Prioritising national healthcare service issues from free text feedback – A computational text analysis & predictive modelling approach
Bibliographic record
Abstract
Patient experience surveys have become a key source of evidence for supporting decision-making and continuous quality improvement within healthcare services. To harness free-text feedback collected as part of these surveys for additional insights, text analytics methods are increasingly employed when the data collected is not amenable to traditional qualitative analysis due to volume. However, while text analytics techniques offer good predictive capabilities, they have limited explanatory features often required in formal decision-making contexts, such as programme monitoring or evaluation. To overcome these limitations, this study integrates computational text and predictive modelling as part of a Computational Grounded Theory method to determine the effect of quality gaps in care dimensions and their prioritisation from free-text feedback. The feedback was collected as part of a national survey to support decisions on continuous improvement in Maternity Services in Ireland. Our approach enables (1) operationalising the service quality lexicon in the context of maternity care to explain the effect of quality gaps in care dimensions on overall satisfaction from free-text comments; and (2) extending the service quality lexicon with two organisational and political decision-making concepts: “Salience” and “Valence”, for prioritising perceived quality gaps. These methodological affordances enable the extension of service quality theory to explicitly support the prioritisation of improvement decisions which before now required additional decision frameworks. Results show that tangibles-, process-, and reliability-related care issues have the highest importance in our study context. We also find that hospital contexts partly determine the relative importance of gaps in care dimensions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.072 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".