Cross-Sectional Analysis of Patient-Centered Language Use in Journals Publishing Research Focused on Heart Failure

Abstract

Purpose: Detrimental effects of using non–patient-centered language (nPCL) have been reported for diabetes, mental illness, and obesity, and both the American Medical Association (AMA) and International Committee of Medical Journal Editors (ICMJE) recommend using patient-centered language in medical literature. Heart failure is a common yet stigmatized disease, and nPCL may further propagate stigma. This study analyzed current use of nPCL in journals focused on heart failure research and also examined whether the journals steer authors to adhere to AMA or ICMJE guidelines regarding nPCL. Methods: Following systematic search of PubMed for heart failure-related articles published from May 1, 2018, to April 30, 2020, cross-sectional analysis was performed. Each selected article was inspected for an array of nPCL terms and frequency of nPCL usage. Chi-squared tests and multivariable logistic regressions were used to assess relationships between study characteristics and nPCL use. Results: Of the 195 articles fully analyzed, 108 (55.4%) contained a nPCL term, the most frequently used being “heart failure patient” (78.7%), “burden” (23.1%), and “suffer” (15.7%). Use of nPCL was disproportionately more common in original research articles (63.5%) and less common in case reports (18.2%). Articles that did not detail any treatment or intervention used the most nPCL (71.1%). No statistically significant association was found between a journal’s impact factor and its adherence to AMA or ICMJE recommendations. Conclusions: nPCL is widely used in publications reporting on heart failure. We encourage authors and journals to reduce nPCL to help decrease the stigma patients with this disease often encounter.

Keywords

• patient-centered language
• heart failure
• stigma
• health research
• publishing