Constructing a Chinese Medical Conversation Corpus Annotated with Conversational Structures and Actions

Constructing a Chinese Medical Conversation Corpus Annotated with Conversational Structures and Actions Nan Wang† Yan Song‡ Fei Xia♮ †Sociology Department, University of California, Los Angeles, CA 90095, USA ‡Tencent AI Lab, Shenzhen, Guangdong Province, China ♮Linguistics Department, University of Washington, Seattle, WA 98104, USA nwang3@ucla.edu, clksong@tencent.com, fxia@uw.edu Abstract Overuse of antibiotics and the attributed bacterial resistance is one of the most serious global public health crises today. Previous research reported that patients’ advocacy for antibiotic treatment was consequential on antibiotic over-prescribing. To investigate how the advocacy and other factors contribute to antibiotic over-prescribing, qualitative and quantitative analysis of doctor-patient conversation can yield valuable findings. In this paper, we introduce AMed (Annotated Corpus of Medical Conversations), a manually transcribed corpus of medical dialogue in Chinese pediatric consultations, with annotation of conversational structures and actions. Based on the annotation, a significant association between patient request for antibiotic and antibiotic over-prescribing is discovered. As this corpus is the first with annotation of conversational structures and actions on medical consultation conversations in Chinese, it can be a valuable resource for discourse and dialogue research in general, and for the understanding of human collaboration and negotiation behavior in clinical consultations in particular. Furthermore, findings from analyses of the corpus can shed light on ways to improve physician-patient communication in order to reduce antibiotic over-prescribing. Keywords: Conversation Analysis, physician-patient communication, antibiotics over-prescribing 1. Introduction Overuse of antibiotics and the attributed bacterial resistance is one of the most serious global public health crises today. Multiple and rising levels of resistance are found world- wide; some of the common illnesses become fatal again as the old drugs become ineffective and the pipeline for de- veloping new antibiotics become dry (Laxminarayan et al., 2013). The antibiotic overuse crisis is extremely severe in China. The country was the second largest consumer of antibiotics in the world during 2000-2010 (Boeckel et al., 2014) , and its bacterial resistance has reached alarming levels (Xiao et al., 2012). As a result, antibiotic overuse is an extremely severe and urgent problem in China. On av- erage, 138g antibiotics were consumed per person a year in 2012 —ten times that consumed in the United States (Yuan, 2014). One main contributor to antibiotic overuse is the high prescription rate of antibiotics, which was over 50% in outpatient care according to a previous study (Wang et al., 2014). A study in 784 health institutions across the coun- try found that antibiotics were prescribed twice as many as recommended by the WHO standard (Li et al., 2012). Overall, antibiotic prescription rates were over 50% in out- patient care; 75% of the patients were prescribed one an- tibiotic, and 25% were prescribed two or more antibiotics (Wang et al., 2014). With increasing global travel and ex- change, antibiotic overuse in China is not only a domestic issue but also has a global impact. Over-prescribing of antibiotics can be resulted from interaction-generated problems (e.g., misunderstanding in communication) that has little to do with sound medical judgment (Macfarlane et al., 1997). …

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