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PubMed2006

How useful are post consultation letters to patients?

BACKGROUND: As part of the NHS plan it was suggested that all patients receive copies of letters sent to their General Practitioner following outpatient consultations. The former Secretary of State for Health extended this proposal, suggesting that patients have a specific letter to themselves after a hospital consultation. METHODS: The aim of this study was to send cardiorespiratory patients attending Charing Cross Hospital, a copy of the letter sent to their G.P. plus a specific letter to themselves and to assess the usefulness and comprehensibility of each. The letters were analysed for dictation time, Flesch Reading Ease Score, Flesch-Kincaid Grade Level and word count. Eighty-four out of 105 sequential patients (80%) consented and were sent both types of letter after their attendance. Patients returned both letters circling any items they did not understand and stated a preference for the GP letter, patient letter, or both. The patients' GPs were subsequently also asked for their views on each letter. RESULTS: GP letters took significantly longer to dictate than patient letters. The Flesch Reading Ease Score was significantly higher in the patient letters, indicating that the patient letters were easier to read. The GP letters were significantly longer than the patient letters and patients were significantly more likely to circle more items in the GP letters (p < 0.001). The content of letters is sometimes inaccurate. Thirty-six out of 62 patients (58%) would like to receive both letters, 13/62 (21.6%) would prefer the GP letter and 13/62 (20%) wanted only the patient letter. 45 GPs replied (62.5%), 28/45 (62.5%) wanted the GP letter, 14 GPs (31.1%) wanted both letters and 3/45 (6.7%) wanted the patient letter only. General themes concerned insufficient clinical details and the GPs preferred the structure of the letters written to them. CONCLUSION: Patients appreciate copies of the letter being sent to their GP but comprehension is less good than with a shorter letter written especially to the patient. More attention needs to be paid to making letters to GPs simpler to read without losing the structure and detail liked by GPs. A compromise might be to dictate the letter in front of the patient and to provide a speciality-specific glossary to accompany each letter.

Ambulatory Care↗
PubMed1982

Application of geometric models to letter recognition: distance and density.

This article reviews studies in which a single letter is visually presented under adverse conditions and the subject's task is to identify the letter. The typical results for such studies are (a) certain pairs of letters are more often confused than other pairs of letters; (b) certain letters are more easily recognized than others; and (c) confusion errors for a letter pair are often asymmetric, the number of errors differing depending on which letter of the pair is presented as the stimulus. A geometric model incorporating the properties of distance and spatial density (after Krumhansl) is presented to account for these results. The present application of the distance-density model assumes that each letter is constructed in a typical 5 X 7 dot matrix. Each letter is represented in 35-dimensional space based on its constituent dots. A central idea behind the model, embodied in the property of spatial density, is that an explanation of typical results must take into account the relationship of the entire stimulus set to both the presented letter and the responded letter. Specifically, according to the model, (a) pairs of letters that are close in geometric space are more often confused than pairs of letters that are distant; (b) letters that are in less spatially dense regions are more easily recognized than letters that are in more spatially dense regions; and (c) asymmetric confusion errors result when one member of a letter pair is in a denser region than the other member of the letter pair. The distance-density model is applied to published and unpublished results of the authors as well as published results from two other laboratories. Alternative explanations of the three typical letter recognition results are also considered. The most successful alternative explanations are (a) confusions are an increasing function of the number of dots that two letters share; (b) letters constructed from fewer dots are easier to recognize; and (c) asymmetries arise when one member of a letter pair is more easily recognized, since that letter then has fewer confusion errors to give to the other letter of the pair. The model is discussed in terms of the distinction between template matching and feature analysis. An alternative classification of letter recognition models is proposed based on the global versus local qualities of features and the spatial information associated with each feature. The model is extended to explain reaction time study results. It is suggested that the distance-density model can be used to create optimal letter fonts by minimizing interletter confusions and maximizing letter recognizability.

Discrimination Learning↗