Abstract
This research explored the feasibility of using multidimensional scaling (MDS) analysis in novel combination with other techniques to study comprehension of epistemic adverbs expressing doubt and certainty (e.g., evidently, obviously, probably) as they relate to health communication in clinical settings. In Study 1, Australian English speakers performed a dissimilarity-rating task with sentence pairs containing the target stimuli, presented as “doctors' opinions.” Ratings were analyzed using a combination of cultural consensus analysis (factor analysis across participants), weighted-data classical-MDS, and cluster analysis. Analyses revealed strong within-community consistency for a 3-dimensional semantic space solution that took into account individual differences, strong statistical acceptability of the MDS results in terms of stress and explained variance, and semantic configurations that were interpretable in terms of linguistic analyses of the target adverbs. The results confirmed the feasibility of using MDS in this context. Study 2 replicated the results with Canadian English speakers on the same task. Semantic analyses and stress decomposition analysis were performed on the Australian and Canadian data sets, revealing similarities and differences between the two groups. Overall, the results support using MDS to study comprehension of words critical for health communication, including in future studies, for example, second language speaking patients and/or practitioners. More broadly, the results indicate that the techniques described should be promising for comprehension studies in many communicative domains, in both clinical settings and beyond, and including those targeting other aspects of language and focusing on comparisons across different speech communities.
Highlights
How people understand expressions of uncertainty, especially as they relate to discussing medical risk, is a challenging area of study in physician-patient communication (Berry, 2004; Gigerenzer, 2008; Pryer and Hewitt, 2010; Jones, 2013; Pilnick and Zayts, 2014)
multidimensional scaling (MDS) analysis proved feasible for use with dissimilarity ratings on adverbs embedded in carrier sentences
There was evidence for intragroup consistency, seen in the strong fit when weights derived from the consensus analysis were used with the Classical MDS analysis (C-MDS) analysis
Summary
How people understand expressions of uncertainty, especially as they relate to discussing medical risk, is a challenging area of study in physician-patient communication (Berry, 2004; Gigerenzer, 2008; Pryer and Hewitt, 2010; Jones, 2013; Pilnick and Zayts, 2014). The physician is using the adverbs perhaps, possibly, and likely to convey the lack of absolute certainty about outcomes (see Skelton et al, 1999). Such adverbs are inherently vague and may be open to misinterpretation, with potentially serious consequences in situations such as obtaining informed consent or delivering bad news (Babrow et al, 1998; Fox, 2000). Even quantifying uncertainty in terms of probabilities can be open to misinterpretation (Gigerenzer and Edwards, 2003) For this reason, health communication researchers need tools for studying how speakers handle the subtleties of key expressions such as adverbs of uncertainty and doubt. Our goal in this paper is to explore the feasibility of using one particular set of tools for this purpose, with a primary focus on health communication in clinical settings
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