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Purpose: This paper discusses an advanced version of our audiovisual-assisted therapeutic ambience in radiotherapy (AVATAR) radiolucent display systems designed for pediatric radiotherapy, enabling anesthesia-free treatments, video communication, and biofeedback. The scope of the AVATAR system is expanded here in two major ways: (i) through alternative mounting systems to accommodate a broader range of radiotherapy machines (specifically to fit robotic-arm and toroidal geometry photon radiotherapy and proton radiotherapy systems) and (ii) through additional hardware to provide videocalling, optimized audio for clear communication, and combined video inputs for biofeedback, translation, and other advanced functionalities. Methods and materials: Because robustness requires strong parts and radiotransparency requires thin, light parts, three-dimensional printing was used to rapidly prototype hollow structures and to iteratively improve robustness. Two system designs were made: one that mounts superior and another that mounts inferior to the patient's head. Radiation dose measurements and calculations were conducted to assess dose perturbations at surface and depth due to the screen. Results: For 6-MV volumetric modulated arc therapy (VMAT) plans, with and without the screen, the mean and maximum dose differences inside the planning target volume were 0.2% and 2.6% of the 200 cGy prescription, respectively. For a single static beam through the screen, the maximum measured excess surface dose was 13.4 ± 0.5%, and the largest measured dose attenuation at 5-cm waterequivalent depth was 2.1 ± 0.2%. These percentages are relative to the dose without the screen at those locations. Conclusions: The radiolucent screen systems provided here are shown to give minimal dosimetric effects on megavoltage VMAT photon treatments. For static beams, however, surface dose effects should be considered when these beams pass through the thickest components of the screen. Design files are also provided. [ABSTRACT FROM AUTHOR]

AbstractIn amyotrophic lateral sclerosis/motor neuron disease (ALS/MND), it is necessary to communicate difficult news during the initial diagnosis and throughout the disease trajectory as the condition progresses. However, delivering difficult news to people with ALS/MND is an emotionally demanding task for healthcare and allied health professionals—one for which many feel ill-prepared because of limited training in this area. Ineffective communication of difficult news damages the patient-provider relationship and negatively impacts patient quality of life (QoL). To address this issue, we developed the A-L S-PIKES protocol based on available literature and our extensive clinical experience. It provides easy-to-follow, stepwise guidelines to effectively deliver difficult news to people with ALS/MND (PALS) that includes: Advance Preparation (preparing for the discussion logistically and emotionally); Location & Setting (creating a comfortable setting that fosters rapport); Patient’s Perceptions (assessing PALS’ understanding and perception of their condition); Invitation (seeking PALS’ permission to share information); Knowledge (sharing information in a clear, understandable manner); Emotion/Empathy (addressing emotions with empathy and providing emotional support); and Strategy & Summary (summarizing the discussion and collaboratively developing a plan of action). A–L S–PIKES provides practical guidelines on how to prepare for and conduct these challenging conversations. It emphasizes effective communication tailored to the individual needs of PALS and their families, empathy, sensitivity, and support for PALS’ emotional well-being and autonomy. The aim of A-L S-PIKES is to both enhance skills and confidence in delivering difficult news and to improve the QoL of PALS and their families. Future studies should systematically evaluate the feasibility and effectiveness of A-L S-PIKES to establish its utility in clinical practice. [ABSTRACT FROM AUTHOR]

Infections by multidrug-resistant organisms (MDROs) pose significant public health challenges, including increased mortality rates, healthcare costs, and significant impacts on the quality of life for patients. Utilizing a systematic review methodology adhering to PRISMA guidelines, we performed a comprehensive search across three databases, identifying 20 relevant studies that investigated the psychological effects of infections due to MDROs on hospitalized adults. The primary outcomes examined included depression, anxiety, and other psychosocial impacts, while secondary outcomes included patient and caregiver understanding of the infection. Findings revealed consistent associations between contact isolation due to MDRO infections and heightened levels of depression and anxiety among patients, although evidence regarding the impact on anger was mixed. Other psychological aspects, such as feelings of stigmatization and reduced healthcare provider interactions, were also recorded. The current systematic review highlights the importance of addressing these psychological effects through holistic, patient-centered care approaches, emphasizing the need for better communication and comprehensive education for both patients and healthcare providers. Our findings suggest that mitigating the psychological burden of MDROs can enhance overall patient care and outcomes and call for further research to optimize care strategies for patients hospitalized for infections due to MDROs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Accurate projections of procedural case durations are complex but critical to the planning of perioperative staffing, operating room resources, and patient communication. Nonlinear prediction models using machine learning methods may provide opportunities for hospitals to improve upon current estimates of procedure duration. OBJECTIVE: The aim of this study was to determine whether a machine learning algorithm scalable across multiple centers could make estimations of case duration within a tolerance limit because there are substantial resources required for operating room functioning that relate to case duration. METHODS: Deep learning, gradient boosting, and ensemble machine learning models were generated using perioperative data available at 3 distinct time points: the time of scheduling, the time of patient arrival to the operating or procedure room (primary model), and the time of surgical incision or procedure start. The primary outcome was procedure duration, defined by the time between the arrival and the departure of the patient from the procedure room. Model performance was assessed by mean absolute error (MAE), the proportion of predictions falling within 20% of the actual duration, and other standard metrics. Performance was compared with a baseline method of historical means within a linear regression model. Model features driving predictions were assessed using Shapley additive explanations values and permutation feature importance. RESULTS: A total of 1,177,893 procedures from 13 academic and private hospitals between 2016 and 2019 were used. Across all procedures, the median procedure duration was 94 (IQR 50-167) minutes. In estimating the procedure duration, the gradient boosting machine was the best-performing model, demonstrating an MAE of 34 (SD 47) minutes, with 46% of the predictions falling within 20% of the actual duration in the test data set. This represented a statistically and clinically significant improvement in predictions compared with a baseline linear regression model (MAE 43 min; P

Migraines are one of the most common and expensive neurological diseases worldwide. Non-pharmacological and digitally delivered treatment options have long been used in the treatment of migraines. For instance, migraine management tools, online migraine diagnosis or digitally networked patients have been used. Recently, applications of ChatGPT are used in fields of healthcare ranging from identifying potential research topics to assisting professionals in clinical diagnosis and helping patients in managing their health. Despite advances in migraine management, only a minority of patients are adequately informed and treated. It is important to provide these patients with information to help them manage the symptoms and their daily activities. The primary aim of this case study was to examine the appropriateness of ChatGPT to handle symptom descriptions responsibly, suggest supplementary assistance from credible sources, provide valuable perspectives on treatment options, and exhibit potential influences on daily life for patients with migraines. Using a deductive, qualitative study, ten interactions with ChatGPT on different migraine types were analyzed through semi-structured interviews. ChatGPT provided relevant information aligned with common scientific patient resources. Responses were generally intelligible and situationally appropriate, providing personalized insights despite occasional discrepancies in interaction. ChatGPT's empathetic tone and linguistic clarity encouraged user engagement. However, source citations were found to be inconsistent and, in some cases, not comprehensible, which affected the overall comprehensibility of the information. ChatGPT might be promising for patients seeking information on migraine conditions. Its user-specific responses demonstrate potential benefits over static web-based sources. However, reproducibility and accuracy issues highlight the need for digital health literacy. The findings underscore the necessity for continuously evaluating AI systems and their broader societal implications in health communication. [ABSTRACT FROM AUTHOR]

MRI often induces anxiety, leading to incomplete scans and claustrophobia-related distress. Open MRI systems aim to enhance patient comfort. This study examines how prior MRI experiences impact subsequent encounters in an open upright MRI scanner. In this cross-sectional study, 118 adult patients completed a self-administered questionnaire from August 2022 to October 2023. It covered previous MRI experiences, including questions about claustrophobia, premature scan terminations, sedative medication usage, general MRI experiences, and interactions with radiology technologists. Patients in open upright MRI reported less claustrophobia compared to closed MRI systems (18.4% vs. 58.3%), fewer premature scan terminations (5.3% vs. 31.0%), and less sedative use (5.3% vs. 46.9%). Moderate positive correlations were found between past and current claustrophobic events and premature scan terminations. Effective communication with radiology technologists was essential for patient comfort and reduced claustrophobia. Scan duration and noise triggered discomfort in 26.1% and 21.6% of study participants respectively. Persons without prior MRI experience were more satisfied with the examination and expressed no clear preference for future MRI settings, contrasting those with previous exposure favoring the open MRI setup. The study emphasizes the benefits of open upright MRI for high-risk claustrophobic patients. It identifies the lasting impact of negative MRI experience on future examinations and highlights the crucial role of radiology technologists. Integrating open MRI scanners in medical facilities and prioritizing effective communication with radiology technologists enhances patient comfort. Positive experiences with open MRI may improve patient compliance and offer greater flexibility for future examinations. [ABSTRACT FROM AUTHOR]

Amygdalin is purported to exhibit anti-cancer properties when hydrolyzed to hydrogen cyanide (HCN). However, knowledge about amygdalin efficacy is limited. A questionnaire evaluating the efficacy, treatment, and dosing protocols, reasons for use, HCN levels, and toxicity was distributed to physicians and healers in Germany, providing amygdalin as an anti-cancer drug. Physicians (20) and healers (18) provided amygdalin over 8 (average) years to nearly 80 annually treated patients/providers. Information about amygdalin was predominantly obtained from colleagues (55%). Amygdalin was administered both intravenously (100%) and orally (32%). Intravenous application was considered to maximally delay disease progression (90%) and relieve symptoms (55%). Dosing was based on recommendations from colleagues (71%) or personal experience (47%). If limited success became apparent after an initial 3g/infusion, infusions were increased to 27g/infusion. Treatment response was primarily monitored with established (26%) and non-established tumor markers (19%). 90% did not monitor HCN levels. Negative effects were restricted to a few dizzy spells and nausea. Only 58% were willing to participate in clinical trials or contribute data for analysis (34%). Amygdalin infusions are commonly administered by healers and physicians with few side effects. The absence of standardized treatment calls for guidelines. Since intravenous application bypasses metabolization, re-evaluation of its mode of action is required. [ABSTRACT FROM AUTHOR]

Introduction: People being investigated for cancer face a wealth of complex information. Non‐specific symptom pathways (NSS) were implemented in the United Kingdom in 2017 to address the needs of patients experiencing symptoms such as weight loss, fatigue or general practitioner 'gut feeling', who did not have streamlined pathways for cancer investigation. This study aimed to explore the health literacy skills needed by patients being investigated for cancer in NSS pathways. Methods: This study employed ethnographic methods across four hospitals in England, including interviews, patient shadowing and clinical care observations, to examine NSS pathways for cancer diagnosis. We recruited 27 patients who were shadowed and interviewed during their care. We also interviewed 27 professionals. The analysis focused on patient communication and understanding, drawing on the concepts of personal and organisational health literacy. Results: Our analysis derived six themes highlighting the considerable informational demands of the NSS pathway. Patients were required to understand complex blood tests and investigations in primary care and often did not understand why they were referred. The NSS pathway itself was difficult to understand with only a minority of patients appreciating that multiple organs were being investigated for cancer. The process of progressing through the pathway was also difficult to understand, particularly around who was making decisions and what would happen next. The results of investigations were complex, often including incidental findings. Patients whose persistent symptoms were not explained were often unsure of what to do following discharge. Conclusion: We have identified several potential missed opportunities for organisations to support patient understanding of NSS pathways which could lead to inappropriate help‐seeking post‐discharge. Patients' difficulties in comprehending previous investigations and findings could result in delays, overtesting or inadequately targeted investigations, hindering the effective use of their medical history. Third, patients' limited understanding of their investigations and results may impede their ability to engage in patient safety by reporting potential care errors. Patient or Public Contribution: Patient, public, clinical and policy representatives contributed to developing the research objectives through a series of meetings and individual conversations in preparation for the study. We have held several events in which patients and the public have had an opportunity to give feedback about our results, such as local interest groups in North London and academic conferences. A clinical contributor (J.‐A. M.) was involved in data analysis and writing the manuscript. [ABSTRACT FROM AUTHOR]

PurposeThis paper discusses an advanced version of our audiovisual-assisted therapeutic ambience in radiotherapy (AVATAR) radiolucent display systems designed for pediatric radiotherapy, enabling anesthesia-free treatments, video communication, and biofeedback. The scope of the AVATAR system is expanded here in two major ways: (i) through alternative mounting systems to accommodate a broader range of radiotherapy machines (specifically to fit robotic-arm and toroidal geometry photon radiotherapy and proton radiotherapy systems) and (ii) through additional hardware to provide video-calling, optimized audio for clear communication, and combined video inputs for biofeedback, translation, and other advanced functionalities.Methods and materialsBecause robustness requires strong parts and radio-transparency requires thin, light parts, three-dimensional printing was used to rapidly prototype hollow structures and to iteratively improve robustness. Two system designs were made: one that mounts superior and another that mounts inferior to the patient’s head. Radiation dose measurements and calculations were conducted to assess dose perturbations at surface and depth due to the screen.ResultsFor 6-MV volumetric modulated arc therapy (VMAT) plans, with and without the screen, the mean and maximum dose differences inside the planning target volume were 0.2% and 2.6% of the 200 cGy prescription, respectively. For a single static beam through the screen, the maximum measured excess surface dose was 13.4 ± 0.5%, and the largest measured dose attenuation at 5-cm water-equivalent depth was 2.1 ± 0.2%. These percentages are relative to the dose without the screen at those locations.ConclusionsThe radiolucent screen systems provided here are shown to give minimal dosimetric effects on megavoltage VMAT photon treatments. For static beams, however, surface dose effects should be considered when these beams pass through the thickest components of the screen. Design files are also provided.

BackgroundEfficient triage of patient communications is crucial for timely medical attention and improved care. This study evaluates ChatGPT’s accuracy in categorizing nephrology patient inbox messages, assessing its potential in outpatient settings.MethodsOne hundred and fifty simulated patient inbox messages were created based on cases typically encountered in everyday practice at a nephrology outpatient clinic. These messages were triaged as non-urgent, urgent, and emergent by two nephrologists. The messages were then submitted to ChatGPT-4 for independent triage into the same categories. The inquiry process was performed twice with a two-week period in between. ChatGPT responses were graded as correct (agreement with physicians), overestimation (higher priority), or underestimation (lower priority).ResultsIn the first trial, ChatGPT correctly triaged 140 (93%) messages, overestimated the priority of 4 messages (3%), and underestimated the priority of 6 messages (4%). In the second trial, it correctly triaged 140 (93%) messages, overestimated the priority of 9 (6%), and underestimated the priority of 1 (1%). The accuracy did not depend on the urgency level of the message (p = 0.19). The internal agreement of ChatGPT responses was 92% with an intra-rater Kappa score of 0.88.ConclusionChatGPT-4 demonstrated high accuracy in triaging nephrology patient messages, highlighting the potential for AI-driven triage systems to enhance operational efficiency and improve patient care in outpatient clinics.

Can Nurses Approach Inappropriate Sexual Patient Behaviors Therapeutically? A Cross-Sectional Survey

The rapid evolution of artificial intelligence (AI) in healthcare, particularly in radiology, underscores a transformative era marked by a potential for enhanced diagnostic precision, increased patient engagement, and streamlined clinical workflows. Amongst the key developments at the heart of this transformation are Large Language Models like the Generative Pre-trained Transformer 4 (GPT-4), whose integration into radiological practices could potentially herald a significant leap by assisting in the generation and summarization of radiology reports, aiding in differential diagnoses, and recommending evidence-based treatments. This review delves into the multifaceted potential applications of Large Language Models within radiology, using GPT-4 as an example, from improving diagnostic accuracy and reporting efficiency to translating complex medical findings into patient-friendly summaries. The review acknowledges the ethical, privacy, and technical challenges inherent in deploying AI technologies, emphasizing the importance of careful oversight, validation, and adherence to regulatory standards. Through a balanced discourse on the potential and pitfalls of GPT-4 in radiology, the article aims to provide a comprehensive overview of how these models have the potential to reshape the future of radiological services, fostering improvements in patient care, educational methodologies, and clinical research.

3D printing is an essential technology for clinical decision-making, affording significant improvements over conventional imaging alone. Product usefulness surveys offer potential in measuring the quality and impact of 3DP to assist clinical decision-making and patient communication. A narrative literature review (Scoping Review articles only) frames the benefits and limitations of 3D print surgical workflow and user experiences. A usability survey was co-designed with a company to measure the impact of their 3D prints on surgical practice, and secondary data analysis was conducted of to understand the effectiveness and usefulness of the technology in a real-world healthcare setting. Three categories of usefulness and relevance were identified. High-value relevance (positive Likert scores over 70%) related to pre-operative planning, clinical communication, and the value of the technology. Moderate scores (50% to 69%) related to time saving with pre-operative surgery, and effectiveness of patient care and diagnosis. Minor relevance (less than 50%) included direct cost savings, physical resource efficiencies, time in intra-operative surgery, or intra-operative risks. This research considers 3D printings relationship to medical error prevention, limitations and future recommendations for usability surveys of this type and it identified issues around gender inclusion in Design for Health research. [ABSTRACT FROM AUTHOR]

Background: Informed consent is an essential process in clinical decision‐making, through which healthcare providers educate patients about benefits, risks, and alternatives of a procedure. Statistical risk information is difficult to communicate and the effectiveness of aids aimed at supporting this type of communication is uncertain. This systematic review aims to study the impact of risk communication adjuncts on patients' understanding of statistical risk in surgery and interventional procedures. Methods: A systematic search was performed across Medline, Embase, PsycINFO, Scopus, and Web of Science until July 2021 with a repeated search in September 2022. RCTs and observational studies examining risk communication tools (e.g., information leaflets and audio‐video) in adult (age >16) patients undergoing a surgical or interventional procedure were included. Primary outcomes included the objective assessment of statistical risk recall. Secondary outcomes included patient attitudes with respect to statistical information. Due to the study heterogeneity, a narrative synthesis was performed. Results: A total of 4348 articles were identified, and following abstract and full‐text screening 14 articles, including 9 RCTs, were included. The total number of adult patients was 1513. The most common risk communication tool used was written information (n = 7). Most RCTs (7/9, 77.8%) showed statistically significant improvements in patient understanding of statistical risk in the intervention group. Quality assessment found some concerns with all RCTs. Conclusion: Risk communication tools appear to improve recall of statistical risk. Additional prospective trials comparing various aids simultaneously are warranted to determine the most effective method of improving understanding. [ABSTRACT FROM AUTHOR]

Background: Effective communication between healthcare practitioners and patients in the emergency department (ED) is crucial for patient satisfaction and quality of care. This study explored patients' perspectives on communication with nurses and physicians in the ED. Methods: A cross-sectional study was conducted using a sample of 159 patients to assess the type of information relayed by nurses and doctors. The interview data were analyzed to examine nursing staff communication, physician communication, and communication difficulties. Results: Nurses were found to be less likely to inform patients about their results or disposition. While 81.2% of physicians introduced themselves to patients, only 51.6% stated their status level. Approximately 68.6% of subjects were offered analgesia or treatment, and 60% reported no communication difficulties with medical staff. Empathy was demonstrated by 54.2% of healthcare practitioners, and nearly 80% of patient encounters were conducted in understandable language. Conclusion: The study highlights the importance of effective communication in the ED, including empathy, information provision, and language barriers. To improve patient satisfaction and healthcare quality, medical organizations should develop comprehensive work plans, provide communication skills workshops, and enhance the ED work environment. Future research should focus on the perspectives of medical staff and explore communication in larger samples and various contexts. [SJEMed 2023; 4(2.000): 128-133]

Abstract Background An especially significant event in the patient–oncologist relationship is the initial consultation, where many complex topics—diagnosis, treatment intent, and often, prognosis—are discussed in a relatively short period of time. This study aimed to measure patients' understanding of the information discussed during their first medical oncology visit and their satisfaction with the communication from medical oncologists. Methods Between January and August 2021, patients without prior systemic treatment of their gastrointestinal malignancy (GI) attending the Princess Margaret Cancer Centre (PMCC) were approached within 24 h of their initial consultation to complete a paper‐based questionnaire assessing understanding of their disease (diagnosis, treatment plan/intent, and prognosis) and satisfaction with the consultation. Medical oncology physicians simultaneously completed a similar questionnaire about the information discussed at the initial visit. Matched patient–physician responses were compared to assess the degree of concordance. Results A total of 184 matched patient–physician surveys were completed. The concordance rates for understanding of diagnosis, treatment plan, treatment intent, and prognosis were 92.9%, 59.2%, 66.8%, and 59.8%, respectively. After adjusting for patient and physician variables, patients who reported treatment intent to be unclear at the time of the consultation were independently associated with lower satisfaction scores (global p = 0.014). There was no statistically significant association between patient satisfaction and whether prognosis was disclosed (p = 0.08). Conclusion An in‐depth conversation as to what treatment intent and prognosis means is reasonable during the initial medical oncology consultation to ensure patients and caregivers have a better understanding about their cancer.

Summary: In this study, we sought to analyse experiences in weight management among physicians working in the area of obesity and contrast these experiences with best practices. By understanding experiences of physicians working in obesity management, we can better support implementation of best practices in their day‐to‐day practice. An online survey of Canadian primary care physicians, internists and endocrinologists recruited from a nationwide market research database was conducted. The survey captured demographic characteristics and perceptions about weight loss and its management. One hundred and ninety‐two physicians (140 primary care, 22 internists and 30 endocrinologists) were recruited and completed the survey. Challenges identified by the physicians in helping patients lose weight included patients' poor compliance and lack of time and resources to address the issue. Most physicians reported considering obesity to be a chronic disease, but most did not incorporate a multi‐dimensional, chronic disease model of obesity treatment (i.e., combination of lifestyle interventions with psychological, medical and/or surgical interventions). Endocrinologists reported management practices consistent with a chronic disease model more frequently than primary care physicians. These data highlight the need for improvement in obesity management, particularly in primary care. Despite proliferation of guidelines on best practices, implementation of these practices into daily practice remains low. [ABSTRACT FROM AUTHOR]

Little is known about how patients perceive diagnostic uncertainty. We sought to understand how patients and care partners perceive uncertainty in an emergency or urgent care setting, where making a final diagnosis is often not possible. We administered a survey to a nationally representative panel on patient-reported diagnostic excellence in an emergency department or urgent care setting. The survey included items specific to perceived diagnostic excellence, visit characteristics, and demographics. We analyzed responses to two open-ended questions among those who reported uncertainty in the explanation they were given. Themes were identified using an inductive approach, and compared by whether respondents agreed or disagreed the explanation they were given was true. Of the 1,116 respondents, 106 (10 %) reported that the care team was not certain in the explanation of their health problem. Five themes were identified in the open-ended responses: poor communication (73 %), uncertainty made transparent (10 %), incorrect information provided (9 %), inadequate testing equipment (4 %), and unable to determine (4 %). Of the respondents who reported uncertainty, 21 % (n=22/106) reported the explanation of their problem given was not true. The findings of this analysis suggest that the majority of patients and their care partners do not equate uncertainty with a wrong explanation of their health problem, and that poor communication was the most commonly cited reason for perceived uncertainty. [ABSTRACT FROM AUTHOR]

Background: Nurses are faced with the sexual behavior of the patients. These behaviors do not mean that the patient cannot meet their sexual needs. It is not known how often nurses encounter such behaviors, how nurses' approach sexual patient behaviors, and whether nurses have a therapeutic approach. Purpose: This study was carried out in order to reveal how often nurses encounter sexual behaviors of patients and to determine whether nurses show a therapeutic approach to sexual patient behaviors. Methods: The cross-sectional study was conducted with 276 nurses. The data were collected by using a Questionnaire Form. Data were analyzed using descriptive and chi-square test. Results: The mean age of the nurses participating in the study was 31.12 ± 7.26. 93.8% of them were women, 61.6% were married, 57.2% were undergraduate graduates and the average duration of working life was 9.24±7.11. Compared with the nurses in the other groups, the older nurses, the married ones, those with distant education undergraduate degree, those with 13 years or more working experience and those working in intensive care units were more likely to expose to inappropriate sexual behaviors of the patients (p < .05). Nurses stated that 42.4% of them were exposed to the patients with inappropriate sexual behaviors. The types of inappropriate sexual behaviors that the nurses were exposed to were as follows; "verbal or written" (51.1%), "nonverbal" (37.6%), "physical" (11.3%). The approaches of the nurses towards these patients were "non-therapeutic" (68.1%). Conclusion: It was determined that almost half of the nurses encountered sexual patient behaviors and had difficulty in approaching patients who behaved sexually, and most of the nurses had non-therapeutic approaches to patients who behaved sexually. [ABSTRACT FROM AUTHOR]

Copyright of Casos & Revisiones de Salud is the property of Victor Manuel Mendoza Nunez, Universidad Nacional Autonoma de Mexico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: An especially significant event in the patient–oncologist relationship is the initial consultation, where many complex topics—diagnosis, treatment intent, and often, prognosis—are discussed in a relatively short period of time. This study aimed to measure patients' understanding of the information discussed during their first medical oncology visit and their satisfaction with the communication from medical oncologists. Methods: Between January and August 2021, patients without prior systemic treatment of their gastrointestinal malignancy (GI) attending the Princess Margaret Cancer Centre (PMCC) were approached within 24 h of their initial consultation to complete a paper‐based questionnaire assessing understanding of their disease (diagnosis, treatment plan/intent, and prognosis) and satisfaction with the consultation. Medical oncology physicians simultaneously completed a similar questionnaire about the information discussed at the initial visit. Matched patient–physician responses were compared to assess the degree of concordance. Results: A total of 184 matched patient–physician surveys were completed. The concordance rates for understanding of diagnosis, treatment plan, treatment intent, and prognosis were 92.9%, 59.2%, 66.8%, and 59.8%, respectively. After adjusting for patient and physician variables, patients who reported treatment intent to be unclear at the time of the consultation were independently associated with lower satisfaction scores (global p = 0.014). There was no statistically significant association between patient satisfaction and whether prognosis was disclosed (p = 0.08). Conclusion: An in‐depth conversation as to what treatment intent and prognosis means is reasonable during the initial medical oncology consultation to ensure patients and caregivers have a better understanding about their cancer. [ABSTRACT FROM AUTHOR]

Medical students lack opportunities to have authentic conversations with patients with cancer in busy hospitals. An improved understanding of what such communication might look like may provide a framework for end-of-life curricula. The authors performed thematic analysis using written correspondence between patient and student participants in the University of California, San Francisco's Firefly Program whose letters discussed death or dying. Four themes emerged: (1) turmoil, (2) grief, (3) making peace, and (4) past, present, and future. Medical students expressed a fifth theme: unmet student expectations. The study provides educators with a unique perspective to help inform curriculum development and patient care. [ABSTRACT FROM AUTHOR]

BackgroundThe coproduction of care involves patients and families partnering with their clinicians and care teams, with the premise that each brings their own perspective, knowledge, and expertise, as well as their own values, goals, and preferences, to the partnership. Dashboards can display meaningful patient and clinical data to assess how a patient is doing and inform shared decision-making. Increasing communication between patients and care teams is particularly important for children with chronic conditions. Juvenile idiopathic arthritis (JIA), the most common chronic pediatric rheumatic condition, is associated with increased pain, decreased function, and decreased quality of life.ObjectiveThe aim of this study is to design a dashboard prototype for use in coproducing care in patients with JIA. We evaluated the use and needs of end users, obtained a consensus on the necessary dashboard data elements, and constructed display prototypes to inform meaningful discussions for coproduction.MethodsA human-centered design approach involving parents, patients, clinicians, and care team members was used to develop a dashboard to support the coproduction of care in 4 ambulatory pediatric rheumatology clinics. We engaged a multidisciplinary team (n=18) of patients, parents, clinicians, nurses, and staff during an in-person kick-off meeting followed by biweekly meetings. We also leveraged advisory panels. Teams mapped workflows and patient journeys, created personas, and developed dashboard sketches. The final dashboard components were determined via Delphi consensus voting. Low-tech dashboard testing was completed during clinic visits, and visual display prototypes were iterated by using the Plan-Do-Study-Act methodology. Patients and clinicians were surveyed regarding their experiences.ResultsTeams achieved consensus on what data mattered most at the point of care to support patients with JIA, families, and clinicians collaborating to make the best possible health care decisions. Notable themes included the right data in the right place at the right time, data in once for multiple purposes, patient and family self-management components, and the opportunity for education and increased transparency. A final set of 11 dashboard data elements was identified, including patient-reported outcomes, clinical data, and medications. Important design considerations featured the incorporation of real-time data, clearly labeled graphs, and vertical orientation to facilitate review and discussion. Prototype paper-testing with 36 patients and families yielded positive feedback, with 89% (8/9) to 100% (9/9) of parents (n=9) and 80% (8/10) to 90% (9/10) of clinicians (n=10) strongly agreeing or agreeing that the dashboard was useful during clinic discussions, helped to talk about what mattered most, and informed health care decision-making.ConclusionsWe developed a dashboard prototype that displays patient-reported and clinical data over time, along with medications that can be used during a clinic visit to support meaningful conversations and shared decision-making among patients with JIA, their families, and their clinicians and care teams.

Completion of an advance care planning (ACP) process and/or an advance directive should result in patients receiving the care they desire at the end of life. However, three decades of research have shown that is just not the case. ACP has been a front runner in developing the science within palliative care. Some positive outcomes such as lowering levels of surrogate grief may be associated with ACP. Yet, it does not appear that further ACP research will ensure that seriously ill patients will get goal-concordant care. An unfortunate consequence of palliative care research and advocacy so far is the misguided notion of many hospital systems trying to solve their palliative care problems by only implementing an ACP initiative. At best, ACP is but one tool in the collective palliative care toolbox. New tools are needed. Given that we have finite resources, future research should focus more on tools to improve symptom management, better models of care, and systems that will ensure goal-concordant care that meet the needs of the population that the health care system is designed to meet.

BackgroundPatient portals allow communication with clinicians, access to test results, appointments, etc, and generally requires another set of log-ins and passwords, which can become cumbersome, as patients often have records at multiple institutions. Social credentials (eg, Google and Facebook) are increasingly used as a federated identity to allow access and reduce the password burden. Single Federated Identity Log-in for Electronic health records (Single-FILE) is a real-world test of the feasibility and acceptability of federated social credentials for patients to access their electronic health records (EHRs) at multiple organizations with a single sign-on (SSO).ObjectiveThis study aims to deploy a federated identity system for health care in a real-world environment so patients can safely use a social identity to access their EHR data at multiple organizations. This will help identify barriers and inform guidance for the deployment of such systems.MethodsSingle-FILE allowed patients to pick a social identity (such as Google or Facebook) as a federated identity for multisite EHR patient portal access with an SSO. Binding the identity to the patient's EHR records was performed by confirming that the patient had a valid portal log-in and sending a one-time passcode to a telephone (SMS text message or voice) number retrieved from the EHR. This reduced the risk of stolen EHR portal credentials. For a real-world test, we recruited 8 patients and (or) their caregivers who had EHR data at 2 independent health care facilities, enrolled them into Single-FILE, and allowed them to use their social identity credentials to access their patient records. We used a short qualitative interview to assess their interest and use of a federated identity for SSO. Single-FILE was implemented as a web-based patient portal, although the concept can be readily implemented on a variety of mobile platforms.ResultsWe interviewed the patients and their caregivers to assess their comfort levels with using a social identity for access. Patients noted that they appreciated only having to remember 1 log-in as part of Single-FILE and being able to sign up through Facebook.ConclusionsOur results indicate that from a technical perspective, a social identity can be used as a federated identity that is bound to a patient's EHR data. The one-time passcode sent to the patient's EHR phone number provided assurance that the binding is valid. The patients indicated that they were comfortable with using their social credentials instead of having to remember the log-in credentials for their EHR portal. Our experience will help inform the implementation of federated identity systems in health care in the United States.

Despite medical physics becoming a more patient-facing part of the radiation oncology team, medical physics graduate students have no training in patient communication. An introductory patient communication training for medical physics graduate students is presented here. This training exposes participants to foundational concepts and effective communication skills through a lecture and it allows them to apply these concepts through realistic simulated patient interactions. The training was conducted virtually, and eight students participated. The impact of the training was evaluated based on changes in both confidence and competence of the participants patient communication skills. Participants were asked to fill out a survey to assess their confidence on communicating with patients before and after the training. They also underwent a simulated patient interaction pre- and postlecture. Their performance during these was evaluated by both the simulated patient actors and the participants themselves using a rubric. Each data set was paired and analyzed for significance using a Wilcoxon rank-sum test with an alpha of 0.05. Participants reported significantly higher confidence in their feeling of preparedness to interact with patients (mean = 2.38 vs. 3.88, p = 0.008), comfort interacting independently (mean = 2.00 vs. 4.00, p = 0.002), comfort showing patients they are actively listening (mean = 3.50 vs. 4.50, p = 0.005), and confidence handling challenging patient interactions (mean = 1.88 vs. 3.38, p = 0.01), after the training. Their encounter scores, as evaluated by the simulated patient actors, significantly increased (mean = 77% vs. 91%, p = 0.022). Self-evaluation scores increased, but not significantly (mean = 62% vs. 68%, p = 0.184). The difference between the simulated patient and self-evaluation scores for the postinstruction encounter was statistically significant (p = 0.0014). This patient communication training for medical physics graduate students is effective at increasing both the confidence and the competence of the participants in the subject. We propose that similar trainings be incorporated into medical physics graduate training programs prior to students entering into residency.

Amygdalin is purported to exhibit anti-cancer properties when hydrolyzed to hydrogen cyanide (HCN). However, knowledge about amygdalin efficacy is limited. A questionnaire evaluating the efficacy, treatment, and dosing protocols, reasons for use, HCN levels, and toxicity was distributed to physicians and healers in Germany, providing amygdalin as an anti-cancer drug. Physicians (20) and healers (18) provided amygdalin over 8 (average) years to nearly 80 annually treated patients/providers. Information about amygdalin was predominantly obtained from colleagues (55%). Amygdalin was administered both intravenously (100%) and orally (32%). Intravenous application was considered to maximally delay disease progression (90%) and relieve symptoms (55%). Dosing was based on recommendations from colleagues (71%) or personal experience (47%). If limited success became apparent after an initial 3g/infusion, infusions were increased to 27g/infusion. Treatment response was primarily monitored with established (26%) and non-established tumor markers (19%). 90% did not monitor HCN levels. Negative effects were restricted to a few dizzy spells and nausea. Only 58% were willing to participate in clinical trials or contribute data for analysis (34%). Amygdalin infusions are commonly administered by healers and physicians with few side effects. The absence of standardized treatment calls for guidelines. Since intravenous application bypasses metabolization, re-evaluation of its mode of action is required.

Für Interaktionsarbeit „an und mit Menschen" werden die betrieblichen und technologischen Rahmenbedingungen und ihre Anforderungen an die Beschäftigten zunehmend thematisiert. Der Beitrag fokussiert einen bisher wenig beachteten Aspekt: Er beleuchtet am Beispiel der Versorgung von neurologisch schwer erkrankten Patient*innen die Anforderungen, die sich daraus ergeben, dass die Adressaten von personenbezogenen Dienstleistungen aufgrund gesundheitlicher Beeinträchtigungen nur eingeschränkt in der Lage sind, an der Interaktionsgestaltung mitzuwirken. In asymmetrischen Kommunikationssituationen kommt professionell Helfenden die Rolle zu, eine Interaktionsfähigkeit der Klient*innen erst einmal herzustellen. Dies ist neben den technischen und organisatorischen Bedingungen der Interaktionsarbeit als eine eigenständige Anforderung zu begreifen, die entsprechende Kompetenzen und Ressourcen erfordert. For interaction work "on and with people", the operational and technological framework along with its demands on the employees is an increasingly addressed issue. This article focuses on an aspect that has received little attention so far: using the example of caring for seriously neurologically ill patients, it highlights the requirements that arise from the fact that the recipients of personal services are only able to participate in shaping the interaction to a limited extent due to health impairments. In asymmetric communication situations, professional helpers have the role of establishing the client's ability to interact in the first place. In addition to the technical and organisational conditions of the interaction work, this is to be understood as an independent demand that requires corresponding competences and resources. [ABSTRACT FROM AUTHOR]

Abstract Purpose: Non-invasive ventilation (NIV) provides respiratory support without invasive endotracheal intubation but can hinder patients’ ability to communicate effectively. The current study presents preliminary results using a novel in-mask ventilator microphone to enhance talker intelligibility while receiving NIV. Method: A proof-of-concept study assessed sentence intelligibility of five healthy adult talkers using a prototype model of the microphone under continuous positive airway pressure (CPAP; 5/5 cm H2O) and bilevel positive airway pressure (BiPAP; 8/4 cm H2O) ventilator conditions. A pilot study then assessed intelligibility, subjective comprehensibility and naturalness, and patient- and conversation partner-reported communication outcomes for eight patients undergoing therapeutic NIV while being treated in an intensive care unit (ICU). Result: Intelligibility increased significantly with the microphone on in the BiPAP condition for healthy volunteers. For patients undergoing NIV in an ICU, intelligibility, comprehensibility, and patient and conversation partner ratings of conversation satisfaction significantly improved with the microphone on. Patients with lower baselines without the microphone in certain measures (intelligibility, comprehensibility) generally showed a greater microphone benefit than patients with higher baselines. Conclusion: Use of a novel microphone integrated into NIV improved intelligibility during ventilation for both healthy volunteers and patients undergoing therapeutic NIV. Additional clinical studies will define precise benefits and implications of such improved intelligibility. [ABSTRACT FROM AUTHOR]

Screening for domestic violence in healthcare settings increases detection. The emergency department (ED) is one setting where victims frequently attend with injuries and illnesses sustained from violence. However, screening rates remain suboptimal. There is little research about how formal screening occurs, or how less structured interactions are negotiated within the ED context. This article explores this important, but non-mandatory procedure within the context of clinician–patient interactions in Australia. A descriptive qualitative study was undertaken with 21 clinicians across seven EDs in Australia. Thematic analysis was undertaken by two researchers. Results indicate a lack of confidence around DV screening, and tensions in clinicians initiating conversation while managing their own emotional stressors. No participants expressed knowledge of formal screening processes in their workplaces. Successful DV screening programs must provide clinicians with the tools to minimize perceived discomfort in initiating and sustaining conversations while accepting patient preferences regarding disclosure. [ABSTRACT FROM AUTHOR]

Kidney transplantation is a critical treatment option for end-stage kidney disease patients, offering improved quality of life and increased survival rates. However, the complexities of kidney transplant care necessitate continuous advancements in decision making, patient communication, and operational efficiency. This article explores the potential integration of a sophisticated chatbot, an AI-powered conversational agent, to enhance kidney transplant practice and potentially improve patient outcomes. Chatbots and generative AI have shown promising applications in various domains, including healthcare, by simulating human-like interactions and generating contextually appropriate responses. Noteworthy AI models like ChatGPT by OpenAI, BingChat by Microsoft, and Bard AI by Google exhibit significant potential in supporting evidence-based research and healthcare decision making. The integration of chatbots in kidney transplant care may offer transformative possibilities. As a clinical decision support tool, it could provide healthcare professionals with real-time access to medical literature and guidelines, potentially enabling informed decision making and improved knowledge dissemination. Additionally, the chatbot has the potential to facilitate patient education by offering personalized and understandable information, addressing queries, and providing guidance on post-transplant care. Furthermore, under clinician or transplant pharmacist supervision, it has the potential to support post-transplant care and medication management by analyzing patient data, which may lead to tailored recommendations on dosages, monitoring schedules, and potential drug interactions. However, to fully ascertain its effectiveness and safety in these roles, further studies and validation are required. Its integration with existing clinical decision support systems may enhance risk stratification and treatment planning, contributing to more informed and efficient decision making in kidney transplant care. Given the importance of ethical considerations and bias mitigation in AI integration, future studies may evaluate long-term patient outcomes, cost-effectiveness, user experience, and the generalizability of chatbot recommendations. By addressing these factors and potentially leveraging AI capabilities, the integration of chatbots in kidney transplant care holds promise for potentially improving patient outcomes, enhancing decision making, and fostering the equitable and responsible use of AI in healthcare. [ABSTRACT FROM AUTHOR]

Since I started my residency program in Radiology, I have been committed to promoting radiation protection, paying particular attention to the justification and optimization of the examinations [...]

Introduction One important and often difficult act of communication common in psychiatry is communication regarding the need for involuntarily commitment for psychiatric treatment. Thus, we designed an educational workshop for psychiatry residents on how to communicate the plan for involuntarily commitment to a psychiatric hospital. Methods Using faculty expertise, we created a protocol to guide trainees on how to structure conversations around involuntary commitment. Residents first attended a didactic on the protocol, followed by a 1-hour workshop with standardized patients (SPs) 1 week later. The workshop consisted of three 14-minute simulated scenarios with the SP with debriefing. Trainees filled out pre- and postworkshop surveys. Results Fifteen and 12 residents completed the pre- and postworkshop surveys, respectively. Residents' perceived comfort level in their ability to deliver involuntary commitment news significantly improved after the workshop when compared to before (3.0 vs. 3.7 for pre- and postworkshop surveys, respectively). Residents trended toward intending to make more changes to their approach after the workshop when compared to before (2.2 vs. 2.6, respectively). Feedback on the didactic and workshop were largely positive. Discussion To our knowledge, our intervention is the first designed specifically to teach psychiatry residents how to communicate to patients that they are being involuntarily committed to emergent psychiatric treatment. This educational model has potential for improving resident skills and confidence in having difficult conversations around involuntary commitment.

The Association of University Radiologists (AUR) convened its sixth annual Academic-Industry Roundtable in a hybrid fashion in March 2022, with academic radiology and radiology industry leaders gathered in person and via remote videoconference. The open discussion centered around on challenges facing radiology and specifically focused on the people in our field, including patients, radiologists, and radiology staff. Participants identified numerous opportunities for industry and radiology departments to collaborate to improve equitable access to healthcare, communication with patients, use of appropriate imaging, and the state of the radiology workforce. [ABSTRACT FROM AUTHOR]

Introduction and aim. Nursing fields begin to face a wide variety of challenges when they first enter clinical practice. The aim of this study is to determine the difficulties experienced in patient communication by nursing students taking the clinical practice course for the first time Material and methods. Focus group interview design was used for this study. Focus group design is used to give information about the opinions and experiences of the sample group on any subject. It is reported as a convenient design to identify different perspectives on a subject within the scope of the sample. Focus group interviews are a widely used method as data collection technique. Results. The findings of the study continue on 4 main themes at level 3, by identifying the similarities and differences in the codes determined by the three experts (researchers consulted and the researcher conducting/reporting the study). The findings of the study were evaluated in comparison with the findings of the studies reached in the literature and conducted in regions such as Israel, Iran, Sri-Lanka, Kenya, and Africa. Conclusion. There are many problems in student-patient communication in many different dimensions. The difficulties arising due to these problems generally focus on unknown clinical environment, lack of knowledge, differences between theory and practice, and mentor interaction. [ABSTRACT FROM AUTHOR]

Background: Digitalization in the health system is a topic that is rapidly gaining popularity, and not only because of the current pandemic. As in many areas of daily life, digitalization is becoming increasingly important in the medical field amid the exponential rise in the use of computers and smartphones. This opens up new possibilities for optimizing patient education in the context of anesthesia. The main aim of this study was to assess the implementation of remote consent in Europe. Methods: An online survey entitled "Digital online Patient Informed Consent for Anesthesia before Elective Surgery. Recent practice in Europe," with a total of 27 questions, was sent by the European Society of Anesthesiology and Intensive Care (ESAIC) to their members in 47 European countries. To assess the effect of the economy on digitalization and legal status with regard to anesthesia consent, data were stratified based on gross domestic product per capita (GDPPC). Results: In total, 23.1% and 37.2% of the 930 participants indicated that it was possible to obtain consent online or via telephone, respectively. This observation was more often reported in countries with high GDPPC levels than in countries with low GDPPC levels. Furthermore, 27.3% of the responses for simple anesthesia, 18.7% of the responses for complex anesthesia, and 32.2% of the responses for repeated anesthesia indicated that remote consent was in accordance with the law, and this was especially prevalent in countries with high GDPPC. Concerning the timing of consent, patients were informed at least one day before in 67.1% of cases for simple procedures and in 85.2% of cases for complex procedures. Conclusion: Even European countries with high GDPPC use remote informed consent only in a minority of cases, and most of the time for repeated anesthetic procedures. This might reflect the inconsistent legal situation and inhomogeneous medical technical structures across Europe. [ABSTRACT FROM AUTHOR]

The biomedical approach to medical knowledge is widely accepted around the world. This article considers whether the incorporated aspects of physician‐patient interaction have become similarly common across the globe by comparing the gestures that physicians use in their interactions with patients. Up to this point, there has been little research on physicians' use of gestures in health‐care settings. We explore how—in four university hospitals in Turkey, the People's Republic of China, The Netherlands and Germany—physicians use gesture in their discussions with simulated patients about the condition of heart failure. Our analysis confirms the importance of gestures for organising both the personal interaction and the knowledge transfer between physician and patient. From the perspective of global comparison, it is notable that physicians in all four hospitals used similar gestures. This demonstrates the globality of biomedical knowledge in an embodied mode. Physicians used gestures for a range of purposes, including to convey the idea of an 'anatomical map' and for constructing visual models of (patho‐)physiological processes. Since biomedical language is rife with metaphor, it was not surprising that we also identified an accompanying metaphorical gesture which has a similar form in the various locations that were part of the study. [ABSTRACT FROM AUTHOR]

While gamification has been used in pharmacy education, more research is needed to establish that these methods are effective. The objective of our study was to evaluate the effectiveness of a murder mystery activity to teach patient communication and interviewing skills to first year pharmacy students in a pharmacy skills laboratory. A non-medical murder mystery activity was used to introduce and provide practice on communication techniques needed for obtaining a medical history. These techniques included an introduction, confirmation of patient identity, nonverbal expression, self-expression, empathy, emotional response, question style, organization, and appropriate closure. In groups of three to five, students interviewed five different suspects and were assessed as a group on their second and fifth suspect interviews within one, three-hour laboratory session using a standardized rubric. Assessments were completed by students, standardized patients, and faculty. A total of 161 students completed the murder mystery exercise over three years. Total student scores all significantly improved from the second to fifth interview. In addition to total scores, each subtotal score significantly improved from the second to fifth interview, regardless of the evaluator. Within the murder mystery laboratory, students' communication scores improved on a standardized communication rubric. Use of a murder mystery is an effective, engaging way to introduce and practice communication skills that could be adapted by other institutions. [ABSTRACT FROM AUTHOR]

PurposeTo provide insight into the types of questions asked to medical physicists by patients during one-on-one physicist-patient consults at one institution.Materials and methodsMedical physicists trained in patient communication techniques met with patients to provide an overview of the treatment planning and delivery processes, discuss the patient's treatment plan, and answer any technical questions. From August 2016 to December 2019, 152 physicist-patient consults were conducted. In the initial months of the study (August 2016-December 2017), following each physicist-patient consult, all patient questions were documented by the physicists. For the remaining time period (January 2018-December 2019), any newly encountered questions were periodically added to the list. The questions were compiled into a comprehensive list and organized into categories.ResultsThere were a total of 88 unique patient questions. These questions fit into four topical categories. Fifty-four questions (61.4%) were in the "Treatment Planning and Delivery Questions" category, 15 questions (17.1%) were in the "General Radiation Questions or Concerns" category, 13 questions (14.8%) were in the "Safety and Quality Assurance Questions" category, and 6 questions (6.8%) were in the "Medical Questions" category. Overall, patients were primarily concerned about how radiation works, the treatment planning and delivery processes, and what is being done to keep them safe throughout their treatment.ConclusionPhysicist-patient consults provided an opportunity to address the technical aspects of radiation therapy with patients in greater detail. The fact that patient questions could be conveniently grouped into only four topical categories indicates that it may be straightforward for other medical physicists to prepare for effectively addressing technical questions during physicist-patient consults.

Efforts to increase patient comfort by minimizing pain and anxiety have been shown to improve clinical outcomes, reduce pain thresholds, decrease analgesic requirements and complication risk, strengthen the physician-patient relationship, and increase overall patient satisfaction. Patients also have a strong preference for patient-centered communication and educational discussion with physicians. In recent years, the increasing emphasis on patient experience scores as a metric for quality care has had significant implications for physician practice and has reinforced attempts to provide more patient-centered care. Though different pharmacologic agents and techniques have been extensively reviewed in the dermatologic literature, there have been few studies of non-pharmacologic strategies for improving patient-centered care. This evidence-based review describes alternative techniques that have been suggested for use in dermatologic surgery. Mechanoanesthesia, cold therapy, verbal and audiovisual distraction, music, optimal needle insertion methods, hypnosis and guided-imagery, perioperative communication, and educational strategies have been reported to improve the patient experience in dermatologic surgery. These interventions are often cost-effective and easy to implement, avoid medication side effects, and serve as adjunct approaches to enhance patient comfort. This review examines the corresponding evidence for these nonpharmacologic strategies to provide a clinical resource for the dermatologic surgeon seeking to optimize the patient experience.

Background Chronic pain is a prevalent and burdensome problem within the Canadian health care system, where the gold standard treatment occurs at multidisciplinary pain facilities. Patient intake questionnaires (PIQs) are standard practice for obtaining health information, with many patients including free-text (e.g., writing in margins of questionnaires) on their PIQs. Aims This study aims to quantitatively examine whether and how patients who include free-text on PIQs differ from those who do not. Methods We retrospectively analyzed 367 PIQs at a Canadian pain facility in Winnipeg, Canada. Patients were categorized into free-text (i.e., any text response not required in responding to questions) or no free-text groups. Groups were compared on sociodemographics, pain, health care utilization, and depressive symptoms with independent samples t-tests and chi-square analyses. Results Patients with free-text compared to those without had more sources of pain (6.66 vs. 4.63), longer duration of pain (123.2 months vs. 68.1 months), and a greater proportion of past pain conditions (66.3% vs. 55.2%). Additionally, they had tried more treatments for their pain, had seen more specialists, had tried more past medications, were currently on more medications, and had undergone more tests. No differences were identified for depressive symptoms across groups. Conclusions This study is the first to examine patient and health-related correlates of free-text on PIQs at a Canadian pain facility. Results indicate that there are significant differences between groups on pain and health care utilization. Thus, patients using free-text may require additional supports and targeted interventions to improve patient–physician communication and patient outcomes.