Exhibits from lay summaries, science communicators and academia.

The knowledge gap opens when there is a mismatch between what the writer assumes the layperson can understand versus what they actually do grasp. This is a knowledge gap that extends like deep fault line between the medical establishment and laypeople, from the health professional-patient consultation to the written materials that the pharmaceutical industry produces to patients.

Yet, it is not only from these official sources. The medical register, the medical gaze, the voice of medicine, the Patient Voice agenda-but-only-on-their-terms, is pervasive. It is not only Patient Information Leaflets, Consent Forms or Clinical Outcomes Assessments, it is also in forms of formal and informal communication about health. This article looks at examples from lay summaries, online science communicators and an academic-turned-podcaster.

These are all instances where the purpose of the communication activity ought to be reaching to out to laypeople about medical and health issues. The aim ought to be clear communication, imparting knowledge that could benefit a layperson in their own lives. The information received may help them understand complex information. It is an opportunity to narrow the knowledge gap between professional and layperson. As I stated repeatedly in other articles, whether the communicator decides to narrow or widen the knowledge gap is a choice. Do they push them away with pointless jargon or do they bring them closer by clearer communication? If they push them away, then it is worth wondering about the reason behind this. Alas, the pondering does not last long, because the motivation is very clear: they want to show how clever they are.

Exhibit 1: Plain English summaries of academic papers

The purpose of a plain English summary in an academic paper is to communicate scientific knowledge to a lay audience. It is supposed to do what it says on the tin. However, many Plain English summaries seem like shorter précis of the abstract, which is itself supposed to be an overview of the key points of the academic paper. So, the Plain English version is a summary of a summary. There is very little diversion from the medical or academic style. This example is from a recent paper in a Quality of Life journal:

“This study assessed the relative importance of selected predictors to respondents’ [acronyms of five PRO measures] derived from [full title and acronym of COA]. Variable importance quantifies the contribution of each individual predictor variable in a set of variables to the prediction accuracy of the outcome variable.” 

Exhibit 2: A science communicator posting on LinkedIn

This was posted by a medical doctor who styles themselves as an online health communicator. There has been an explosion of YouTube health communicators in recent years. It is a great pity that most of them emerged after the Covid-19 crisis had subsided. The public might have benefited from their clear communication... The following exhibit was posted in 2024 to showcase the writer’s talent: 

“Genome editing involves targeted modifications to the genomic DNA of living organisms using engineered nucleases, such as CRISPR-Cas9. The technology offers profound implications for treating genetic disorders by enabling precise correction of disease-causing mutation at their source.” “Effective regulation and effective oversight are essential to harness these advancements while addressing societal and ethical concern.” “Genome editing enables precise DNA modifications using engineered enzymes, enhancing our understanding of gene functions across various organisms.”

“Genome editing represents a suite of technologies, such as CRISPR- Cas9, TALENS and ZFNs, that enable targeted modifications to genomic DNA with high precision. These tools have revolutionized genetic research, providing unprecedented control over gene function and regulations with significant implications for understanding pathogenesis and developing gene therapies.”

Exhibit 3: The Podcaster Virologist

The following is a verbatim transcript of an interview with a virologist and podcaster on Good Morning Britain TV programme in the UK in early January 2021. It was the interviewee’s task to explain how the Oxford – AZ RNA vaccine works:

 “…we basically grow a virus, smash it up and chemically brutalise it and then inject the shrapnel into people and the bits of…what are left over…the provoke the immune system to respond….In this case, what they’ve done is to take the genetic code from the virus itself that codes for the outer coat of the virus, a part of the virus called the spike or the S-protein…they’ve put that into an oily coat and these oily coated droplets – they are absolutely tiny – you inject into the body. Cells in the body then pick up those packets and read it and they make that part of the virus encoded by that genetic code show it to the immune system and the virus….”

The last two in particular are a mess. Look at the acronyms of exhibit 2 that are not necessary for lay communication. Consider the muddle of mixed metaphors in Exhibit 3.

This is not communicating. This is big-brain self-love.

I asked ChatGPT to render these into concise, lay language:

Exhibit 2, Rewritten by ChatGPT:

“Genome editing is a technology that allows scientists to make precise changes to the DNA of living organisms. One of the most well-known methods for this uses a special protein that can cut and edit DNA. This technology has the potential to treat genetic disorders by fixing the root cause of the disease directly in the DNA.

To fully benefit from these advancements while addressing ethical and social concerns, proper regulation and oversight are necessary.

Genome editing helps researchers understand how genes work by making specific changes to DNA. It can be used in many different organisms to study gene functions more accurately.

There are several tools used in genome editing that allow scientists to target and edit DNA with high precision. These tools have revolutionised genetic research by giving scientists more control over how genes function and are regulated. This has important implications for understanding diseases and developing new gene therapies.”

Exhibit 3, rewritten by ChatGPT, with more coherent metaphors:

“Traditional vaccines work by taking the virus, breaking it into tiny pieces, and then injecting those pieces into the body. These pieces can’t make you sick, but they teach your immune system how to recognise and fight the real virus if it ever shows up.

This new type of vaccine works differently. Instead of using pieces of the virus, it uses a set of instructions that tells your body how to make a harmless part of the virus – a piece called the spike protein that sits on the surface of the virus.

These instructions are wrapped in tiny droplets of fat, like a message in a bubble. When the vaccine is injected, your cells absorb these bubbles, read the instructions, and make the spike protein.

Your immune system then learns to recognise this spike protein as a warning sign. That way, if the real virus shows up later, your body knows how to fight it off.”

The point is, communicating clearly is a choice (and ChatGPT does a better job at lay writing, at least in these cases).

Thank you for reading!

Mark Gibson

Leeds, United Kingdom, December 2024