Coding Structures and Actions with the COSTA Scheme in Medical Conversations

This paper describes the COSTA scheme for coding structures and actions in conversation. Informed by Conversation Analysis, the scheme introduces an innovative method for marking multi-layer structural organization of conversation and a structure-informed taxonomy of actions. In addition, we create a corpus of naturally occurring medical conversations, containing 318 video-recorded and manually transcribed pediatric consultations. Based on the annotated corpus, we investigate 1) treatment decision-making process in medical conversations, and 2) effects of physician-caregiver communication behaviors on antibiotic over-prescribing. Although the COSTA annotation scheme is developed based on data from the task-specific domain of pediatric consultations, it can be easily extended to apply to more general domains and other languages.

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