Optimizing Readability and Format of Plain Language Summaries for Medical Research Articles: Cross-sectional Survey Study

Abstract

Background Plain language summaries (PLSs) are intended to provide readers with a clear, nontechnical, and easily understandable overview of medical and scientific literature; however, audience preferences for specific PLS formats have yet to be fully explored. Objective This study aims to evaluate the preferred readability level and format for PLSs of medical research articles of different disease states via a web-based survey of audiences of different age groups. Methods Articles describing phase III clinical trials published in top-level, peer-reviewed journals between May 2016 and May 2018 were identified for 3 chronic disease states representing a range of adult patient age groups: (1) psoriasis, a skin disease representative of younger patients; (2) multiple sclerosis (MS), a neurological disease representative of middle-aged patients; and (3) rheumatoid arthritis (RA), a painful joint disease representative of older patients. Four PLSs were developed for each research article, of which 3 were text-only summaries (written with high, medium, and low complexity) and 1 was an infographic. To evaluate each of the 4 PLS formats, a 20-question open survey (specific to one of the 3 diseases) was sent to a representative sample selected via UK-based patient association websites, Twitter, and Facebook patient groups. A weighted-average calculation was applied to respondents’ ranked preferences for each PLS format. Results For all 3 articles, the weighted-average preference scores showed that infographic (psoriasis 2.91, MS 2.71, and RA 2.78) and medium-complexity text-based PLS (reading age 14-17 years, US Grade 9-11; psoriasis 2.90; MS 2.47; RA 2.77) were the two most preferred PLS formats. Conclusions Audience preferences should be accounted for when preparing PLSs to accompany peer-reviewed original research articles. Oversimplified text can be viewed negatively, and graphical summaries or medium-complexity text-based summaries appear to be the most popular. Plain Language Summary Patients and caregivers should have the chance to read about medical research in a format they can understand. However, we do not know much about the formats that people with different illnesses or ages prefer. Researchers wanted to find out more about this. They selected 3 medical articles about illnesses that affect different age groups: psoriasis (younger patients), multiple sclerosis (middle-aged patients), and rheumatoid arthritis (older patients). They created 4 summaries of each article. One was a graphical summary, and the other 3 were words-only summaries of high, medium, and low complexity. Then, the researchers posted surveys on UK patient group websites and Facebook patient groups to ask people what they thought of the summaries. The surveys were taken by 167 people. These people were patients with psoriasis, multiple sclerosis, or rheumatoid arthritis, or their caregivers. Most were women, and about half had a university degree. For each illness, most people preferred the graphical summary. Among the word-only summaries, most people preferred the medium-complexity wording written for a reading age of 14 to 17 years. People felt that the graphical and medium-complexity summaries were clear and concise, while the others used jargon or were too simple. Authors of medical articles should remember these results when writing summaries for patients. More research is needed about the preferences of other people, such as those with other illnesses. (See Multimedia Appendix 1 for the graphical summary of the plain language summary.)

Patients at the Heart of the Scientific Dialogue: An Industry Perspective

“…PLS should be peer-reviewed, not be oversimplified to avoid patronizing, and should rely on standard terminology to avoid confusion [35]. Enhanced content such as infographics and video abstracts are also increasingly used to optimize engagement [33,36]. It is still somewhat uncommon for PLS of published articles to be offered by oncology journals; however, each year more journals are becoming amenable to inclusion either with its own DOI or as part of the Supplement (e.g., Annals of Oncology, Cancer, Adis Springer Nature Journals, Future Oncology) and hopefully the recommendation of GPP 2022 will encourage more journals to allow PLS [37].…”

Easily readable? Examining the readability of lay summaries published in Autism Research

“…The general public needs to understand what researchers have found and how the findings are relevant to them. Although one can assume that lower readability means less accessibility for the lay audience (Plavén-Sigray et al, 2017), oversimplified lay summaries can be perceived negatively (Martínez Silvagnoli et al, 2022). That is, simpler lay summaries do not always guarantee better reading experience.…”

Plain language summaries: Enabling increased diversity, equity, inclusion and accessibility in scholarly publishing

“…This allows content to be tailored towards a more specific target audience and is a crucial consideration when writing for audiences with limited health literacy. Audio and visual formats also have the potential to increase ease of information digestion and reader engagement with a publication (Bredbenner & Simon, 2019;Buljan et al, 2018Buljan et al, , 2020Chapman et al, 2019;Gardner et al, 2019;Huang et al, 2018;Martinez Silvagnoli et al, 2022;Stones et al, 2022). Many publishers and journals are increasingly offering these formats, but some are accepting enhanced formats only if plain text PLS have also been submitted (e.g., Taylor & Francis journals).…”