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Currently submitted to: Journal of Medical Internet Research

Date Submitted: Jul 23, 2020
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How Can We Optimize the Readability and Format of Plain Language Summaries for Medical Journal Articles? A Cross-sectional Survey Study

  • Leia Martínez Silvagnoli; 
  • Caroline Shepherd; 
  • James Pritchett; 
  • Jason Gardner; 



Plain language summaries (PLS) are intended to provide readers with a clear, non-technical, and easily understandable overview of medical and scientific literature; however, audience preferences for specific PLS format have yet to be fully explored.


To evaluate the preferred readability level and format for PLS of medical journal articles across different disease states, with online audiences from various age groups.


Articles describing phase III clinical trials from top-level, peer-reviewed journals published between May 2016–May 2018 were identified for three disease states representing a range of patient age groups (psoriasis, a skin disease [younger patients]; multiple sclerosis [MS], a nerve-based disease [middle-aged patients]; and rheumatoid arthritis [RA], a painful joint disease [older patients]). Four PLS were developed for each article: three as text only (written with high-, medium-, and low-complexity) and one as an infographic. To evaluate each of the four PLS formats, a 20-question survey (specific to one of the three diseases) was sent to a representative sample, via UK-based patient association websites, Twitter, and Facebook patient groups. A weighted-average calculation was applied to responders’ ranked preferences for each PLS format.


Across all three diseases, the weighted-average preference scores showed that infographics (psoriasis=2.91; MS=2.71; RA=2.78) and medium-complexity text PLS (reading age: 14–17 years, US Grade 9–11; psoriasis=2.90; MS=2.47; RA=2.77) were the two most-preferred PLS formats in each case.


Audience preferences should be accounted for when preparing PLS to accompany original peer-reviewed research articles. Oversimplified text can be viewed negatively, and infographic versions or medium-complexity text appear to be the most popular.


Please cite as:

Martínez Silvagnoli L, Shepherd C, Pritchett J, Gardner J

How Can We Optimize the Readability and Format of Plain Language Summaries for Medical Journal Articles? A Cross-sectional Survey Study

JMIR Preprints. 23/07/2020:22122

DOI: 10.2196/preprints.22122


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