The effects of presenting oncologic information in terms of opposites in a medical context

Background: An extensive body of literature has demonstrated that many patients who have been asked to participate in clinical trials do not fully understand the informed consent forms. A parallel independent study has demonstrated that opposites have a special status in human cognitive organization: they are common to all-natural languages and are intuitively and naturally understood and learnt. Purpose: The study investigates whether, and how, the use of opposites impacts on doctor–patient communication: does using the terms “small–large” to describe a nodule (ie, bipolar communication) rather than speaking in terms of centimeters (ie, unipolar communication) affect a patient’s understanding of the situation? And is it better to speak of “common–rare” side effects (ie, bipolar communication) instead of the number of people who have suffered from particular side effects (ie, unipolar communication)? Methods: Two questionnaires were created and used, one presenting the information in terms of opposites (ie, bipolar communication) and another using unipolar communication. Results: The participants’ perception of their situation (in terms of feeling healthy–ill, being at high–low risk, and their treatment requiring high–low commitment) varied in the two conditions. Moreover, self-reported levels of understanding and satisfaction with how the information was communicated were higher when opposites were used. Limitations: Since this is the first study that addresses the merits of using bipolar structures versus unipolar structures in doctor–patient communication, further work is needed to consolidate and expand on the results, involving not only simulated but also real diagnostic contexts. Conclusion: The encouraging results imply that further testing of the use of opposites in informed consent forms and in doctor–patient communication is strongly advisable. Keywords: opposites, bipolar, unipolar, informed consent, doctor–patient communication, understanding, satisfaction