Grey’s Anatomy, Scrubs, and House are each cherished TV series depicting medical emergencies intertwined with tantalizing hospital drama. While the storylines may differ, each series shares a similar theme: Every episode begins with the presentation of a patient case, followed by diagnostic testing, and finally a diagnosis. Once the diagnosis is made, a healthcare professional diligently presents the case—stating symptoms, diagnosis, and treatment. As soon as the patient is told their diagnosis, usually their first question is, “What does that mean?” While we often are wrapped up in the dramatic plot of these series, this patient moment is reflective of an everyday occurrence, wherein health literacy is a challenge in the patient landscape. So how can we, as healthcare professionals and scientists, make patient questions and concerns easier to answer?
Plain language summaries, often referred to as “lay summaries” or “lay language summaries,” have become an essential part of scientific communication. Plain language summaries are intended to increase the reach and impact of clinical research by informing patients of the relevance and outcomes of the research. The ultimate goal is to make the information easily understandable. Readability grading formulas help writers know the reading ease and accessibility of the content. But when we are targeting a diverse group of people, or the “general public,” the real question is how “lay” are these lay summaries for all audiences?
Readability measures the complexity of the words and sentence structure in a document, producing a final score of readability upon completion. The hypothesis is that complex, longer sentences are harder to understand and read. Readability scores are usually reported as a reading level by years of formal education.
Though various readability formulas are available, the problem with many of them is that they focus only on a few dimensions of readability, such as word and sentence length. But sometimes it may take more words to explain a complex concept clearly. Unnecessary wordiness, nominalizations, and passive voice are other dimensions that can make text more difficult to read.
Another problem with readability formulas is that reading level is reported in years of education, which can be presumptuous. When we refer to a particular reading level, there is an assumption that a student of that grade was diligent enough to study and understand all the subjects taught at that level. Contrarily, the student may not have optimal reading skills. In addition, the formulas are not useful if a writer needs to create or modify the content. And trying to simplify the text only by changing the length of the words and sentences may result in a more complex document.
Therefore, always remember that these readability scores are only an approximation of what really matters: how difficult it is for your readers to make sense of your content. Easy-to-read and easy-to-understand are the criteria that will help you to get “lay enough” to be understood by the general public.
Here are some pointers to ensure readability:
Avoid intricate wording and technical terminology.
Write in the active voice.
Remember that though you are aiming for a reading level of sixth grade, you are not writing for sixth-grade children. Never treat your audience as children, and use a mature tone of voice.
Do not put a strain on the cognitive abilities of the patients by making them remember things from one part of the text to another.
What may seem like a simple everyday word may be jargon for a layperson. Pay attention to such terms.
The fewer words, the better. Fewer words, smaller sentences, and smaller paragraphs.
Pick out complex words and replace them with shorter, simpler synonyms.
The only way to be sure that your summary meets the needs of your audience is to show it to a few laypersons and ask for their opinion, then revise your summary accordingly. Finally, balance readability with common sense by asking yourself: “Is it readable? Understandable? Is it ‘lay’ enough?” Remember—always aim to write a plain language summary “lay” enough that nobody needs to ask you, “What does that mean?”
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