The Roter Interactional Analysis System (RIAS): Frequency of Four Code Groupings According to Physician Specialty*
| Communication Behavior | Unadjusted | Controlled for Encounter Duration Only | Expanded Model† | ||||||
|---|---|---|---|---|---|---|---|---|---|
| IM | FP | P | IM | FP | P | IM | FP | P | |
| I. Data gathering | |||||||||
| a. Closed-ended biomedical questions | 23.1 | 16.5 | .02‡ | 21.4 | 18.6 | .05‡ | 22.2 | 18.4 | .01‡ |
| b. Open-ended biomedical questions | 2.9 | 3.0 | .24 | 2.9 | 3.0 | .74 | 2.3 | 2.4 | .64 |
| c. Closed-ended psychosocial questions | 8.7 | 6.8 | .11 | 8.9 | 6.8 | .04‡ | 8.0 | 6.2 | .09 |
| d. Open-ended psychosocial questions | 1.6 | 1.5 | .72 | 1.5 | 1.6 | .54 | 2.3 | 2.4 | .79 |
| e. Bids for clarification | 1.2 | 0.3 | .05‡ | 1.2 | 0.3 | .06 | 1.0 | 0.1 | .14 |
| Total count | 37.4 | 28.2 | .02‡ | 36.0 | 30.1 | .02‡ | 35.8 | 29.6 | .02‡ |
| II. Patient education and counseling | |||||||||
| a. Provides biomedical information | 32.0 | 37.6 | .19 | 32.8 | 37.3 | .04‡ | 31.7 | 34.9 | .22 |
| b. Provides psychosocial information | 3.9 | 7.6 | .02‡ | 3.9 | 7.8 | .02‡ | 5.6 | 8.1 | .02‡ |
| c. Counsels biomedical | 14.2 | 13.8 | .78 | 14.1 | 13.9 | .87 | 14.7 | 13.3 | .23 |
| d. Counsels psychosocial | 7.2 | 8.0 | .56 | 7.4 | 8.3 | .39 | 5.2 | 5.5 | .81 |
| Total count | 57.5 | 67.4 | .18 | 59.7 | 66.4 | .08 | 57.3 | 61.8 | .25 |
| III. Rapport building | |||||||||
| a. Personal remark | 7.8 | 8.6 | .69 | 8.0 | 8.3 | .80 | 9.9 | 10.6 | .31 |
| b. Laughter | 2.8 | 3.5 | .30 | 2.9 | 3.4 | .30 | 3.7 | 5.1 | .03‡ |
| c. Approval | 3.8 | 4.7 | .26 | 1.2 | 1.6 | .46 | 4.7 | 5.0 | .13 |
| d. Empathy | 0.3 | 0.5 | .07 | 0.3 | 0.5 | .06 | 0.4 | 0.6 | .06 |
| e. Concern | 2.1 | 2.3 | .49 | 2.1 | 2.4 | .30 | 2.9 | 3.1 | .35 |
| f. Reassure | 3.4 | 3.9 | .38 | 3.4 | 4.0 | .13 | 4.7 | 5.6 | .06 |
| g. Legitimate | 0.6 | 0.7 | .46 | 0.7 | 0.8 | .30 | 0.9 | 1.0 | .54 |
| Total count | 20.9 | 24.3 | .34 | 18.6 | 21.0 | .26 | 27.6 | 30.9 | .14 |
| IV. Partnership building | |||||||||
| a. Paraphrase | 4.3 | 3.4 | .16 | 3.8 | 3.9 | .31 | 4.9 | 4.6 | .47 |
| b. Partnering | 0.1 | 0.1 | .22 | 0.1 | 0.1 | .20 | 0.0 | 0.1 | .46 |
| c. Asks for opinion | 0.5 | 0.3 | .24 | 0.5 | 0.3 | .18 | 0.5 | 0.4 | .52 |
| d. Asks for understanding | 3.3 | 3.0 | .58 | 3.1 | 3.1 | .96 | 3.3 | 3.0 | .31 |
| e. Asks for reassurance | 0.0 | 0.0 | .62 | 0.0 | 0.0 | .69 | 0.0 | 0.1 | .90 |
| Total count | 8.2 | 6.8 | .21 | 7.6 | 7.6 | .97 | 8.5 | 8.3 | .88 |
IM, internal medicine; FP, family practice.
* Frequency analysis conducted using two-tailed significance testing and generalized estimation equations to control for variable number of office visits per physician.
† Controlled for duration of encounter, experimental group, generalized health questionnaire (GHQ) score, being an established patient, physician age, patient income, patient ethnicity, and patient age.
‡ P < .05.