Medical Text Simplification by Medical Trainees: A Feasibility Study

Current healthcare practice is transitioning from a provider-centered model to a patient-centered model of care, where patients are no longer passive recipients of care, but are encouraged to actively engage in and take greater responsibility for medical decision-making. As part of this trend patients are gaining access to larger and more diverse sets of medical texts through Electronic Medical Record (EMR) systems (e.g., doctor's notes, discharge summaries, etc.). The availability of medical notes that are accurate and easily understandable for patients will be crucial for the success of this new care model. However, medical notes are primarily written for the purpose of providerto-provider communication and are generally difficult for lay persons to understand, especially those individuals with low health literacy. Thus, patients are not fully able to utilize this information due to linguistic and literacy barriers. Our ultimate goal is to develop a health IT intervention that addresses this gap by combining information technology with untapped human expertise, such as knowledge held by medical students and other trainees. This paper describes an initial feasibility study to determine whether medical trainees have sufficient expertise to convert medical reports into understandable, everyday language. We measure the effect of simplifications on objective comprehensibility, patient preferences, and then relate the outcome to linguistic characteristics of the texts. Our results show that comprehensibility improves substantially even without prior task-specific training of medical students, and that student-generated simplifications are strongly preferred over the original medical texts.