I didn’t give many examples of keywords actually at work in the book, so I’m taking this opportunity to point to some recent examples of interest.
The first is from the AEM Education and Training journal, which deals with emergency medicine, and is titled, “The Keyword Effect: A Grounded Theory Study Exploring the Role of Keywords in Clinical Communication.”
It uses grounded theory (a particularly popular research methodology in the health sciences) to examine how physicians use specific words and phrases to describe patient conditions in conversation with fellow clinicians. The authors explain that “These descriptors, such as ‘butterfly rash,’ ‘honey‐colored crust,’ and ‘hot‐potato voice,’ liken a physical or radiographic finding to a nonmedical comparator and are closely associated with a single diagnosis.”
For their study, the authors interviewed physicians and medical students working in a pediatrics emergency ward in a Chicago hospital about their use and non-use of keywords in their clinical conversations, and found that such keywords were commonly used, as they increased both efficiency and understanding, though they could sometimes be misleading if both parties didn’t have a clear understanding of the diagnostic implications of “currant jelly stool,” for example.
The authors conclude that “keywords may play an important role in communicating and activating illness scripts between providers. Keywords also potentially contribute to medical error by fostering premature closure and anchoring bias. Training in cognitive debiasing strategies should increase awareness of keywords and their potential to introduce bias. Providers should be aware how keywords affect their communication and consciously balance the need for communicative efficiency and the potential for error.”
This is an excellent illustration of the use of keywords in medical discourse and provides an interesting contrast to contemporary studies of online medical search through the use of keywords in Medline’s Medical Subject Headings (MeSH), such as this article about “General practice-related MeSH terms in main journals: a bibliometric analysis from 2011 to 2021” in the British Journal of General Practice or this one on the BioASQ challenges in “The road from manual to automatic semantic indexing of biomedical literature: a 10 years journey” from Frontiers in Research Metrics & Analytics.
As an aside, I should note that “hot potato voice” isn’t a MeSH subject heading (or even a keyword) in Medline.
Keywords In and Out of Context 