番茄社区

Common medical phrases often confused individuals in ways that could affect health outcomes, a cross-sectional study found.

Among 215 adults surveyed outside the medical setting, most knew "negative" cancer screening results meant not having cancer (96%), but fewer understood that the phrase "your tumor is progressing" was bad news (79%) or that having positive lymph nodes meant the cancer has spread (67%), reported Michael Pitt, MD, of the University of Minnesota in Minneapolis, and colleagues.

Not surprisingly, participants had a significantly better understanding of common-language equivalents compared with jargon phrases (98% vs 87%, P<0.001), the authors wrote in .

Only two of the 13 survey questions showed a significant relationship between education level and the accuracy of understanding medical jargon (people with graduate degrees had greater understanding of "unremarkable" and "nothing by mouth"), which led researchers to suggest education couldn't fully account for the differences.

Healthcare professionals already know jargon should be avoided because it may lead to confusion and adverse outcomes, Pitt's group noted.

However, Pitt told 番茄社区: "As doctors, we have found that while we often use words or phrases our patients may not understand, this is often because we simply have heard them so often that we simply forget there was a time we too didn't know what they meant."

"We call this 'jargon oblivion' and feel the only cure is for us to learn from our patients when we are using terminology or phrases that are rarely understood," said Pitt.

Reached for comment, Leslie Jurecko, MD, MBA, the chief safety, quality and patient experience officer of the Cleveland Clinic, told 番茄社区 that these jargon phrases studied are so embedded that "I think it will be very challenging to eliminate all of this jargon from medical care."

One thing her institution uses is coaching in the repeat-back method, she said, to "encourage them to have their patients repeat back for understanding, and that opens up the dialogue." Clarifying and validating what was said allows patients a safe place to ask further questions, she added.

"We also see in practice -- and I think this is nationally and globally -- that medical providers will use acronyms, and that has always been problematic, both in verbal and written language," Jureko said. "We are always trying to get rid of that in the medical record."

For this study, Pitt and colleagues examined data on 215 participants recruited at the 2021 Minnesota State Fair near St. Paul to complete an electronic survey. Adults who did not work or train in the medical field and were able to speak and read English were included. Participants were stratified by those who received a verbal (n=99) or written (n=116) survey.

The survey asked questions about common medical terms, such as the meaning of "febrile"; assessed participant understanding of other phrases, such as "You will need to be NPO at 8 a.m."; and inquired about the confidence level of respondents.

Participants' age averaged around 42, and 63% were women. Nearly one-third had a graduate or professional education, one-third had a bachelor's degree, and 16% had some college education.

Participants showed a varied ability to comprehend medical jargon phrases. While most understood that it was good news to have an "unremarkable chest radiography" (80%), only a few accurately understood that it was generally bad news to hear a clinician say their "radiography was impressive" (21%).

Only 41% accurately interpreted that hearing that the "neuro exam is grossly intact" meant good news.

While 29% were able to correctly interpret that "bugs in the urine" indicated a urinary tract infection, only 9% understood the term febrile. Notably, only 2% understood the meaning of an "occult" infection. "More people believed that the phrase 'had an occult infection' had something to do with a curse than understood that this meant that they had a hidden infection," the researchers pointed out.

Multivariable logistic regression linked older age to an increased understanding of the phrases "nothing by mouth" and "negative blood cultures" but a reduced understanding of the meaning of "impressive radiography findings."

"Given that increasing age comes with more opportunities to have heard these terms used in a medical context, it is somewhat surprising that older age was only associated with better understanding of two of the 13 phrases," the group wrote.

And the more confident participants were in answering the questions, the more likely they were correct.

After finding no significant difference among audio/verbal or written versions of the survey, researchers suggested this indicated "that future studies of jargon understanding may support the less time-intensive written survey approach."

The authors acknowledged limitations to the data, including possible selection bias, given the high proportion (77%) with an associate degree or higher.

"Though participation was open to all adult fairgoers who volunteered, there is likely a naturally occurring bias in selecting individuals who would visit a university research building during their visit to a fair," they noted. "Additionally, this research building had a mask mandate to mitigate the spread of SARS-CoV-2 at the time of study, whereas many other areas of the fair did not."

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