High levels of socioeconomic deprivation do not inhibit patients’ communication of concerns in head and neck cancer review clinics

Classified as probably not a substantial claim. May combine two claims.

Healthcare professionals tend to involve low SES patients less in their consultations by giving them less information, spending less time building rapport with them and listening less attentively.

“Furthermore healthcare professionals tend to involve low SES patients less in their consultations by giving them less information, spending less time building rapport with them and listening less attentively (9,11,12).”

• cites [9] sourceNot checked — no full text of the source
• cites [11] sourceNot checked — no full text of the source
• cites [12] sourcePartly supported

  The 'What the doctor did in consultation' section and Table VII report that doctors perceived themselves as explaining, listening, and giving advice less often to patients in social classes IV and V. The paper does not establish that they spent less time building rapport or listened less attentively; it also cautions that patient perceptions differed less by social class than doctors’ perceptions did. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Low educated patients attached most importance to affective elements of a consultation, whereas middle and high educated patients felt that problem-solving was more important.

“The Aelbrecht et al. (24) study found that low educated patients attached most importance to affective elements of a consultation, whereas middle and high educated patients felt that problem-solving was more important.”

• cites [24] sourceSupported

Classified as probably not a substantial claim.

Doctor-patient communication differs depending upon the patient's SES.

“However studies have found that doctor-patient communication differs depending upon the patient's SES (10).”

• cites [10] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

The present study's findings are in line with a previous study on patient preferences for communication style.

“This is in line with a previous study on patient preferences for communication style (24).”

• cites [24] sourceSupported

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

More communication is not necessarily better communication.

“Whilst we acknowledge that more communication is not necessarily better communication (25), it may be advantageous for clinicians to adopt active strategies that allow them to build rapport with lower SES patients who are keen to voice their concerns.”

• cites [25] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

There was a positive correlation between IMD decile and time to first cue or concern which approached significance, r = .218, p = .077.

“There was a positive correlation between IMD decile and time to first cue or concern which approached significance, r = .218,p = .077.”

May combine two claims.

There were no significant correlations between IMD decile and the number and type of cues and concerns or the type of healthcare provider responses.

“There were no significant correlations between IMD decile and the number and type of cues and concerns or the type of healthcare provider responses.”

• Also stated in: § Results · plain

  “As can be seen in Table 4 there were no significant correlations between IMD decile and number of cues and concerns, elicitation of cues and concerns, clinician responses to cues and concerns, type of cues and proportion of concerns to cues.”

• Also stated in: § Discussion · plain

  “In the present study no significant correlations were found between IMD decile and number of cues and concerns, elicitation, or consultant responses.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Low SES patients are quick to express any issues to their consultant, with relatively little small-talk around these or other issues.

“It may be that low SES patients are quick to express any issues to their consultant, with relatively little small-talk around these or other issues.”

May combine two claims.

Shorter consultations suggest that less time is invested in either providing elaborate answers to patients' concerns or with rapport building.

“Shorter consultations suggest that less time is invested in either providing elaborate answers to patients' concerns or with rapport building.”

Classified as probably not a substantial claim. May combine two claims.

Low SES patients tend to participate less actively in consultations, for example asking fewer questions, as well as being less likely to express emotions and spontaneously volunteer information.

“Low SES patients tend to participate less actively in consultations, for example asking fewer questions, as well as being less likely to express emotions and spontaneously volunteer information (11).”

• cites [11] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Higher SES patients may have received more elaborate clinician responses to their cues and concerns.

“Alternatively, higher SES patients may have received more elaborate clinician responses to their cues and concerns, although we note that the clinician did not favour higher or lower SES groups in eliciting concerns.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Patient participation is linked to positive patient outcomes such as improved quality of life, reduced anxiety and depression, greater satisfaction, better sharing of information, and better treatment adherence.

“Research suggests that patient participation is linked to positive patient outcomes such as improved quality of life, reduced anxiety and depression, greater satisfaction, better sharing of information, and better treatment adherence (6)(7)(8)(9).”

• cites [6] sourceNot checked — no full text of the source
• cites [7] sourceNot checked — no full text of the source
• cites [8] sourceNot checked — no full text of the source

May combine two claims.

The negative association when consultation length was controlled does not show that lower SES patients expressed more cues and concerns, but that a greater amount of time was taken in discussions between patients and their consultant during which patients did not express cues or concerns.

“This does not show that lower SES patients expressed more cues and concerns, but that a greater amount of time was taken in discussions between patients and their consultant during which patients did not express cues or concerns.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

There may have been greater general discussion and rapport building.

“There may have been greater general discussion and rapport building.”

May combine two claims.

Less communication exists between lower SES patients and their clinician, possibly because patients are quicker to broach their concerns.

“However, our findings suggest that less communication exists between lower SES patients and their clinician, possibly because patients are quicker to broach their concerns.”

• AssumptionRests on an assumption: Area-level deprivation measured by IMD is a valid proxy for patient socioeconomic status.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Building rapport is an important aspect of clinical communication with a number of benefits for patients.

“Nonetheless, building rapport is an important aspect of clinical communication with a number of benefits for patients (5,(7)(8)(9), and low SES patients may be placed at a disadvantage if less time is spent building rapport.”

• cites [5] sourceNot checked — no full text of the source
• cites [7] sourceNot checked — no full text of the source
• cites [8] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The sample size may have been too small to detect any significant differences.

“Firstly only 110 audiotapes were analysed as part of this study, therefore the sample size may have been too small to detect any significant differences.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Low SES patients may be placed at a disadvantage if less time is spent building rapport.

“Nonetheless, building rapport is an important aspect of clinical communication with a number of benefits for patients (5,(7)(8)(9), and low SES patients may be placed at a disadvantage if less time is spent building rapport.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

All procedures performed in this study were approved by and in accordance with the ethical standards of the Clinical Audit Department, University Hospital Aintree, University of St Andrews School of Medicine and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

“All procedures performed in this study were approved by and in accordance with the ethical standards of the Clinical Audit Department, University Hospital Aintree, University of St Andrews School of Medicine and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

High SES patients were more interested in receiving information and engaging in problem-solving during the consultation.

“It may be that in the present study high SES patients were more interested in receiving information and engaging in problem-solving during the consultation.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Informed consent was obtained from all individual participants included in the study.

“Informed consent was obtained from all individual participants included in the study.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Because IMD scores pertain to postcodes, an individual may live in an area with a high level of deprivation but be high SES in terms of education or occupation.

“As IMD scores pertain to postcodes, it is possible that although an individual may live in an area with a high level of deprivation they may be high SES in terms of education or occupation.”