Patients often misunderstand common medical phrases

Patients frequently misunderstand physician phrases and assign opposite meanings of what was intended, leading to confusion about health outcomes, a study published in JAMA Network Open reported.

Although clinicians acknowledge that medical jargon should be avoided when communicating with patients, they often use it, Rachael Gotlieb, MD, of the University of Minnesota Medical School, and colleagues noted.

“Though this medical language may facilitate communication between health care professionals, its use with patients can introduce confusion that may have serious consequences,” they wrote.

Previous research has shown that the public rarely understands medical terminology and acronyms, but Gotlieb and colleagues assessed specific phrases that have different meanings depending on usage, “because these phrases may be particularly confusing to patients.”

The researchers utilized a 13-question written and verbal survey — comprised of a mix of open-ended and multiple-choice questions — during a 3-day period at the 2021 Minnesota State Fair.

Several questions used phrases with terms that possess differing meanings outside of a medical setting, such as “unremarkable”; “febrile”; “occult infection”; and “grossly intact.”

In addition, the researchers assessed terms that were previously shown to be confusing to patients, such as “negative” and the acronym “NPO.” They also examined participants’ understanding of the full phrase for NPO, “nothing by mouth,” as a way of assessing the outcomes through how phrases are communicated.

A total of 215 respondents (mean age, 42 years) completed the survey. Among them, 65% had a bachelor’s degree or higher, and 63% were female.

Gotlieb and colleagues reported that most respondents (96.3%) understood that a negative cancer screening meant they did not have cancer, and 79.1% knew that the phrase “your tumor is progressing” is bad news.

Meanwhile, only 41.4% and 20% correctly defined “neuro exam is grossly intact” and “have you been febrile,” respectively, while 1.9% understood what was meant by a patient having an “occult infection.”

The full phrase “nothing by mouth” was understood by 75.3% respondents compared with 11.2% who recognized its acronym “NPO” (P < .001).

The researchers pointed out that the COVID-19 pandemic may have influenced the public’s understanding of certain terms. For example, the public’s understanding of “negative” and “positive” in the context of viral testing may account “for the near-universal understanding of negative cancer screening being considered good news in our study,” the researchers wrote.

“However, it is worth noting that when comparing the understanding of the phrase ‘your blood test shows no infection’ and ‘your blood culture was negative,’ significantly more respondents correctly interpreted the phrase that avoided the word negative altogether,” they added.

Old age was associated with a better understanding of only two out of the 13 questions, surprising to Gotlieb and colleagues “given that increasing age comes with more opportunities to have heard these terms used in a medical context.”

The researchers concluded that medical jargon continues to be a source of confusion, so clinicians should avoid such phrases to achieve better communication with patients.

“Future studies should continue characterizing the understanding of jargon among the public and testing recommended alternatives to improve our communication with patients,” they wrote.