Are dermatologists familiar with acronyms?

Milica Markovic¹ , Branislav Ivanović² , Milan Bjekić¹ , Sandra Sipetic³

¹ City Institute for Skin and Venereal Diseases, Belgrade, Serbia
² Faculty of Philology, Belgrade University, Belgrade, Serbia
³ Institute of Epidemiology, School of Medicine, Belgrade, Serbia

Correspondence Address:
Milica Markovic
City Institute for Skin and Venereal Diseases, Džordža Vašingtona 17, Belgrade 11000
Serbia

Sir,

Acronyms were initially introduced during the early 20 ^th century, which places them among the relatively new linguistic phenomena with wide spectrum of definitions. The purpose of this study is to analyze the current knowledge of Serbian dermatologists regarding the recognition of acronyms and assessment of familiarity with selected acronyms among practicing dermatologists with the practice experience of various duration.

The anonymous inquiry questionnaire containing poetic letter with 10 hidden acronyms [Appendix 1] has been delivered to 52 certified practicing dermatologists. The final mixture of acronyms hidden in the text included 54-year-old up to 2-year-old acronym. Only 26.7% recognized more than 50% of the hidden acronyms [Figure - 1]. Two groups emerged: The "poor" and "good" acronym knowledge group of dermatologists [Table - 1]. Dermatologists in the "poor" knowledge group were significantly older with the higher mean age (P < 0.05), majority of participants (85.7%) in this group had more than 10 years of practice. Conversely, up to 79.2% dermatologists in the "good" knowledge group were younger specialists who started to practice within the past decade (P < 0.001). Moreover, their own perception of fluency in speaking English (P < 0.05) is greater. Gender, type of practice (public vs. private) and the presence or absence of English language education, did not significantly differ between "good" and "poor" acronym knowledge group.

Figure 1: Distribution of dermatovenereologists according to the number of recognizable acronyms

Specific type of acronym was significant for the recognition process so in the "good" knowledge group, terms SAPHO, CHILD, LAMB, DRESS, and KID were significantly more frequently detected by dermatologists. The most frequently detected acronyms in both groups were LEOPARD and SAPHO, respectively.

According to the MedLine and PubMed database search, more than 90 abbreviations were recorded in dermatology regarding the naming of dermatological diseases and syndromes (e.g. SSSS, AD, DLE). Some of the commonly used acronyms describing diseases or syndromes in dermatology are (in alphabetical order) AGEP, BIDS, CHILD, CLOVE, COIF, CREST, DRESS, EMPACT, HATS, ILVEN, KID, LAMB, LEOPARD, MIDAS, NAME, PAN, PAPA, PHACES, POEMS, REM, SACRAL, SAPHO, SDRIFE, TEN, and WILD. The first acronym used in dermatology, TEN appeared only 13 years after the offical acceptance of the exact acronym definition, and the rise of acronyms in naming of dermatoses and syndromes continued during the past 6 decades. ^[1]

Since, the dermatology is visual i.e descriptive medical specialty one could expect that the theory of visual word recognition would have the greatest impact on identification and memorization of acronyms. ^[2] This might well be supported by study on acronym "superiority effect" which presents that familiarity of a word (i.e., with pre-existing lexical representation) has even superior effect on recognition and memory than orthographic regularity (effective spelling of the letter string) when it comes to visual word recognition. ^[3]

The acronymophyllia which appeared in other medical fields could have been easily avoided in dermatology by using three simple rules when creating one: (1) the acronym must have at least three letters and be easily pronounceable, (2) it has to make the communication easier, (3) and to be more readily recognized by the reader compared to the original phrase ^[4] adding the familiarity as the most important characteristic. All acronyms elected in the study obey the proposed rules: Surprisingly well- recognized acronym SAPHO could only be explained by Serbian-Greek historical connections and hence familiarity with Greek goddess Sapho.

Since, its cumbersome to memorize all the acronyms and syndrome names (NAME, LAMB, LEOPARD, Carney syndrome) that refer to almost the same skin lesions: Lentigines and/or ephelides and various benign tumors, all of them being rare, only the oldest acronym LEOPARD was highly recognizable, which emphasizes the significance of the clinical endpoint. ^[5]

The duration of acronym usage and interpretation in dermatology appeared to be important factor in recognition of "older" acronyms but only in case of a half-century old mnemonic words which holds primarily for LEOPARD. Similarly, there was complete ignorance of the 2 year old term WILD.

Influence of fluency in speaking English on acronym recognition is evidenced in this survey. Word leopard have the same written and pronounced version in Serbian unlike the "animal" lamb, which remained unrecognized by poor English speakers.

In conclusion, the strongest evidence stands for positive causality between the amount of time spent on acronym usage in dermatology and the extent of visual word recognition, with significant positive influence of the recently gained knowledge through board exam (not more than 10 years of practice), younger age of practicing dermatologist and fluency in English.

Acknowledgment

This study was supported by the Ministry of Science and Technology of the Republic of Serbia, through Contract No 175402 (2011-2014).

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