A practical 'How-To' Guide to plain language summaries (PLS) of peer-reviewed scientific publications: results of a multi-stakeholder initiative utilizing co-creation methodology

Are plain language summaries more readable than scientific abstracts? Evidence from six biomedical and life sciences journals

In recent decades, members of the general public have become increasingly reliant on findings of scientific studies for decision-making. However, scientific writing usually features a heavy use of technical language, which may pose challenges for people outside of the scientific community. To alleviate this issue, plain language summaries were introduced to provide a brief summary of scientific papers in clear and accessible language. Despite increasing attention paid to the research of plain language summaries, little is known about whether these summaries are readable for the intended audiences. Based on a large corpus sampled from six biomedical and life sciences journals, the present study examined the readability and jargon use of plain language summaries and scientific abstracts on a technical level. It was found that (1) plain language summaries were more readable than scientific abstracts, (2) the reading grade levels of plain language summaries were moderately correlated with that of scientific abstracts, (3) researchers used less jargon in plain language summaries than in scientific abstracts, and (4) the readability of and the jargon use in both plain language summaries and scientific abstracts exceeded the recommended threshold for the general public. The findings were discussed with possible explanations. Implications for academic writing and scientific communication were offered.

Understanding preferences for receiving health communications and information about clinical trials: a cross-sectional study among US adults

OBJECTIVE

Effective health communication is critical for understanding and acting on health information. This cross-sectional study explored participants' understanding of their health condition, their preferences for receiving health communications, and their interest in receiving clinical trial results across several therapeutic areas.

METHODS

The study recruited participants via social media, email newsletters, and advocacy organizations. An online screener captured demographic information (health conditions, age, race/ethnicity, gender, and education). Eligible participants were emailed an online survey assessing preferred sources and formats for receiving health information, interest in learning about topics related to the results of clinical trials, and health literacy levels.

RESULTS

In total, 449 participants (median age, 35 years [range, 18-76]; White, 53%; higher education, 65%; mean (range) health literacy score, 1.9 [0.4-3.0]) from 45 US states completed the survey representing 12 disease indications (bipolar, blood and solid tumor cancers, irritable bowel syndrome, inflammatory bowel disease, major depressive disorder, migraine, Parkinson's, psoriasis/atopic dermatitis, retinal vein occlusion/macular degeneration, rheumatoid arthritis, and spasticity). Healthcare providers were the preferred source of health information (59%), followed by Internet searches (11%). Least preferred sources were social media (5%), friends/family (3%), and email newsletters (2%). Participants preferred multiple formats and ranked reading materials online as most preferred (33%), along with videos (28%) and infographics (27%). Printed materials (14%) and audio podcasts (9%) were the least preferred formats. A majority of the participants reported that the health information they found was hard to understand (57%) and confusing (62%). Most participants (85%) were somewhat/very interested in learning about clinical trial results, with the highest interest in short summaries of safety (78%) and efficacy (74%) results.

CONCLUSION

Effective health communication may be achieved via multiple formats shared directly by healthcare providers.

Using ChatGPT and Google Bard to improve the readability of written patient information: a proof of concept

Patient information materials often tend to be written at a reading level that is too advanced for patients. In this proof-of-concept study, we used ChatGPT and Google Bard to reduce the reading level of three selected patient information sections from scientific journals. ChatGPT successfully improved readability. However, it could not achieve the recommended 6th-grade reading level. Bard reached the reading level of 6th graders but oversimplified the texts by omitting up to 83% of the content. Despite the present limitations, developers of patient information are encouraged to employ large language models, preferably ChatGPT, to optimize their materials.

Publishing clinical trial results in plain language: a clash of ethical principles?

Plain language resources (PLR) are lay summaries of clinical trial results or plain language summaries of publications, in digital/visual/language formats. They aim to provide accurate information in jargon-free, and easy-to-understand language that can meet the health information needs of the general public, especially patients and caregivers. These are typically developed by the study sponsors or investigators, or by national public health bodies, research hospitals, patient organizations, and non-profit organizations. While the usefulness of PLR seems unequivocal, they have never been analyzed from the perspective of ethics. In this commentary, we do so and reflect on whether PLR are categorically advantageous or if they solve certain issues but raise new problems at the same time. Ethical concerns that PLR can potentially address include but are not limited to individual and community level health literacy, patient empowerment and autonomy. We also highlight the ethical issues that PLR may potentially exacerbate, such as fair balanced presentation and interpretation of medical knowledge, positive publication bias, and equitable access to information. PLR are important resources for patients, with promising implications for individual as well as community health. However, they require appropriate oversight and standards to optimize their potential value. Hence, we also highlight recommendations and best practices from our reading of the literature, that aim to minimize these biases.

Recommended characteristics and processes for writing lay summaries of healthcare evidence: a co-created scoping review and consultation exercise

BACKGROUND

Lay summaries (LSs) of scientific evidence are critical to sharing research with non-specialist audiences. This scoping review with a consultation exercise aimed to (1) Describe features of the available LS resources; (2) Summarize recommended LS characteristics and content; (3) Outline recommended processes to write a LS; and (4) Obtain stakeholder perspectives on LS characteristics and writing processes.

METHODS

This project was a patient and public partner (PPP)-initiated topic co-led by a PPP and a researcher. The team was supported by three additional PPPs and four researchers. A search of peer-reviewed (Ovid MEDLINE, Scopus, Embase, Cochrane libraries, CINAHL, PsycINFO, ERIC and PubMed data bases) and grey literature was conducted using the Joanna Briggs Institute Methodological Guidance for Scoping Reviews to include any resource that described LS characteristics and writing processes. Two reviewers screened and extracted all resources. Resource descriptions and characteristics were organized by frequency, and processes were inductively analyzed. Nine patient and public partners and researchers participated in three consultation exercise sessions to contextualize the review findings.

RESULTS

Of the identified 80 resources, 99% described characteristics of a LS and 13% described processes for writing a LS. About half (51%) of the resources were published in the last two years. The most recommended characteristics were to avoid jargon (78%) and long or complex sentences (60%). The most frequently suggested LS content to include was study findings (79%). The key steps in writing a LS were doing pre-work, preparing for the target audience, writing, reviewing, finalizing, and disseminating knowledge. Consultation exercise participants prioritized some LS characteristics differently compared to the literature and found many characteristics oversimplistic. Consultation exercise participants generally supported the writing processes found in the literature but suggested some refinements.

CONCLUSIONS

Writing LSs is potentially a growing area, however, efforts are needed to enhance our understanding of important LS characteristics, create resources with and for PPPs, and develop optimal writing processes.

Why and how to publish aphasia-friendly research summaries

BACKGROUND

A common complaint of people with aphasia and their families is their inability to find information about current aphasia treatment research (Hinckley, Boyle, Lombard & Bartels-Tobin, 2014; Hinckley & El-Khouri, 2021). Plain language summaries, video summaries, and graphical summaries are three ways to disseminate research results that are more accessible to a broader audience. The purpose of this tutorial is to discuss the motivations for disseminating research in understandable ways, and to provide information and resources on how aphasia-friendly dissemination can be done.

METHOD

We report an overview of evidence on the importance of and characteristics of dissemination. Next, we provide specific characteristics and resources for producing plain language summaries, video summaries, and graphical abstracts. Finally, we conducted a systematic search for journals in the area of stroke rehabilitation after consultation with a research librarian. The publication webpages of each journal were inspected to gather information about whether and how the journal published plain language summaries, video summaries, or graphical abstracts. Editors were contacted as needed to complete the information. Sixty journals in stroke rehabilitation were identified, and a total of 43 journals (71%) publish video abstracts, graphical summaries, and/or plain language summaries either independently or through third-party platforms.

CONCLUSIONS

The findings are discussed in the context of the importance of making research consumer-friendly. We offer specific recommendations for aphasia researchers, and future directions for publishing research in ways that will have an impact on the broader public are suggested.

Linguistic analysis of plain language summaries and corresponding scientific summaries of Cochrane systematic reviews about oncology interventions

BACKGROUND

Cochrane plain language summaries (PLSs) are an important format to present high-quality healthcare evidence to patients with cancer and their families. They should be written in a way everyone can understand, since they serve as a tool in decision-making and present a bridge to overcome the gap between the healthcare users and professionals.

OBJECTIVE

The aim of the study was to assess the language characteristics of PLSs of Cochrane systematic reviews of oncology interventions in comparison with corresponding Cochrane scientific abstracts (SAs).

METHODS

In this cross-sectional study, we included all Cochrane PLSs and SAs of systematic reviews of oncology interventions available in the Cochrane Database of Systematic Reviews. We assessed text readability, measured using the Simple Measure of Gobbledygook (SMOG) index, and the prevalence of words related to different language tones (clout, authenticity, emotions and analytical tones). Two independent assessors categorized the conclusiveness of the efficacy of interventions into nine categories.

RESULTS

The overall median SMOG index for 275 PLSs was 13.0 (95% confidence interval [CI] 12.8-13.3). Readability scores did not differ across Cochrane Review Groups. SAs had a higher readability index than the corresponding PLSs (median = 16.6, 95% CI = 16.4-16.8). Regarding linguistic characteristics, PLSs were shorter than SAs, with less use of analytical tone, but more use of a positive emotional tone and authenticity. Overall, the 'Unclear' category of conclusiveness was the most common among all PLSs. Also, PLSs with 'No evidence' conclusions were the shortest and had the lowest SMOG index.

CONCLUSION

PLSs of Cochrane systematic reviews of oncological interventions have low readability and most give unclear conclusions about the efficacy of interventions. PLSs should be simplified so that patients and their families can benefit from appropriate health information on evidence synthesis. Further research is needed into reasons for unclear language to describe evidence from oncology trials.