Medical Writing Writing Matters Pleasing the reader by pleasing the eye—Part 1 The role of format and design in readability

Volume 21, Issue 3 - Writing Matters

Pleasing the reader by pleasing the eye—Part 1 The role of format and design in readability


Whoever writes wants to be read. Yet, even if we succeed in creating an informative, logically structured, and adequately worded text tailored to our target audience, i.e., text we consider to have an adequate level of readability, our documents may still go unread—or read with antipathy. Next to linguistic factors, therefore, there is a wide range of other aspects determining how well we understand a text, including layout, typography, or cultural adequacy. Documents people can use effectively and with ease have language, graphics, and design combine into a harmonious whole. Good design helps arouse interest and singles a text out from many others that vie for our attention. In short, good design is no luxury. This article is the first in a series of assays on the role of format and design in readability. Rather than attempting to transform writers into graphics designers, the goal is to have writers see the beauty of layout and typography and have them harmoniously blend with the content to be conveyed.

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  1. Jobs S. You've got to find what you love. Commencement address delivered on 12 June 2005. Standford University News Available from:
  2. Raynor DK, Blenkinsopp A, Knapp P, et al. A systematic review of quantitative and qualitative research on the role and effectiveness of written information available to patients about individual medicines. Health Technol Assess 2007;11(5).
  3. Doak C, Doak L, Root J. Health literacy studies. Teaching patients with low literacy skills. 2nd ed. Philadelphia: J. B. Lippincott Company; 1996. Available from:
  4. DuBay WH. The Principles of Readability. 2004. Available from:
  5. Klare GR. The measurement of readability. Ames, Iowa: Iowa State University Press; 1963.
  6. McLaughlin GH. Proposals for british readability measures. In: Downing J, Brown AL (eds). The third international reading symposium. London: Cassell; 1968. p. 186–205.
  7. Dale E, Chall JS. The concept of readability. Elementary English 1949;26:19–26.
  8. Kandula S, Zeng-Treitler Q. Creating a gold standard for the readability measurement of health texts. AMIA Annu Symp Proc 2008; 353–7.
  9. Mostenthal PB, Kirsch IS. A new measure for assessing document complexity: The PMOSE/IKIRSCH document readability formula. J Adolesc Adult Literacy 1998;41:638–657.
  10. Arnold CL, Davis TC, Frempong JO, et al. Assessment of newborn screening parent education materials. Pediatrics 2006;117:S320–5.
  11. Gray WS, Leary B. What makes a book readable? Chicago: University of Chicago Press; 1935.
  12. Whitbread D. The design manual. University of New South Wales Press Ltd.; 2001.
  13. Garfield S. Just my Type. London: Gotham; 2011.
  14. Reynolds LJ. Lloyd J. Reynolds Collection. Autobiographical Notes. 1977. Available from:
  15. Schwartz T. The Dance of the Pen. Reed Magazine; 2003. Available from:
  16. Ascender Corporation. Charles Biglow Available from:
  17. Carter R, Meggs PB, Day B. Typographic design: form and communication. John Wiley & Sons; 2011.
  18. Waller R. Making connections: typography, layout and language. AAAI Technical Report FS-99-04 1999. Available from:



Writing Matters
Message from the President
EMWA news
Getting what you want from your scientific writing: tips for writing clearly
What's your problem? A practical approach to scientific document design
The joys of outlining in medical writing
Pleasing the reader by pleasing the eye—Part 1 The role of format and design in readability
Writing visually for medical writers
Quality control: getting the best out of your review
Pharmaceutical medical writing competencies: Comparing self-perception with employers' expectations
In the Bookstores
Journal Watch
The Webscout
Manuscript Writing
Regulatory writing
English Grammar and Style
Out On Our Own
Gained in Translation


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Editoral Board


Raquel Billiones


Evguenia Alechine

Jonathan Pitt

Managing Editor

Victoria White

Deputy Managing Editor

Alicia Brooks Waltman

Associate Editors

Anuradha Alahari

Jennifer Bell

Nicole Bezuidenhout

Claire Chang

Barbara Grossman

Sarah Milner

John Plant

Sampoorna Rappaz

Amy Whereat

Section Editors

Daniela Kamir


Jennifer Bell


Nicole Bezuidenhout 

Digital Communication

Somsuvro Basu

EMWA News 

Ana Sofia Correia 

Gained in Translation

Ivana Turek

Getting Your Foot in the Door

Wendy Kingdom / Amy Whereat

Good Writing Practice

Alison McIntosh 

In the Bookstores

Maria Kołtowska-Häggström

Lingua Franca and Beyond

Maddy Dyer


Lisa Chamberlain-James

Medical Communications/Writing for Patients

Payal Bhatia

Medical Devices

Evguenia Alechine

My First Medical Writing

Anuradha Alahari

News from the EMA

Adriana Rocha


Tiziana von Bruchhausen


Clare ChangZuo Yen Lee 

Regulatory Matters

Sam Hamilton

Regulatory Public Disclosure

Claire Gudex

Teaching Medical Writing

Louisa Ludwig-Begall / Sarah Kabani

The Crofter: Sustainable Communications

Louisa Marcombes

Veterinary Writing

Editors Emeritus

Elise Langdon-Neuner

Phil Leventhal

Layout Designer

Chris Monk