Speaking in Code

Illuminating the truth - Don't Speak in Code

The value of plain language in technical communication.

Your non-technical audience is not stupid nor should you treat them as such. Science is akin to a foreign language or secret code.

The Plain Writing Act of 2010 requires US governmental agencies to use plain language that is easy to understand. Plain language does not "dumb down" or patronize the reader, but does take into account the audience. For example, when explaining endocrinology to a group of engineers -- brilliant and highly educated yet novice on the topic of biology -- I had to define a common language.

In this blog post, excerpts from a plain language summary are used to illustrate strategies for communicating with non-technical audiences.

Background on the source document.

Published in Nature, "Rare coding variants in Phospholipase D3 (PLD3) confer risk for Alzheimer's disease" (Cruchaga et al., 2014) describes whole-exome sequencing in families with a history of late-onset Alzheimer's disease. The study identified coding variants in PLD3 that are inversely related to the expression of plaque-forming amyloid beta peptide.

What does this mean?

Non-technical audiences may ask questions such as the following: What are coding variants? If I have a coding variant mentioned in the paper, does that mean I will develop the disease?

A plain language summary of this article was written with a specific audience in mind: adults recruited for genetic testing who have limited to no understanding of basic biology. Excerpts from the summary are used here to illustrate four important strategies when communicating with non-technical audiences.

Translation Strategy #1: Step back, way back.

When communicating with a non-technical audience, consider:

  • What is the level of reading comprehension of the audience?
  • Does the audience understand basic biology? Molecular biology?
  • Is the audience familiar with common medical terms?
  • Will the audience have been exposed to some of the words or concepts?

Additionally, when communicating with a non-technical audience, I consider the following questions the reader might have:

  • What is the disease?
  • Why does the disease happen?
  • Why do I care?

The plain language summary begins simply and gets to the point quickly:

"Alhzeimer's disease affects the brain and causes memory loss. Why do some people get Alzheimer's disease? That is not entirely understood, but the disease is often observed in multiple members of the same family.

A study of families with a history of Alzheimer's disease found a possible genetic cause."

Alzheimer's disease is associated with many symptoms in addition to memory loss -- why doesn't the summary start with a more detailed description of the signs and symptoms of the disease? The goal of the first sentence was to introduce the idea in simple, relatable terms. And more importantly, the signs and symptoms of Alzheimer's aren't relevant; the audience in question are patients with a familial risk of Alzheimer's who have been recruited for genetic testing. They need context as to why they should consent to testing.

Translation Strategy #2: Explain complex concepts in a step-wise fashion.

The summary continues:

"What are genes? What causes Alzheimer's?

Our genes or DNA are like the blueprints for a house. The building blocks for a house include materials like wood or brick while the building blocks for a living being include materials called proteins. These building materials can serve different functions in the body.

The body makes many different proteins. There is one particular protein called beta amyloid that causes the damage in the brain of an Alzheimer's disease patient.

How does beta amyloid cause damage? The beta amyloid proteins stick to and damage the nerve cells in the brain forming beta amyloid plaques. These plaques cause memory loss and the other symptoms of Alzheimer's disease."

The sentences are short, simple in structure, and contain very few technical terms or abbreviations. The abbreviation DNA is common enough to likely be familiar to non-technical audiences. An analogy is used to illustrate the abstract concept of gene products.

Translation Strategy #3: Highlight important ideas afer each section.

In this example, the study identified coding variants for a phospholipase gene whose expression is inversely related to the expression of plaque-forming amyloid beta peptide. Headings, phrased as questions, are used liberally. Complex ideas are highlighted in a series of statements that are set off from the rest of the text:

"More beta amyloid protein in the brain means higher risk of Alzheimer's disease."

"People with the gene variant for phospholipase D3 protein had higher levels of beta amyloid protein."

Using technical terms that we've built into the reader's vocabulary, the above sentences set the groundwork for the cause/effect relationship explained in subsequent paragraphs of the plain language summary.

Translation Strategy #4: What's in it for me?

In the pursuit of being accurate and fact-based, it is easy to overlook the most important question -- why should the audience care? The answer has to be expressed in one easy soundbite of information. The last sentence of the writing sample concludes:

"Volunteering for a simple genetic test resulted in this discovery that may lead to new treatments for Alzheimer's disease."

The study itself contains no actionable data; the PLD3 gene variants are not of diagnostic value due to their relative rarity. The study does, however, highlight the importance of genetic testing in densely affected families.

Why bother?

Constructing a plain language summary is in many respects more challenging that writing a manuscript for a peer-reviewed journal or preparing a nonclinical report for inclusion in a regulatory filing. In those examples, the scientist is communicating to other scientists who possess similar foundational knowledge. Explaining molecular biology to someone who has never so much as looked under a microscope presents unique challenges. In some instances, regulatory mandates require plain language summaries, but aside from that what is the value?

People do not value what they do not understand.

If as scientists we want our work to be valued, we must ensure that it can be understood at some basic level by every audience.

In her acceptance speech for the 1952 National Book Award, Rachel Carson said that there is not a separate literature of science; we must write as the subject (and audience) demands.

A manuscript submitted for publication in a peer-reviewed journal is comprehensible to a relatively small portion of the population. To ensure broader understanding of our work, we must push ourselves to communicate in plain language.

This is not to suggest that manuscripts be written for a non-technical audience. A manuscript is written in a specific style that is fit for purpose. Rather, consider crafting a plain language summary (this is not the same as the abstract) to be shared more broadly. How and where to post that plain language summary? That is a topic for another time. Until then, remember:

Good science poorly communicated = poor science.

Cruchaga C, Karch CM, Jin SC. Rare coding variants in Phospholipase D3 (PLD3) confer risk for Alzheimer's disease. Nature. 2014; 505(7484):550-554.

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