Mariken Stegmann

Concerning treatment, the following eight items were desired: the option(s), the selected  option(s), the explanation(s) given, the aims (curative or palliative), a summary/conclusion of  any multidisciplinary meeting, the prognosis, the short‐term side‐effects, the expected  effectiveness, and the response to date. There were also a few other requirements of the  included information. Five completion‐related items were included, such as the provision of  a summary/conclusion, details of what the patient has been told and whom the patient  should contact. When a patient was hospitalised, six additional items were requested, such  as the discharge destination.   Layout and writing preferences  All parties preferred referral letters to be short (mean 1.36 pages) and specialist letters to be  longer (mean 1.76 pages). However, the panels did not agree about the preferred structure  or writing style (Table 3). The oncologists preferred a structured format, unlike the other  two panels, which preferred an unstructured format with no predefined sections. Moreover,  most patient representatives thought the information could be best communicated in a  short‐hand or abbreviated medical style (e.g., “chemotherapy delayed because of cough,  whereas half of the doctors was in favour of full phrases (e.g., “We delayed chemotherapy  for one week because the patient developed a cough”).Most respondents thought that  correspondence from specialists should not include all information available in the hospital  records, and only a minority advocated using jargon (specialism‐specific abbreviations; e.g.,  "hipec" for "hyperthermic intra peritoneal chemotherapy"). However, all parties agreed that  it was appropriate to use abbreviations that are in common use (“e.g.” for exempli gratia)  and most GPs thought that common medical abbreviations (e.g., BP for blood pressure)  were appropriate (Table 3).  Table 3.  Layout and writing preferences  Referral letters Specialist letters GPs  (%)  MSs  (%)  Ps  (%)  Overall  (%)  GPs  (%)  MSs  (%)  Ps  (%)  Overall  (%)  Format and writing style  A structured format is important 54.0  61.8 61.1 58.5 43.2 71.8 66.6  59.6  I prefer phrases above  short‐hand or  abbreviated medical style  45.9  46.2 22.2 41.8  54.1 64.1 22.2  52.1  The specialist letter should contain all  information available in hospital records  25.6 35.7 72.2  38.4  Use of abbreviations   No abbreviations 2.7  2.6  11.1  4.3  2.7  5.1  11.1  5.3  Only general abbreviations 35.1  46.2  77.8  47.9  35.1  46.2  72.2  46.8  Also medical abbreviations 54.1  38.5  5.6  38.3  59.5  35.9  11.1  40.4  Also jargon abbreviations  8.1  12.8 5.6  9.6  2.7  12.8 5.6  7.4  GPs = General Practitioners, MSs = medical specialists, Ps = patients  88 Chapter 7