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Competing Agendas in Upstream Engagement Meetings Between Celiac Disease Experts and Patients

This article examines discussions between innovators and patient users about emergent medical technologies in the field of celiac disease. Using discursive psychology and conversation analysis, the authors analyze participants’ talk with regard to the social activities performed. They find that the topical agenda, preference structure, and presuppositions incorporated in the innovators’ questions restrict patients’ scope for saying things in and on their own terms. Not participants’ intentions per se but what the questions indirectly communicate profoundly shapes the agenda of these meetings. This may explain why some of the difficulties of innovator-user interaction are persistent and hard to pinpoint.