute, Seattle, WA.
  • Trevor Cohen
    University of Washington, Seattle, WA.