Monday, November 26, 2012

Paper Blogs 10



Reference Paper

Modeling Eye Gaze Patterns in Clinician-Patient Interaction With Lag Sequential Analysis
Enid Montague, Jie Xu, Ping-yu Chen, Onur Asan, Bruce P. Barrett, and Betty Chewning
(Digital Object Identifier: 10.1177/0018720811405986)

Overview of the Paper
Non-verbal communication is very important in Clinician-Patient interaction. It is a very important aspect which may affect patient outcomes. In this paper the authors tried to examine whether lag sequential analysis could be used to describe the eye gaze orientation of the clinician and patient in a medical settings. This study topic is especially important, because new technologies are implemented in multiuser settings where trust is a very critical point. And, nonverbal cues are very critical to achieve the trust. So, this study method can be used in future technologies.

Study showed that, during health care encounters, if there was a moderate level of mutual gaze between the clinician and the patient, then patient perceived it as empathy, clinician’s interest in patient and warmth. Also, positive interactions and communication of the patient were correlated with the measure of satisfaction of the patients. In this study, the authors try to find out the answers of two research questions:

      1.      How was the clinician’s gaze related to the patient’s gaze?
a.       Did the patient follow where the clinician gazed?
b.      If so, what was the timing of this behavior relative to the clinician’s behavior?
      2.      How was the patient’s gaze related to the clinician’s gaze?
a.       Did the clinician follow where the patient gazed?
b.      If so, what was the timing of this behavior relative to the patient’s behavior?

  

Evaluation and Validity of the Paper

In this study, the eye gaze behavior of clinicians and patients were recorded. They recorded 110 videos in medical encounters. Then they analyzed the eye gaze behavior by lag sequential analysis method to find out significant behavior. They performed both event-based and time-based lag sequential analysis in there study. They performed the event-based lag sequential analysis to check whether there was any event lag between their behaviors. And, the time-based lag sequential analysis was to find out the time lag between the events, if there was any.

From there event-based lag analysis, the authors found that the patient’s gaze followed gaze of clinicians. But, the clinician’s gaze did not follow patient’s gaze. And, the time-based lag analyses showed that, the patient’s behavior usually followed clinician’s behavior within 2s of the initial behavior.


Improvement Scopes

One extension of this paper will be to implement an automated gaze detection method in their system. In their experiment, the authors used human coders to code the gaze of clinicians and also patients. From the videos it is sometimes very hard for the human coders to detect the gaze perfectly, which may lead to some erroneous result.   

 

 

Further Reading

One of the interesting articles, which are cited by this paper, is “Meaning of five patterns of gaze”, by Michael Argyle, Luc Lefebvre, and Mark Cook [2] (Digital Object Identifier: 10.1002/ejsp.2420040202). In this paper, the authors used a conversation-setting where the participants were talked with different trained confederates, who displayed five patterns of gaze with different subjects. The gaze patters were: zero, looking while talking, looking while listening, normal and continuous. Then, after the conversation the participants rated the confederates. The authors wanted to see how the scores of the confederate depended on the gaze patterns.

References

 
[1] E. Montague, J. Xu, P. Chen, O. Asan, B. Barrett, and B. Chewning, “Modeling eye gaze patterns in clinician–patient interaction with lag sequential analysis,” Human Factors: The Journal of the Human Factors and Ergonomics Society, vol. 53, no. 5, pp. 502–516, 2011.
[2] M. Argyle, L. Lefebvre, and M. Cook, “The meaning of five patterns of gaze,” European journal of social psychology, vol. 4, no. 2, pp. 125–136, 1974.


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