Samira Khan, a fictional 46-year-old teacher, attends to discuss mildly abnormal liver blood tests found during a medication review. She feels well. The pattern is non-specific, there is no immediate danger signal, and repeat tests plus an ultrasound are planned. Samira asks, “Does this mean I have something serious?”
No real patient or identifiable patient information is used.- Separate the result, its possible meaning and the limits of current knowledge.
- Use absolute, plain-language risk communication without false reassurance.
- Agree a monitoring plan, named responsibility and a route back if circumstances change.
See the purpose behind each line
Before I explain the numbers, what have you been most worried they might mean?
Elicit the person’s concern before supplying information.I saw ‘abnormal’ and thought it might be cancer.
I can understand why that word was alarming. The tests show a small change in two liver enzymes. They do not, by themselves, diagnose cancer or any single condition.
What I know today is that you are well and there is no result that needs emergency treatment. What I do not yet know is whether this is temporary, medicine-related or due to another liver condition.
The useful next step is to repeat the blood tests in four weeks and arrange an ultrasound. I will review both results and contact you. If you have not heard within one week of the final test, please contact the practice.
Could you tell me, in your own words, what the result means and what will happen next? I want to check that I explained it clearly.
“The result is abnormal, but it does not yet tell us one definite cause.”
“Here is what we know, what remains uncertain and how we will reduce that uncertainty.”
“There is no sign today that you need emergency treatment.”
“I will take responsibility for reviewing the next results; this is when and how you should expect to hear.”
“It is probably nothing.”
It minimises concern and offers reassurance without a plan.“Your LFTs are deranged.”
Jargon and emotive wording can increase anxiety without adding meaning.“We cannot know, so we just have to wait.”
It presents uncertainty as passive rather than managed.“No news is good news.”
It leaves responsibility for test follow-up unsafe and unclear.- Listing a long differential diagnosis before asking what the person already understands or fears.
- Conflating a test abnormality with a diagnosis.
- Using vague probability words without context or numbers when reliable numbers exist.
- Failing to name who will review the result, by when and what happens if contact is missed.
Test the communication decision
Could I do this reliably?
Where do I tend to hide uncertainty behind jargon or over-reassurance, and what sentence will I use differently in my next results conversation?
This note stays on this device and is not sent to Clinora.