177 - When Negative is Good and Positive is Bad - Patient Understanding of Medicalized English

Poster Number: 177

Rachael Gotlieb, University of Minnesota Medical School, Minneapolis, MN, United States; Corinne Praska, University of Minnesota Medical School, Minneapolis, MN, United States; Victoria Charpentier, University of Minnesota Medical School, Minneapolis, MN, United States; Katherine A. Allen, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States; Emily Hause, University of Minnesota Masonic Children's Hospital, Saint Anthony, MN, United States; Marissa A. Hendrickson, University of Minnesota Medical School, Minneapolis, MN, United States; Scott Lunos, University of Minnesota, Minneapolis, MN, United States; Jordan Marmet, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States; Michael B. Pitt, University of Minnesota, Minneapolis, MN, United States

Background: Healthcare providers aiming to avoid medical jargon may do so by minimizing technical terminology and acronyms. A subclass of jargon that can be overlooked is “medicalized English” – words that are well understood by the lay public but have a different meaning in medical contexts.

Objective: We aimed to determine the general public’s understanding of commonly used medicalized English.

Design/Methods: We surveyed fairgoers over three days at the 2021 Minnesota State Fair to capture a cross-section of the Minnesota public. Adults >18 years old without any medical or nursing training volunteered to take a survey via iPad. Participants were asked to indicate their understanding of phrases a doctor might say or write.
Multiple choice questions included prompts such as “Your nodes are positive” and asked if this was good news, bad news, or they were unsure. Free-text response questions asked what a doctor would mean by phrases such as “occult infection” or “bugs in the urine.” Free-text was coded as correct, partially correct, or incorrect/blank by two independent researchers, adding a third researcher for discrepancies.
We compared demographics and survey questions using a t-test for age, Fisher’s exact tests for categorical variables and Wilcoxon rank-sum tests for Likert scale questions. McNemar’s test was used to compare correct responses for two “blood” questions.

Results: There were 217 respondents (63% female; mean age 42); 65% had a bachelor’s degree or higher). Most (96%) knew that “negative” cancer screening results meant they did not have cancer, but fewer (79%) knew that “your tumor is progressing” was bad news, or that “positive” lymph nodes meant the cancer had spread (67%). Most (80%) recognized that an “unremarkable” chest X-ray was good news. However, many thought an “impressive” X-ray was also good news (44%) versus correctly interpreting it as bad news (21%). Under half (41%) of people interpreted “neuro exam is grossly intact” as a good thing, and only 29% understood that “bugs in the urine” was intended to convey a UTI. More people (3%) thought an occult infection had something to do with a curse than accurately knew what it meant (2%). More people correctly understood “Your blood test shows me you do not have an infection in your blood” than “Your blood culture was negative” (97% vs 87%, p < 0.001).Conclusion(s): Many patients misunderstand terms that have different meanings in medicine, such as positive, negative, and impressive. Clinicians should intentionally adjust their language usage to minimize confusion.