What we found

Two letters. AWCL picked the one that worked.

A published trial mailed one of two cover letters to 2,702 women. AWCL scored both without knowing which one got more replies.

Letter A Got more back

Surveys sent back26%

Deadline givenThree weeks

AWCL ranked itHigher

Letter B

Surveys sent back21%

Deadline givenNone

AWCL ranked itLower

What AWCL caught: Letter A said what to do, and by when.

McBride E, Mase H, Kerrison RS, Marlow LAV, Waller J. BMC Medical Research Methodology, 2021.

Isn't this just reading level?

Thirty-seven cancer-center documents were scored with AWCL and, separately, with two readability formulas.

9%

of the Emotional Safety score is explained by reading grade.

5%

of the Action Clarity score is explained by reading grade.

37of 37

documents failed the same check: breaking a complicated procedure into numbered steps.

Plain language soothed the patient without teaching them anything.

In a 2003 randomized trial across 44 institutions, an easy-to-read consent form lowered patients' anxiety about consenting and raised their satisfaction. Their understanding didn't change.

Coyne CA and colleagues, Journal of Clinical Oncology, 2003. A consent form for a clinical trial, and someone else's research, not AWCL's.

AHRQ, TalkingQuality: readability formulas don't measure comprehension.

Will a better score get more people to act?

A pilot shows it, on your own material, in the number you already watch.

  1. 1AWCL scores what you send.
  2. 2The report names what fails.
  3. 3The material is fixed and scored again.
  4. 4You read the number you already track: responses, calls, refills.

AWCL reads the material, not the patient. No study yet ties a score to a medical outcome.

That fear narrows attention isn't ours. The order of operations is.

Eysenck, Derakshan, Santos and Calvo

Emotion, 2007. Anxiety takes up the working memory a task needs.

Moran

Psychological Bulletin, 2016. Across 177 samples and 22,061 people, anxiety went with lower working memory.

Kessels

Journal of the Royal Society of Medicine, 2003. Between 40 and 80 percent of what a clinician tells a patient is forgotten right away.

Healthy People 2030

Making health information usable is the organization's job, not only the patient's.

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Dedicated to David, Rayna, and Robert.