With a leader from UCB, four community college students were able to participate in UCB Big Ideas Competition 2019. Below is their application essay:
A Website to Solve the Comprehension Difficulty of Medical Terminologies
According to the U.S. Department of Education and the National Institute of Literacy, approximately 32 million adults in the United States cannot read. The Organization for Economic Cooperation and Development found that 50 percent of U.S. adults cannot read a book written at an eighth-grade level (1). These data highlight the prevalence of low literacy in the US, which, surprisingly, is not even one of the top 25 most illiterate countries in the world. Thus, we can have a good estimate of the number of low-literate people worldwide. If those people struggle with understanding nontechnical vocabularies, how could they possibly interpret medical terminologies?
A research was conducted on how much medical terminology patients understand. “224 participants were asked to define 50 medical terms selected from a list made by physicians and other health professionals. One expected result did emerge: Participants with a college degree recognized more terms than the rest. Ten of them responded to all 50 words correctly, although not one of the words was identified correctly by all respondents. Gender differences in the ability to understand medical terminology did not emerge, but a difference in understanding depending on age did emerge. Persons older than 65 did not recognize as many of the terms as those in the 45 to 64 age group” (2).
The world is now facing a dilemma of low-literate people having trouble understanding medical terminologies. Our Big Idea is to set up a website to solve this dilemma. It will translate terminologies into basic words that are comprehensible to people with little knowledge of medications. The range of translation will include the description of the medicine, the instruction on how to take it, and its potential side effects under certain conditions.
Before explaining the solution to the issue that we identified above, we shall first look at relevant surveys and experiments.“The comprehension of medicine instructions is essential for the safe and effective use of medicines” (3). Facing this problem, most of the research groups and medical professionals recommend using charts to help patients understand hospital’s instructions. Studies on this problem are similar so we will focus on one of them. We will discuss the advantages and disadvantages of using charts.
The study was conducted in Grahamstown, a town in one of the poorest South African provinces with a high unemployment rate. The natives speak Xhosa. Most of them are low-literate. The research team used Pictograms of South Africa (refer to as SA histogram) to demonstrate medical instructions. “A drug pictogram is "a standardized graphical image that helps communicate drug instructions, precautions, and/or warnings to patients and consumers” (4). The American National Standards Institute (ANSI) sets the threshold level of the pictogram’s communication accuracy to be 85%, while the International Standard Organization (ISO) makes it 67%. (4) The advantage of SA histogram is obvious. As time goes on, it has become widely used among natives in South Africa. Eventually, 95% of the research participants can understand the meaning of the latest version of pictograms. (4) Indeed, conveying information through images makes it easier to understand. Nevertheless, the research mentions little about the limitations of SA histogram on communicating medical instructions. From our perspective, it has three limitations.
(1) The first problem is the possibility of misinterpretation. For example, a clock in the pictogram is used to show when patients should take the medication. However, patients may recognize the clock as the sun, misinterpreting that it should be taken during daytime.
(2) The second limitation is accuracy. The standard 67% and 85% accuracy are not high enough to ensure the precise delivery of details. Meeting the standard accuracy does not mean that the pictogram is pretty effective at communicating medical information. For instance, the proper way to take the medicine for aphtha is to“put [it] in your mouth, rotate it in your mouth, and swallow finally.” (4) This ensures the medicine will contact with fungus well. However, the minute steps increase the inaccuracy of illustrating the instruction through pictograms.
(3) Lastly, the feasibility of SA histogram is restricted to a specific culture. The task of the research team “was to design a sequence of hieroglyphs to be used by the local population of Xhosa-speakers” (4). We can speculate that this pictogram is only available for those live near this area, although the research does not specify it.
In conclusion, when it comes to popularization, the pictorial method shows its drawback. Cost will be substantial if we are to develop a pictorial system for every culture.
We think with the popularization and development of information sharing on the Internet, why not take advantage of the delivery, convenience, and ubiquity of the web to create an instruction web site in various languages for drugs and food? People can go to websites and sort by region.
For us there are now two ways to access our website. The first is by scanning QR codes on drug packages. The code will direct you to our webpage that contains description of that medicine in plain language. The second way is to search our website on the Internet and choose the suggested medicine according to your own medical condition. This will be more accurate and efficient to solve people's different needs. Type in the patient's disease. It recommends drugs to patients based on their location and symptoms. A description of the drug is available after selecting it, including an explanation of its effects and the role of its ingredients. We will also incorporate drug composition analysis.
Let's take the United States as an example. People who are not native English speakers can enter our website by scanning the QR codes on the package of medicines. We plan to reach out to pharmaceutical companies for implementing QR codes on medicines. The website works by providing more easily understood drug descriptions in various languages by region. We are expanding our drug information database through volunteers around the world.
The impact of our website on society is to let more people know how drugs are used and to use drugs more accurately. Moreover, information transmission through the Internet is more convenient and cheaper than the traditional teaching model — lectures. Giving lectures to the general public requires high input of time for preparation and implementation. We can simply let people learn by themselves through the Internet. Our website will be built on shared resources improved by medical students or professionals, who would like to contribute to mitigating the gap in understanding medical terminologies. Everyone can upload a description of the drug on the website. We will develop a filter system that selects the high-quality answers. Our first year of implementation will start with some common medications on the market. International students studying in the United States are a competent group of benefactors and contributors. They can look up medical information specific to the United States on our website. Encouraging them to share medical information about their own countries will enrich our database. The visibility and utilization of our website will be our two other focuses.
Team Lead & Project Director: Wenyuan Wang is a student at UC Berkeley intended
Economics and Data Science. She wishes to familiarize the general public with medical knowledge that will enable them to quickly interpret instructions and descriptions on medications. She had utilized quantitative data to examine the public understanding of drugs’ description. The idea carried out in this essay is built on her previous findings.
Sijia Sun, majoring in Biological Pharmacy, has some expertise in medicinal objects. She has interned in several pharmaceutical companies in China and understands the drug safety supervision system in China and the US. She will provide empirical supports and professional information for our idea.
Mingxin Shi, majoring in Computer Science, is experienced in building network platforms and developing software. He hopes to popularize basic medical knowledge using digital technology and promote safer drug use for Americans speaking different languages.
Yifei Li, a Pre-Med student, is concerned about the accuracy of patients’ interpretation of medical instructions. He believes that the wording of medications should be easily understood. He can help improve the idea by collecting and analyzing feedback from patients on the effectiveness of medical descriptions.
Peiyu Yan, majoring in Psychology and Anthropology, is interested in the experience of people with long medication history from diverse cultural backgrounds. She is going to research on people’s concerns on drug instructions and summarize them into different categories based on languages. She will then analyze the gap in understanding medical terminologies in the context of translation difficulty.
Reference List 1. World, One Young. “32 Million American Adults Can't Read: Why Literacy Is the Key to Growth.” Medium, Medium, 16 Feb. 2018, medium.com/@OneYoungWorld_/32-million- american-adults-cant-read-why-literacy-is-the-key-to-growth-818996739523.
2. “Doctor-Patient Communication: Is Patient Knowledge of Medical Terminology Improving?”Taylor&Francis,www.tandfonline.com/doi/abs/10.1207/ s15327027hc0502_2.
3.ErgonomicsSA,2004(2) http://citeseerx.ist.psu.edu/viewdoc/ download?doi=10.1.1.541.615&rep=rep1&type=pdf\
4.South African Journal of Science 100, November/December 2004Ros Dowse*† and Martina Ehlers https://journals.co.za/docserver/fulltext/sajsci/100/1112/ sajsci_v100_n11_a35.pdf?expires=1573783098&id=id&accname=guest&checksu m=D8A4422687293D5A1B7090DC472CEF05