When you were in school, did you ever use "word tricks" to remember items on a list? For example, it isn't easy to memorize the names and order of the planets, especially in grade school. But by using an acronym — a word or series of words in which each letter (or the first letter) stands for another word — the task becomes much easier. I learned this one: My very educated mother just sent us nine pizzas (representing Mercury, Venus, Earth, Mars, Jupiter, Saturn, Uranus and Neptune). (We can eliminate "pizzas" and substitute "nachos" for "nine" now. Pluto is no longer considered a planet.)
In medical school, we used acronyms all the time to remember parts of the anatomy. One that I continue to use describes the tendons of the rotator cuff muscles in the shoulder: SITS stands for supraspinatus, infraspinatus, teres minor, and subscapularis.
An acronym may be used so often that it takes over as the common name of the disease; the corresponding word for each letter may be forgotten because use of the acronym is used so commonly. In non-medical fields, this occurs often. Scuba diving is a good example (that is, diving with the use of a self-contained underwater breathing apparatus). Another common acronym is laser, which stands for light amplification by stimulated emission of radiation.
This same approach applies to the names of many medical illnesses, and, as a result, medical providers throw these terms around as if everyone understands them. And leave it to medical jargon to include an acronym (laser,) within another acronym, LASIK, which stands for laser-assisted in situ keratomileusis. With lasik surgery, the cornea is reshaped while in its normal location with the help of lasers; "in situ" means "in the normal location, "kerato" indicates the cornea, and "mileusis" means "to shape". Given how long it takes just to decipher and explain the words represented by the letters, no wonder it's called lasik.
Similarly, many diseases, examinations, tests, operations and research studies are commonly named by use of acronyms.
Common Medical Acronyms
One of the first acronyms I learned about was CABG (pronounced like the vegetable) which stands for "coronary artery bypass graft." During discussions of medical conditions, no one ever used the entire name; soon, the term became second nature even if it sounded odd to anyone not knowing the context.
The CREST syndrome has nothing to do with toothpaste; it's a disorder related to progressive systemic sclerosis (also called scleroderma), and is characterized by calcium deposits in the skin (calcinosis), intermittent coldness and color changes in the fingers (Raynaud's phenomenon), severe heartburn (esophageal reflux), thickening of the skin on the fingers (sclerodactyly) and small red spots under the skin (telangiectasia).
The Apgar score, a widely accepted means of rating a newborn's health just after delivery, is an example of an acronym that is used so commonly that many don't realize that it's an acronym: its letters stand for appearance (color), pulse (heart rate), grimace (reflex, irritability), activity (muscle tone) and respiratory effort. "Apgar" is an unusual term in that it is not only an acronym but also an eponym, a term named after a person (its inventor, Virginia Apgar).
Research studies have increasingly used acronyms, in part to make them easy to remember and perhaps so that they are more likely to be noticed. A well-known example is the Multiple Risk Factor Intervention Trial, or MRFIT, that studied large numbers of persons without known disease to see whether the chance of developing illness (such as heart disease) could be reduced by improving one or more risk factors.
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Why an Acronym?
Sometimes the use of an acronym is particularly appealing because a condition has so many features or such a long name that it becomes helpful to use a single word or phrase. Other times it's simply a shortcut or timesaving way to jog the memory. But more often than not, it's simply the name that stuck, perhaps because it is "user-friendly" – it's a lot easier to call a disease CREST than "the limited form of progressive systemic sclerosis." And an acronym that "catches on" may be impossible to remove as the common name used by medical professionals.
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Perhaps acronyms are just another way that health-care providers speak "medicalese" when plain English would do just as well (or better). But it seems to be a part of human nature to cut corners when given the chance, so acronyms are here to stay. Knowing a few of the most common, or knowing where to look them up, can go a long way toward figuring out what your doctor is saying. In any situation where the terminology is confusing, ask your doctor for a translation. You may find that once decoded, acronyms provide useful information in a way that is easy to remember. Just try to remember all of the planets in order without one!
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Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.