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Cross-Sectional Analysis of Patient-Centered Language Use in Journals Publishing Research Focused on Heart Failure
Vivian Pham1,2, Benjamin Greiner3, Ryan Ottwell2,4
1Department of Internal Medicine, University of Oklahoma Medical Center, Oklahoma City, OK.
Insights
Non-patient-centered language (nPCL) is prevalent in heart failure research, potentially increasing patient stigma. Reducing nPCL in publications is recommended to foster more compassionate communication and support for individuals with heart failure.
Area of Science:
- Cardiology
- Medical Communication
- Health Disparities
Background:
- Non-patient-centered language (nPCL) negatively impacts patient perception in conditions like diabetes, mental illness, and obesity.
- Professional organizations like the American Medical Association (AMA) and International Committee of Medical Journal Editors (ICMJE) advocate for patient-centered language.
- Heart failure is a common condition often accompanied by stigma, which nPCL may exacerbate.
Purpose of the Study:
- To analyze the prevalence of nPCL in heart failure research journals.
- To determine if journals guide authors on adhering to AMA/ICMJE guidelines regarding nPCL.
- To investigate the association between study characteristics and nPCL usage.
Main Methods:
- A systematic PubMed search identified heart failure articles published between May 2018 and April 2020.
- A cross-sectional analysis involved inspecting 195 articles for nPCL terms and their frequency.
- Statistical methods, including chi-squared tests and logistic regressions, were employed to examine nPCL use correlations.
Main Results:
- Over half of the analyzed articles (55.4%) contained nPCL, with "heart failure patient" (78.7%) being most common.
- nPCL was more frequent in original research (63.5%) and articles lacking treatment details (71.1%).
- No significant link was found between journal impact factor and adherence to AMA/ICMJE nPCL recommendations.
Conclusions:
- Non-patient-centered language is frequently used in heart failure research publications.
- A reduction in nPCL is encouraged for authors and journals to mitigate patient stigma.
- Promoting patient-centered language can improve the experience of individuals with heart failure.
Purpose:
Detrimental effects of using non-patient-centered language (nPCL) have been reported for diabetes, mental illness, and obesity, and both the American Medical Association (AMA) and International Committee of Medical Journal Editors (ICMJE) recommend using patient-centered language in medical literature. Heart failure is a common yet stigmatized disease, and nPCL may further propagate stigma. This study analyzed current use of nPCL in journals focused on heart failure research and also examined whether the journals steer authors to adhere to AMA or ICMJE guidelines regarding nPCL.
Methods:
Following systematic search of PubMed for heart failure-related articles published from May 1, 2018, to April 30, 2020, cross-sectional analysis was performed. Each selected article was inspected for an array of nPCL terms and frequency of nPCL usage. Chi-squared tests and multivariable logistic regressions were used to assess relationships between study characteristics and nPCL use.
Results:
Of the 195 articles fully analyzed, 108 (55.4%) contained a nPCL term, the most frequently used being "heart failure patient" (78.7%), "burden" (23.1%), and "suffer" (15.7%). Use of nPCL was disproportionately more common in original research articles (63.5%) and less common in case reports (18.2%). Articles that did not detail any treatment or intervention used the most nPCL (71.1%). No statistically significant association was found between a journal's impact factor and its adherence to AMA or ICMJE recommendations.
Conclusions:
nPCL is widely used in publications reporting on heart failure. We encourage authors and journals to reduce nPCL to help decrease the stigma patients with this disease often encounter.
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