38 Exploring communication in clinical encounters: a longitudinal qualitative study of adolescents with non-traumatic knee pain attending in secondary care
Bibliographic record
Abstract
Introduction Effective communication is essential for building trust, reducing diagnostic uncertainty and supporting adolescents with knee pain. The experiences of the adolescents during the clinical encounter can influence their acceptance, pain beliefs and self-management abilities. Still, few studies have explored the patient-clinician exchanges during the clinical encounter. Therefore, we aimed to explore the communication between adolescents with non-traumatic knee pain and orthopedic surgeons, and to understand how these interactions influence adolescents understanding of their pain condition and self-management.Materials and Methods We recruited adolescents aged 10–19 years experiencing non-traumatic knee pain. We video-recorded consultations with adolescents attending first appointments with an orthopedic surgeon. We conducted two follow-up interviews with the adolescents, 1–3 and 14–17 days after their initial consultation. Data were analyzed using inductive reflexive thematic analysis. The findings from all time points were synthesized, forming the basis for the longitudinal analysis.Results Nine adolescents with non-traumatic knee pain were included. The consultations lasted between 11 and 17 minutes. Adolescents struggled to understand messages about their knee pain, leading to uncertainty about the diagnosis, management plan, and need for further examinations. They also found it difficult to recall what was discussed during the clinical encounter. This meant that some individuals paused their activities, stagnated their self-management and youths waiting for clear answers.Conclusion The study illustrated the complexity of educating adolescents with non-traumatic knee pain. We observed a significant loss of information and uncertainties during/after the clinical encounter. More research into how health information is retained in adolescents is needed.
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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 | 0.027 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.008 | 0.005 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
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".