WTF? Interpreting TLAs in D/C letters


The misinterpretation of Web 2.0 acronyms by parentals is a perennial source of entertainment, but this study from the MJA highlights that misinterpretation of abbreviations is also prevalent amongst doctors.

Is one doctor's PEARL the same as another's PERLA? Is an MVA an MVC? Do they have GORD or GERD? Do you FREOM or HSDNM? Does you patient have HT, IHD, CCD, T2DM, RA, OA, OP, AVR or AS? Did they go to IR, OR, OT, ICU or ICCU?

The lexicon of medical abbreviations is vast, steeped in tradition and twisted by colloquial notations. I recall the early days as a medical student struggling to decipher the medical record (partly due to the handwriting) and noting the geographical variability in the terms used. This becomes important when the main tool of communication between a hospital team and a patient's regular doctor becomes lost in translation, nowadays not because of handwriting, but because of ambiguous abbreviations.


This study looked at 200 discharge letters from a tertiary referral centre and identified 371 abbreviations in use, many used multiple times across letters. From these, they identified the top 20 most used and clinically significant acronyms and surveyed the regional GPs for their interpretation.

Almost half of the respondents misinterpreted SNT (soft, non-tender), and almost a third did not understand TTE (transthoracic echocardiogram), EST (exercise stress test), NKDA (no known drug allergy) and CTPA (computed tomography pulmonary angiogram).


The generalisability of these findings are limited by the survey respondents all being in one region (although in the same region as the hospital, so theoretically not too medically disparate). A response rate of 55% leaves the possibility open that the results could be inaccurate.

IMHO (In My Humble Opinion...)

I use a large number of these abbreviations throughout my notes and discharge letters. I know what they mean, but do the recipients? This certainly gives food for thought about ensuring clarity in our communication, especially where we are asking the recipients to use the information included to provide ongoing care for our patients. I will be bearing this in mind as I write my next discharge letter; the time taken to spell out a few extra words will be minimal and may prevent a miscommunication.

Next job: fixing my handwriting. ROFLMAO.





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