The effects of presenting oncologic information in terms of opposites in a medical context

Roberto Burro, Ugo Savardi, Maria Antonietta Annunziata, Paolo De Paoli, Ivana Bianchi

Research output: Contribution to journalArticlepeer-review


Background: An 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. Purpose: The 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)? Methods: Two questionnaires were created and used, one presenting the information in terms of opposites (ie, bipolar communication) and another using unipolar communication. Results: The 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. Limitations: Since 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. Conclusion: The encouraging results imply that further testing of the use of opposites in informed consent forms and in doctor-patient communication is strongly advisable.

Original languageEnglish
Pages (from-to)443-459
Number of pages17
JournalPatient Preference and Adherence
Publication statusPublished - Jan 1 2018


  • Bipolar
  • Doctor-patient communication
  • Informed consent
  • Opposites
  • Satisfaction
  • Understanding
  • Unipolar

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Social Sciences (miscellaneous)
  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Health Policy


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