A linguistic framework for assessing the quality of written patient information: its use in assessing methotrexate information for rheumatoid arthritis

Abstract

Patient information leaflets are an important adjunct to verbal exchange between doctor and patient. Their value is dependent upon whether they contain useful information from the viewpoint of the patient and are easily understood. We developed a framework based upon linguistic theory for assessing the quality of written patient information and applied it to a set of leaflets about methotrexate treatment. Items included the overall structure of the text, the technicality of the vocabulary used, the number of content words per clause ('lexical density'), and the clarity of the role relationship between author and reader. The leaflets consisted of up to nine identifiable sections (range 3-8): background information about the drug, summary of its use, dosage instructions, outline of benefits and side-effects, monitoring information, constraints on patient behavior, storage instructions, and clinical contact availability. Most leaflets contained a high number of content words per clause and the identity of the author was clear in only three (17%). Linguistic analysis provides highly relevant information about written patient information. Together with critical assessment of factual and visual aspects, consideration of key linguistic features should improve the quality of informational texts for our patients.

Format and readability of an enhanced invitation letter did not affect participation rates in a cancer registry-based study: a randomized controlled trial

“…Design characteristics are those that relate to document design such as layout, font, and use of visual material [23,24]. Content characteristics include the use of active voice, short words, and sentences, and are argued to reduce the complexity of written materials [18,23].…”

The contents of dental implant patient information leaflets available within the UK

“…The use of detailed information leaflets which could be used as a defence in potential malpractice lawsuits have been advocated 11 . Often written patient information is not referenced and does not give an indication of the strength of evidence to support the information that is being provided which makes verifying the scientific quality of the information more difficult 12 . There is also a potential for bias within the patient information leaflets produced by commercial manufacturers, and information leaflets available in general dental practices have been found to have limitations 13 .…”

Do cervical cancer screening patient information leaflets meet the HPV information needs of women?

“…Patient information leaflets play a central role in the exchange of information between doctors and their patients [27,28] and research suggests that patients want detailed health information made available in this format [29]. Patient information leaflets, however, are often politically charged, mass produced and quickly outdated, resulting in inconsistent and often inaccurate information [22,28,[30][31][32].…”