Year 2017, Volume 17 , Issue 2, Pages 141 - 142 2017-06-23

Bilgilendirilmiş onam belgelerini geliştirme: açıklık, okunabilirlik ve metin tutarlılığı hakkında öneriler
Enhancement of the informed consent documents: suggestions about legibility, readability and text coherence

Nuri ERDOĞAN [1] , Hakan İMAMOĞLU [2]


Dear Editor,

The initial step in the informed consent (IC) process is the disclosure of information to the patient. The information can be disclosed by means of personal communication, multimedia interventions, or through the use of a written material. From the perspective of law, it is necessary that the content of the patient-physician communication should be documented and signed by both parties. Therefore, information disclosure through a written document is the preferred method of conduct in most healthcare institutions. However, although this approach provides official recording, it bears other difficulties: The text presented to the patients should be legible, readable and coherent in itself.

In patients with presbyopia or other difficulties in sight, the problems about legibility can be overcome by following the American Printing House guidelines for print document design.1 Text coherence may require modifications with reference to 1. logical/semantic associations and; 2. grammatic associations between successive sentences; 3. proper use of the conjunctions; 4. contextual relations between parts of the text; and 5. establishment of the overall thematic integrity.2 Finally, enhancement of the readability requires assessment formulas which are specific to that language.

In case of Turkish language, to our knowledge, there is only one formula that fulfills the requirements of a scientific approach: Çetinkaya-Uzun Readability Formula.3 The readability score in this formula is defined as

Readability Score=118.8-25.9xAWL-0.9xASL

where AWL is the Average Word Length, and ASL is the Average Sentence Length. Based on multiple regression analysis, the formula also provides years of schooling that correspond three categories of readability levels: Readability scores ≥51 correspond to 5-7 years; scores 35–50 correspond to 8-9 years; and scores 0-34 correspond to 10 or more years of schooling, which is the category of independent reading. Regardless of the language, any readability formula which provides such a categorical approach in schooling gives an additional insight about the IC practice: Patients below the category of independent reading (e.g. Turkish patients with schooling level of 9 years or less according to Çetinkaya-Uzun Readability Formula), are prone to misconduct in IC process, therefore increasing the liability of physicians. This group of patients can be easily discriminated by asking his/her last year in schooling.

In conclusion, the above mentioned suggestions may help the researchers who are interested in enhancement of the IC documents with regard to legibility, readability and text coherence. In addition to its function as an assessment tool, any reading formula which provides a categorical approach for independent reading also serves to identify the patients at risk for IC misconduct. 

Informed consent, legibility, readability, text coherence
  • American Printing House guidelines for print document design [Internet]. American Printing House. Available from: http://www.aph.org/research/design-guidelines/ , (Date of Access: 4th April 2017).
  • Ülper H. Öğrenci metinlerinin tutarlılık ölçütleri bağlamında değerlendirilmesi. Turkish Studies 2011;6:849-63.
  • Çetinkaya G, Uzun GL. Identifying and Classifying The Readability Levels of Turkish Texts. ATINER'S Conference Paper Series, No: LIT2012-0281. Athens, Greece: Athens Institute for Education and Research;2012.
Subjects Health Care Sciences and Services
Journal Section Letter to the Editor
Authors

Author: Nuri ERDOĞAN
Country: Turkey


Author: Hakan İMAMOĞLU
Country: Turkey


Dates

Publication Date : June 23, 2017

Bibtex @letter { amj308640, journal = {Ankara Medical Journal}, issn = {}, eissn = {2148-4570}, address = {}, publisher = {Ankara Yildirim Beyazit University}, year = {2017}, volume = {17}, pages = {141 - 142}, doi = {10.17098/amj.308640}, title = {Enhancement of the informed consent documents: suggestions about legibility, readability and text coherence}, key = {cite}, author = {Erdoğan, Nuri and İmamoğlu, Hakan} }
APA Erdoğan, N , İmamoğlu, H . (2017). Enhancement of the informed consent documents: suggestions about legibility, readability and text coherence . Ankara Medical Journal , 17 (2) , 141-142 . DOI: 10.17098/amj.308640
MLA Erdoğan, N , İmamoğlu, H . "Enhancement of the informed consent documents: suggestions about legibility, readability and text coherence" . Ankara Medical Journal 17 (2017 ): 141-142 <https://dergipark.org.tr/en/pub/amj/issue/29961/308640>
Chicago Erdoğan, N , İmamoğlu, H . "Enhancement of the informed consent documents: suggestions about legibility, readability and text coherence". Ankara Medical Journal 17 (2017 ): 141-142
RIS TY - JOUR T1 - Enhancement of the informed consent documents: suggestions about legibility, readability and text coherence AU - Nuri Erdoğan , Hakan İmamoğlu Y1 - 2017 PY - 2017 N1 - doi: 10.17098/amj.308640 DO - 10.17098/amj.308640 T2 - Ankara Medical Journal JF - Journal JO - JOR SP - 141 EP - 142 VL - 17 IS - 2 SN - -2148-4570 M3 - doi: 10.17098/amj.308640 UR - https://doi.org/10.17098/amj.308640 Y2 - 2017 ER -
EndNote %0 Ankara Medical Journal Enhancement of the informed consent documents: suggestions about legibility, readability and text coherence %A Nuri Erdoğan , Hakan İmamoğlu %T Enhancement of the informed consent documents: suggestions about legibility, readability and text coherence %D 2017 %J Ankara Medical Journal %P -2148-4570 %V 17 %N 2 %R doi: 10.17098/amj.308640 %U 10.17098/amj.308640
ISNAD Erdoğan, Nuri , İmamoğlu, Hakan . "Enhancement of the informed consent documents: suggestions about legibility, readability and text coherence". Ankara Medical Journal 17 / 2 (June 2017): 141-142 . https://doi.org/10.17098/amj.308640
AMA Erdoğan N , İmamoğlu H . Enhancement of the informed consent documents: suggestions about legibility, readability and text coherence. Ankara Med J. 2017; 17(2): 141-142.
Vancouver Erdoğan N , İmamoğlu H . Enhancement of the informed consent documents: suggestions about legibility, readability and text coherence. Ankara Medical Journal. 2017; 17(2): 141-142.