Australian Lefty on Politics, Governance, Science and Info Management

Medical terminology for fun and profit

Posted by Dave Bath on 2008-12-08

If you saw The Hollowmen episode on the shenanigans to get “Insuleze” paid for by the taxpayer, you can bet that Big Pharma drumming up public support for a new expensive treatment will be looking at the following study in great detail:

"The Role of Medical Language in Changing Public Perceptions of Illness" (doi:10.1371/journal.pone.0003875) in PLoS ONE goes into the quantitative detail of how relabelling a condition affects perceptions of its severity, even when the full description of the condition is given to the test subject.  They studied well-known conditions, as well as the (beloved of Big Pharma) "newly medicalized disorders".

From the discussion (my bolding):

This study demonstrates that a medical label for a recently medicalized disorder results in perceptions of increased severity, increased disease representativeness and lower prevalence compared to the same disorder presented in its synonymous, lay label.  This effect is relatively stable across disorders, and remains even when a full description of the disorder is provided.

Meanwhile, the lay term for conditions like stroke and heart attack were considered more serious than their medicalese terms.

The following delightful (and awkward for some) question comes from the introduction:

Is the creation of new medical terminology validating and accrediting disorders previously considered outside of the traditional biomedical realm?  In this case, the original impetus for the terminological changes may come not from changes in general public perception, but from other stakeholders.

Yeah… doesn’t take much to guess who those "other stakeholders" are!

So, here is a sample list of synonymous phrases:

Lay Medicalized
Recognized medical conditions
High blood pressure Hypertension
Gall bladder disease Cholecystitis
Coeliac disease Gluten-induced enteropathy
Stroke Cerebrovascular accident
Lou Gehrig’s Amyotrophic lateral sclerosis
Heart attack Myocardial infarction
Cushing’s Hypercortisolism
Sore throat Pharyngitis
Recently medicalized
Impotence Erectile function disorder
Chronic fatigue syndrome Myalgic encephalomyelitis
Male pattern baldness Androgenic alopecia
Dandruff Sebhorrheic dermatitis
Chronic heartburn Gastroesophageal reflux disease
Excessive hair growth Hypertrichosis
Excessive sweating Hyperhidrosis
Skin tags Acrochordon

Yep, and "coprolalia" for "potty mouth".

Note: Chronic fatigue syndrome is something I’d call recently recognized rather than recently medicalized. It’s debilitating in a way hypertrichosis and erectile dysfunction aren’t.

Mind you, this suggests that I could get acceptance for treatment of "androgenic alopecia" by recommending the (very effective at preventing progression of the condition) simple outpatient procedure called orchiectomy … (a.k.a. cutting your balls off).

Here are results that show that not only was the medicalese version perceived as more severe, but also rarer for recently medicalized conditions, but perceptions went the other way for conditions that have been medically recognized for ages… interesting. (Dashed lines are "recently medicalized".)

Perceptions by recentness and terminology

Perceptions by recentness and terminology

Let’s hope that the Hollowmen and their clients (a.k.a. the politicians) read this paper (or get it read to them) so they don’t spend our money on useless medical procedures when Big Pharma comes along.  It’d be useful if the tabloid TV and press read it too…. naaah, the words are too long.

See Also/Notes:


4 Responses to “Medical terminology for fun and profit”

  1. Hi Dave, it is a very common misperception that ME is the new, made-up name for CFS – rather, it is the other way around. Previous to the 1950’s outbreaks of this disease were called things like atypical or non-paralytic poliomyelitis, and the name Myalgic Encephalomyelitis was coined in the 50’s for this disease. It wasn’t until the epidemic outbreaks in the US in the Eighties that the term “CFS” was coined, to the horror of all serious ME researchers, clinicians, and patients. The US CDC “downgraded” it to an almost meaningless, genenralized list of complaints, but very carefully excluding the infectious and neurological essence of this disease. Do your research Dave! Just came across your post by accident and wanted to correct this all too common misperception. Aylwin

  2. I was all set to post, and Aylwin beat me to it. ME was the original term. “Chronic fatigue syndrome” is the insurance company-ized name.

  3. Dave Bath said

    Aylwin… admitted that ME/CFS is the most real of the “recently recognized” … not recently made up names. The problem is that it was only RECENTLY recognized by a whole lot of doctors (and the public). My guess is that insurance/human resources types had a lot to do with the delay.

  4. Dave Bath said

    I suspect that ME/CFS was used as a serious thing in the “recent” set as a kind of control.

    It’d actually be great if (anonymized) raw data was available for this kind of thing from PLoS. I’ve had a quick look for this paper, but cannot see it.

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