Plain language summaries: A systematic review of theory, guidelines and empirical research

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.

Equivalent user experience and improved community augmented meta-analyses knowledge for a new version of a Plain Language Summary guideline

Plain Language Summaries (PLS) offer a promising solution to make meta-analytic psychological research more accessible for non-experts and laypeople. However, existing writing guidelines for this type of publication are seldom grounded in empirical studies. To address this and to test two versions of a new PLS guideline, we investigated the impact of PLSs of psychological meta-analyses on laypeoples' PLS-related knowledge and their user experience (accessibility, understanding, empowerment). In a preregistered online-study, N = 2,041 German-speaking participants read two PLSs. We varied the inclusion of a disclaimer on PLS authorship, a statement on the causality of effects, additional information on community augmented meta-analyses (CAMA) and the PLS guideline version. Results partially confirmed our preregistered hypotheses: Participants answered knowledge items on CAMA more correctly when a PLS contained additional information on CAMA, and there were no user experience differences between the old and the new guideline versions. Unexpectedly, a priori hypotheses regarding improved knowledge via the use of a disclaimer and a causality statement were not confirmed. Reasons for this, as well as general aspects related to science communication via PLSs aimed at educating laypeople, are discussed.

Belief updating when confronted with scientific evidence: Examining the role of trust in science

In one exploratory study (N = 985) and one preregistered study (N = 1100), we investigated whether trust in science influences belief change on a medico-scientific issue when laypersons are confronted with scientific evidence. Moreover, we tested whether individuals with high trust in science trust science "blindly," meaning that their trust in a scientific claim's source prevents them from adequately evaluating the claim itself. Participants read eight fictitious studies on the efficacy of acupuncture, which were experimentally manipulated regarding direction (evidence favoring acupuncture vs diverging evidence) and quality (high vs low; only Study 2). Acupuncture-related beliefs were measured before and after reading. Moderator and mediator analyses showed that the magnitude of belief change indeed depends on trust in science. Furthermore, we found that people with high trust in science are better able to evaluate the quality of scientific studies, which, in turn, protects them from being influenced by low-quality evidence.

Does the format of result presentation and type of conclusion in Cochrane plain language summaries matter? A randomised controlled trial

OBJECTIVES

This study aimed to investigate whether the format and type of conclusion in Cochrane plain language summaries (PLSs) influence readers' perception of treatment benefit and decision-making.

DESIGN

An online parallel group, three-arm randomised controlled trial was conducted.

SETTING

The study was conducted online.

PARTICIPANTS

The participants were physiotherapy students.

INTERVENTIONS

The participants read two Cochrane PLSs, one with a positive conclusion (strong evidence of benefit) and another with a negative conclusion (strong evidence of non-benefit). Each participant read the results of both reviews presented in one of three formats: (1) numerical, (2) textual or (3) numerical and textual.

MAIN OUTCOME MEASURES

The primary outcome measure was the participants' perception of treatment benefit.

RESULTS

All three groups of participants perceived the treatment to have positive effects when the Cochrane PLS had a positive conclusion, regardless of the format of presentation (mean perception of treatment benefit score: textual 7.7 (SD 2.3), numerical 7.9 (SD 1.8), numerical and textual 7.7 (SD 1.7), p=0.362). However, when the Cochrane PLS had a negative conclusion, all three groups of participants failed to perceive a negative effect (mean perception of treatment benefit score: textual 5.5 (SD 3.3), numerical 5.6 (SD 2.7), numerical and textual 5.9 (SD 2.8), p=0.019).

CONCLUSIONS

The format of Cochrane PLSs does not appear to significantly impact physiotherapy students' perception of treatment benefit, understanding of evidence, persuasiveness or confidence in their decision. However, participants' perception of treatment benefit does not align with the conclusion when the Cochrane PLS indicates strong evidence of non-benefit from the intervention.

TRIAL REGISTRATION NUMBER

CTRI/2022/10/046476.

Conclusiveness, readability and textual characteristics of plain language summaries from medical and non-medical organizations: a cross-sectional study

This cross-sectional study compared plain language summaries (PLSs) from medical and non-medical organizations regarding conclusiveness, readability and textual characteristics. All Cochrane (medical PLSs, n = 8638) and Campbell Collaboration and International Initiative for Impact Evaluation (non-medical PLSs, n = 163) PLSs of latest versions of systematic reviews published until 10 November 2022 were analysed. PLSs were classified into three conclusiveness categories (conclusive, inconclusive and unclear) using a machine learning tool for medical PLSs and by two experts for non-medical PLSs. A higher proportion of non-medical PLSs were conclusive (17.79% vs 8.40%, P < 0.0001), they had higher readability (median number of years of education needed to read the text with ease 15.23 (interquartile range (IQR) 14.35 to 15.96) vs 15.51 (IQR 14.31 to 16.77), P = 0.010), used more words (median 603 (IQR 539.50 to 658.50) vs 345 (IQR 202 to 476), P < 0.001). Language analysis showed that medical PLSs scored higher for disgust and fear, and non-medical PLSs scored higher for positive emotions. The reason for the observed differences between medical and non-medical fields may be attributed to the differences in publication methodologies or disciplinary differences. This approach to analysing PLSs is crucial for enhancing the overall quality of PLSs and knowledge translation to the general public.

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.

A powerful partnership: researchers and patients working together to develop a patient-facing summary of clinical trial outcome data

OBJECTIVE

Availability of easy-to-understand patient-reported outcome (PRO) trial data may help individuals make more informed healthcare decisions. Easily interpretable, patient-centric PRO data summaries and visualizations are therefore needed. This three-stage study explored graphical format preferences, understanding, and interpretability of clinical trial PRO data presented to people with prostate cancer (PC).

MATERIALS AND METHODS

A 7-day online survey exploring people with PC's preferences for different PRO data presentations (stage 1; n = 30) informed development of a draft plain-language resource sheet containing PRO data. After refining for clarity during cognitive debriefing interviews (stage 2; n = 18), the final resource sheet was circulated to people with PC for broader feedback (stage 3; n = 45).

RESULTS

Although participants expressed preferences for certain graphical formats (pie charts and bar charts), preference did not always associate with interpretability and overall message clarity. Iterative development (stages 1 and 2) led to a final resource sheet, which 91.1% of participants in stage 3 considered useful and informative, and 88.9% expressed interest in receiving similar resources in the future.

DISCUSSION

Findings demonstrate PRO data are relevant to people with PC and highlights that targeted resource sheets can support patient-clinician discussions. Appropriate graphical formatting and use of plain-language text is essential for conveying interpretable PRO data. Data visualization preferences are context dependent.

CONCLUSION

Resource sheets summarizing clinical trial PRO data can be helpful for decision-making in PC. Researchers and patients can work together to develop clear, relevant, sensitive, and understandable resource sheets, which equally consider patient priorities as well as those of scientists.

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.

Science Communication as a Collective Intelligence Endeavor: A Manifesto and Examples for Implementation

Effective science communication is challenging when scientific messages are informed by a continually updating evidence base and must often compete against misinformation. We argue that we need a new program of science communication as collective intelligence-a collaborative approach, supported by technology. This would have four key advantages over the typical model where scientists communicate as individuals: scientific messages would be informed by (a) a wider base of aggregated knowledge, (b) contributions from a diverse scientific community, (c) participatory input from stakeholders, and (d) better responsiveness to ongoing changes in the state of knowledge.

Generative AI as a Tool for Environmental Health Research Translation

One valuable application for generative artificial intelligence (AI) is summarizing research studies for non-academic readers. We submitted five articles to Chat Generative Pre-trained Transformer (ChatGPT) for summarization, and asked the article's author to rate the summaries. Higher ratings were assigned to more insight-oriented activities, such as the production of eighth-grade reading level summaries, and summaries highlighting the most important findings and real-world applications. The general summary request was rated lower. For the field of environmental health science, no-cost AI technology such as ChatGPT holds the promise to improve research translation, but it must continue to be improved (or improve itself) from its current capability.

Considerations for Effective Communication of Medical Information

An ongoing and increasing shift is occurring in ways in which the healthcare community (healthcare providers, patients, biopharma) disseminates and consumes information. Adoption of digital technologies, accelerated by the virtual environment created by the COVID-19 pandemic, are leading to new and innovative ways in which medical and scientific information and data are communicated. Digital technologies have largely enabled these approaches and led to an explosive increase in availability of information. This article describes considerations in how the healthcare community, and Medical Affairs organizations in biopharma, can effectively harness these channels to communicate effectively, and incorporate changes in behaviors and approaches to redefine what medical information and data look like.