• Roberto Burro, Ugo Savardi, Maria Antonietta Annunziata, Paolo De Paoli, and Ivana Bianchi.
• Department of Human Sciences, University of Verona, Verona, Italy.
• Patient Prefer Adher. 2018 Jan 1; 12: 443459443-459.

BackgroundAn extensive body of literature has demonstrated that many patients who have been asked to participate in clinical trials do not fully understand the informed consent forms. A parallel independent study has demonstrated that opposites have a special status in human cognitive organization: they are common to all-natural languages and are intuitively and naturally understood and learnt.PurposeThe study investigates whether, and how, the use of opposites impacts on doctor-patient communication: does using the terms "small-large" to describe a nodule (ie, bipolar communication) rather than speaking in terms of centimeters (ie, unipolar communication) affect a patient's understanding of the situation? And is it better to speak of "common-rare" side effects (ie, bipolar communication) instead of the number of people who have suffered from particular side effects (ie, unipolar communication)?MethodsTwo questionnaires were created and used, one presenting the information in terms of opposites (ie, bipolar communication) and another using unipolar communication.ResultsThe participants' perception of their situation (in terms of feeling healthy-ill, being at high-low risk, and their treatment requiring high-low commitment) varied in the two conditions. Moreover, self-reported levels of understanding and satisfaction with how the information was communicated were higher when opposites were used.LimitationsSince this is the first study that addresses the merits of using bipolar structures versus unipolar structures in doctor-patient communication, further work is needed to consolidate and expand on the results, involving not only simulated but also real diagnostic contexts.ConclusionThe encouraging results imply that further testing of the use of opposites in informed consent forms and in doctor-patient communication is strongly advisable.

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