Medical Obfuscation: Structure and Function

Crichton, Michael

doi:10.1056/nejm197512112932413

Cited by 66 publications

(17 citation statements)

References 0 publications

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“…Communication in medicine is difficult, and a certain degree of obscurity was also functional in the old-fashioned practice of medicine fueled by paternalism and efficientism. When he was a young graduate of Harvard Medical School, Michael Crichton stated that "medical writing is a highly skilled, calculated attempt to confuse the reader" (23). Unfortunately, this is sometimes still true today, especially in the field of informed consent and risk communication.…”

Section: Figure 1 English Text Readability Scoresmentioning

confidence: 99%

Low Quality and Lack of Clarity of Current Informed Consent Forms in Cardiology

Terranova

Ferro

Carpeggiani

et al. 2012

JACC: Cardiovascular Imaging

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Guidelines on informed consent for clinical practice exhort physicians to use standard plain language to enhance patient comprehension and facilitate shared decision making. The aim of this study was to assess and improve quality and readability of current informed consent forms used in cardiology. We evaluated the currently used informed consent forms, previously written in Italian and English, of 7 common imaging examinations, according to the recommendations of scientific societies. For each text, we also developed a revised informed consent form according to reference standards, including Federal Plain Language guidelines. Regarding readability scores, we analyzed each text (standard and revised) with Flesch-Kincaid (F-K) grade level (higher numbers indicating harder-to-read text) and the Italian language-tailored Gulpease level (from 0 [difficult] to 100 [easy]). Overall quality and readability was poor for both the original English and Italian versions, and readability was improved with the revised form, with higher readability evidenced by changes in both F-K grade level (standard 10.2 ± 2.37% vs. revised 6.5 ± 0.41%; p < 0.001) for English and Gulpease (standard 45.7 ± 2% vs. revised 84.09 ± 2.98%; p < 0.0001) for Italian. In conclusion, current informed consent forms are complex, incomplete, and unreadable for the average patient. Substantial quality improvement and higher readability scores can be achieved with revised forms that explicitly discuss risks and are prepared following standard recommendations of plain writing.

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Section: Figure 1 English Text Readability Scoresmentioning

confidence: 99%

Low Quality and Lack of Clarity of Current Informed Consent Forms in Cardiology

Terranova

Ferro

Carpeggiani

et al. 2012

JACC: Cardiovascular Imaging

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“…Medical writing is justly criticized for its abuse of English; a stubborn problem is ''medicalese''-jargon that obscures rather than clarifies intent (27)(28)(29). Terms such as ''oligozoospermia'' (and its longer permutations) readily fall into this category of medical ''puffery.''…”

Section: ''Pompous Diction''mentioning

confidence: 99%

“Oligozoospermia,” “azoospermia,” and other semen-analysis terminology: the need for better science

Grimes

Lopez

2007

Fertility and Sterility

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“…As the best selling author Michael Crichton wrote when he was a young graduate from Harvard Medical School, “Medical writing is a highly skilled, calculated attempt to confuse the reader.”12 Unfortunately, a side effect of this confusion is that physicians become disoriented and eventually ignore the risks of what they are doing. The real issue is not that physicians do not communicate risks to patients, but rather that physicians do not communicate with other physicians, not even with themselves.…”

Section: Communicating Riskmentioning

confidence: 99%