Choosing words wisely: Language, metaphor, and psychological challenges after pulmonary embolism
Bibliographic record
Abstract
Traditionally, clinical follow-up after pulmonary embolism (PE) has focused on medical therapy: the length of time a patient is anticoagulated, type and dose of anticoagulant, and mitigation of bleeding risk.There is often limited time to address other factors in a patient's recovery and wellbeing.However, when asked, patients describe a negative emotional burden which can persist years after the diagnosis, even when their management and physical recovery has been uncomplicated.1,2 Fear, anxiety, and hypervigilance are faced by many PE patients but are often unexplored in clinical encounters. 2 The choice of language used by healthcare professionals can inflame these psychological challenges or create space for them to be articulated and better understood.Here, we explore how clinician language can fail to address psychological consequences of PE and even exacerbate negative mental health.PE survivors frequently endure significant psychological challenges.Studies suggest that roughly 3% of patients meet the criteria for posttraumatic stress disorder at follow-up. 2 A further 21.3% experience clinically significant anxiety and 18.3% report depressive symptoms within 3 months of their event.3 Nearly one in five continue to endure anxiety or depression up to 2 years post-PE.4 This high prevalence of psychological morbidity correlates with a reduction in wider health-related quality-of-life.The mean SF-36 Mental Component Summary score in a cohort of 251 PE survivors was 43.6 ± 19.8 compared to a normative mean of 50. 5 It showed persistent impairments in social functioning, vitality and role-emotional domains relative to age-and sex-matched population norms.5 CLINICIAN LANGUAGE AT THE POINT OF DIAGNOSISPE can induce a sense of fear and anxiety among healthcare staff.This is especially common when the condition is first recognised.This anxiety may be transferred to patients through a number of ways.6 Sudden, simultaneous attention from a succession of doctors and nurses signals a more serious condition.The sense of fear can be exacerbated when no single healthcare provider sits down with the patient in a quiet | 1 of 3
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".