Expansion of Abbreviations and Acronyms for Patients

Study Overview
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Brief Summary
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This is a prospective, two-arm, parallel, individually randomized controlled trial to estimate the effect of expansion on patient comprehension (primary outcome) of abbreviations and acronyms in their health records. English-speaking adult patients with diagnosed heart failure who receive primary care at three urban hospitals in New York City will be considered. The investigators hypothesize that expansion will significantly increase patient comprehension of abbreviations and acronyms in the health record.

Detailed Description
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Importance: In 2020, an estimated 100 million Americans accessed their own health records online. That number likely increased beginning April 2021, when U.S. federal rules implemented the 21st Century Cures Act requiring electronic health information to be made freely accessible. Medical abbreviations and acronyms may limit patient understanding of health records. Automated expansion is one potential solution, however, the magnitude of its effect on patient comprehension has not been estimated. Objective: To estimate the effect of expansion on patient comprehension of abbreviations and acronyms in their health records. Design: Prospective, two-arm, parallel, individually randomized controlled trial. Participants: Patients who receive primary care at one of three urban hospitals. A purposive sample representative on age, gender, and race will be enrolled between February 2020 and August 2021. To isolate the main effect, the investigators will include only English-speaking adult patients with diagnosed heart failure. Intervention: Participants will be randomized to receive clinical text with abbreviations (control group, n=30) or with expansions (intervention group, n=30). The abbreviations and expansions included hrs (hours), MD (medical doctor), BP (blood pressure), ED (emergency department), yo (year old), pt (patient), HF (heart failure), hx (history), HTN (hypertension), MI (myocardial infarction).

Official Title
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Effect of Expansion of Abbreviations and Acronyms on Patient Comprehension of Their Health Records: A Randomized Clinical Trial

Conditions
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Heart Failure

Intervention / Treatment
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* Other: Expansion of Abbreviations and Acronyms


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult (21 years or older) Confirmed diagnosis of heart failure Able to read and speak English Willing and able to provide informed consent Receives primary care from participating provider Exclusion Criteria: Healthcare professional (MD, DO, RN, etc.) No telephone number or email address Severe cognitive impairment or clinical diagnosis of dementia Major psychiatric illness, including active psychosis Other illness that would preclude participation

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention (Expansion) Arm<br>Expansion of abbreviations and acronyms | Other: Expansion of Abbreviations and Acronyms<br>* Expansion of Abbreviations and Acronyms<br>|
| No Intervention: Control (Abbreviation) Arm<br>No expansion of abbreviations and acronyms | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall comprehension | count of the total number of abbreviated or expanded terms comprehended by the each participant | Day 1, at the time of the intervention administration | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Abbreviations, Acronyms, Personal Health Records, Patient Portals, Consumer Health Informatics, Patient Access to Records