Patients often misunderstand common medical expressions

December 02, 2022

2 minute read


Gotlieb reports that the study was funded by grants from the University of Minnesota’s Driven to Discover Research Facility and the NIH’s National Center for Advancing Translational Sciences.

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According to a study published in Open JAMA Network reported.

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


Data as: Gotlieb R, et al. JAMA Network Open. 2022; doi:10.1001/jamanetworkopen.2022.42972.

“While this medical language can facilitate communication between healthcare professionals, its use with patients can introduce confusion that can have serious consequences,” they write.

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 can be particularly confusing to patients.” .

Researchers used a 13-question written and verbal survey — made up of a mix of open-ended and multiple-choice questions — over a 3-day period at the 2021 Minnesota State Fair.

  • Several questions used phrases with terms that have different meanings outside of a medical setting, such as “unremarkable”; “febrile”; “hidden infection”; and “grossly intact”.

In addition, researchers assessed terms that previously proved confusing to patients, such as “negative” and the acronym “NPO.” They also looked at participants’ understanding of the full sentence for NPO, “nothing by mouth”, as a way to gauge outcomes through how the sentences are communicated.

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

Gotlieb and colleagues reported that most respondents (96.3%) understood that a negative cancer screen 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 “the neurological exam is overall intact” and “have you been feverish”, respectively, while 1.9% understood what was meant by a patient with an “occult infection”.

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

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

“However, it should be noted that when comparing understanding of the phrase ‘your blood test showed no infection’ and ‘your blood culture was negative’, significantly more respondents correctly interpreted the phrase which completely avoided the negative word,” they added.

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

The researchers concluded that medical jargon continues to be confusing, so clinicians should avoid such expressions to achieve better communication with patients.

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

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