Tuesday, April 11, 2023

AI Actually Helps: Quickly Educates Me on the Doctor-Patient '3 Talk Model'

Summary: While reading an MCED article, I found GPT4 was helpful in quickly getting some information on a medical decision making model that was new to me.


This week, Annals of Internal Medicine publishes an article by Selby et al. on Multi-cancer early detection tests, MCED.  The goal is to prepare doctors to have discussions about this testing with patients who have questions right now.  The article is here.

In the short article, the second citation is to decision making with high uncertainty, and the third citation is to something called the "3 Talk Model."  

I had never heard of the 3-talk model; it is by Elwyn et al. and dates to BMJ 2017 (359;J4891; PMID 29109079). It's now open access.  By the way, PMID 29109079 shows both related articles and articles that cite Elwyn directly.

A large table in Selby is built around the 3-Talk Model.  I asked GPT4 "What is the 3 Talk Model?" and got a decent looking answer (as much as I need to know.)  I then asked, "Are there any problems with the 3 Talk Model?" and got what seems like a reasonable answer again.


In medical decision making what is the "3 talk" model?

GPT4. The "3 talk" model, also known as the Three-Talk Model, is a structured approach to medical decision-making and patient communication. The model emphasizes the importance of clear and effective communication between healthcare providers and patients, particularly when it comes to discussing sensitive issues, treatment options, and decisions related to patient care. The model is comprised of three distinct stages:

Team Talk: This stage involves healthcare providers discussing and reviewing the patient's medical history, current condition, and available treatment options among themselves. This helps to ensure that all team members are on the same page and that they have a clear understanding of the patient's medical situation before talking with the patient.

Option Talk: In this stage, the healthcare providers present the patient with the various treatment options available, including the potential risks, benefits, and outcomes associated with each option. This stage is crucial for enabling patients to make informed decisions about their care. It is essential for healthcare providers to present the information in an unbiased manner and to be transparent about the uncertainties surrounding each option.

Decision Talk: The final stage involves discussing the patient's preferences, values, and concerns, and helping them make a decision that aligns with their personal goals and values. Healthcare providers should support and guide the patient in this process, ensuring that they understand the implications of their choice and feel comfortable with the decision they make.

Overall, the Three-Talk Model is designed to facilitate effective and empathetic communication between healthcare providers and patients, with the ultimate goal of helping patients make well-informed decisions about their care.

Have their been any criticisms of this model?  It seems commonsensical.

GPT4. While the Three-Talk Model has been widely accepted and utilized for its structured approach to medical decision-making and patient communication, there are some potential criticisms and limitations:

  • Time constraints: In a busy clinical setting, healthcare providers may not always have the time to engage in in-depth discussions with their patients at each stage of the model. This can lead to rushed conversations or inadequate information sharing, which could impact the effectiveness of the model.
  • Variability in communication skills: The success of the Three-Talk Model relies heavily on the communication skills of the healthcare provider. Not all providers may have the same level of expertise in communicating complex medical information or addressing sensitive issues with patients. This variability could lead to inconsistencies in the quality of patient-provider interactions.
  • Patient comprehension and health literacy: For the model to be effective, patients need to understand the information provided to them and actively engage in the decision-making process. However, some patients may have difficulty comprehending complex medical information, particularly if they have low health literacy. This can limit the effectiveness of the model in supporting informed decision-making.
  • Cultural sensitivity: The Three-Talk Model does not specifically address cultural differences and how they might affect patient-provider communication. In some cases, cultural beliefs or language barriers might hinder effective communication, making it more challenging for healthcare providers to engage patients in the decision-making process.

Despite these potential criticisms and limitations, the Three-Talk Model does provide a valuable framework for healthcare providers to follow when discussing medical decisions with patients. It emphasizes the importance of clear communication and patient-centered care, which are essential for supporting informed decision-making and improving patient outcomes.

bing.com/create  AI pics

I asked GPT4 directly how to have a structured conversation about MCED with a patient.  That is, it's sort of the poor-man's, AI-only version of the Selby article.  I've posted here.