Medical Mumbo Jumbo: Understanding Patient Information

Ever been in a conversation when you feel like the only Earthling among Venutians? Maybe it’s a group of geeks discussing batch files and bit busters, or pilots yakking about ETEs and FARs. Jargon is useful for specialist communication, and it’s also a way of excluding outsiders.

When it comes to understanding your health condition, the last thing you want to feel like is an outsider. But a new study published in JAMA Internal Medicine concluded that, good intentions aside, the language used in some patient/consumer medical information is beyond the scope of their comprehension.

As noted in the JAMA study, 59 in 100 Americans use the Internet to learn about health and health care. While often useful, the Internet can contribute to the “say what?” problem. One of the study’s authors, Dr. Charles Prestigiacomo, described the situation to Reuters. “Patients will often come to the office, and one of the first things they say to you, especially about technical information, they’ll say that they’ve been on the Internet, and they’ll quote one or two key phrases back to you,” he told the news organization. “Unfortunately, the little soundbites, while accurate, may not be complete.”

Prestigiacomo and his researchers from the University of Medicine and Dentistry of New Jersey (UMDNJ) applied several measures to the notion of readability scales (including one charmingly known as “simple measure of gobbledygook (SMOG) grading”). They looked at materials developed by 16 different medical specialty societies.

The average reading level of the online materials ranged from ninth grade to college sophomore. As the JAMA study noted, the average American adult reads at a seventh to eighth grade level. The American Medical Association, the National Institutes of Health and the U.S. Department of Health and Human Services, according to the study, say that patient education materials should be written at a fourth to sixth grade reading level.

As Reuters notes, the new study’s findings mirror those of previous research by the same scientists analyzing patient education materials in individual specialties.

“Organizations often end up using jargon,” Lisa Gualtieri, who studies health communication at Tufts University, told Reuters. They use “the language they’re accustomed to as opposed to [the language] the people they’re trying to reach are accustomed to using.”

Prestigiacomo, a neurological surgeon, tries to reach his patients with the use of analogies. “There are only so many ways you can describe an aneurysm,” he told Reuters. He tells patients these ballooning blood vessels are “like a blister on a tire.”

Acknowledging that that image isn’t “perfectly accurate,” he said, “… sometimes we have to realize that simplifying it to an analogy may be the best way for patients to understand it.”

Of the medical specialties the study examined, obstetrics/gynecology was particularly notable for its failure to communicate. Researchers showed that its patient materials averaged nearly six clichés for every 50 pages, among other language mistakes that undermined rather than illuminated the point being made. The problem with clichés, one of the study authors told Reuters, is that “You go from region to region in the U.S., people aren’t familiar with what each cliche refers to.”

Sometimes, the ability to communicate isn’t just translating more advanced material for a lay readership, it’s a matter of basic writing skills. Using an active instead of passive voice is more immediate, and generally communicates better.

Here’s the difference:

• The ultrasound was ordered by the doctor-passive voice.
• The doctor ordered an ultrasound-active voice.

The range of passive versus active voice use among the specialties studied was 4% for family medicine versus 27% for neurological surgery.

“Concise and to the point is the way to go for this sort of stuff,” one study author told Reuters. The authors also suggested that websites use photos and videos as well as text.

One good outcome of the study, according to Prestigiacomo, is that one medical specialty group has committed to rewriting its patient materials after seeing the results of the research.

If you are researching health or medical information, and you don’t understand the material, use the search function of your browser to define unfamiliar or confusing terms. Some excellent sites for medical information include:

• MedlinePlus (general health topics, demographic groups and drugs)
• DailyMed (drug information)
• PubMedHealth (prevention and treatment of diseases and conditions)

Also, see our blog, “Inquiring Minds Want to Know … Questions Patients Should Always Ask.” And remember: If you don’t understand something your care provider says, ask for clarification.