{
  "abstract": "Background Poor patient–provider communication is a key driver of health outcomes and satisfaction, yet patterns of communication failure across socioeconomic groups remain poorly understood. We tested whether communication quality in primary dental care varies systematically by area-level deprivation.Methods We conducted a cross-sectional, rule-based natural language processing (NLP) analysis of patient reviews from Google Maps. We systematically sampled dental practices from seven UK regions with proportional representation across all Index of Multiple Deprivation (IMD) deciles. Reviews (n=6,171) underwent sentiment analysis and rule-based classification using Parsons’ sociological framework of the sick role, which examines patient cooperation with professional authority. We classified reviews as upholding authority (trust, compliance), challenging it (questioning recommendations, communication failures), or neutral, then examined complaint types within challenging reviews. Outcomes were stratified by area-level deprivation.Results Overall patient satisfaction was high (89.9%, 95% CI 89.2–90.7). Among those challenging professional authority (n=296, 4.8%), complaint types were strongly patterned by deprivation. In the most deprived areas (Decile 1), communication failures (e.g., ‘rushed’, ‘dismissed’, ‘not listened to’) comprised 60% of challenges, falling to 25–38% in affluent areas. Conversely, substantive challenges to clinical recommendations (citing online sources, seeking second opinions) were absent in Decile 1 (0%) but accounted for 10–13% of challenges in less deprived areas. Notably, 38% of patients who challenged professional authority nonetheless awarded 5 stars, suggesting informed questioning can coexist with positive experiences when communication quality is maintained.Conclusion Communication failures are disproportionately concentrated in practices serving deprived populations, indicating systematic provider–patient interaction patterns that may widen oral health inequalities. Actionable responses include: commissioning formulas that protect consultation time in high-deprivation areas; training to mitigate unconscious communication biases; and routine monitoring of ‘being listened to’ as a patient-reported experience measure, stratified by deprivation.",
  "authors": [
    {
      "affiliations": [
        "Department of Computer Science, University of Manchester, Manchester, UK"
      ],
      "name": "Mingyang Li"
    },
    {
      "affiliations": [
        "Division of Dentistry, University of Manchester, Manchester, UK"
      ],
      "name": "Ali Feizollah"
    },
    {
      "affiliations": [
        "Division of Dentistry, University of Manchester, Manchester, UK"
      ],
      "name": "Matthew Byrne"
    }
  ],
  "title": "OP13 Socioeconomic inequalities in patient-provider communication: a cross-sectional natural language processing (NLP) study of UK dental care reviews",
  "uid": "10175fd6-959c-551d-b748-857a3ce03177"
}