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Appl Ergon. 2016 Jan;52:77-84. doi: 10.1016/j.apergo.2015.06.009. Epub 2015 Jul 20.

Tallman lettering as a strategy for differentiation in look-alike, sound-alike drug names: the role of familiarity in differentiating drug doppelgangers.

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School of Packaging, Michigan State University, East Lansing, MI 48824, USA.
Cognition and Cognitive Neuroscience Group, Psychology, Michigan State University, East Lansing, MI 48824, USA.
Department of Statistics, Kansas State University, Manhattan, KS 66506, USA.
School of Packaging, Michigan State University, East Lansing, MI 48824, USA. Electronic address:


Tallman lettering, capitalizing the dissimilar portions of easily confused drug names, is one strategy for reducing medication errors. We assessed the efficacy of Tallman lettering in a visually complex environment using a change detection method with healthcare providers and laypeople. In addition, the effect of familiarity with the drug name was assessed using a subset of responses collected from healthcare providers. Both healthcare providers and laypeople detected changes in confusable pairs of drug names more often (P < 0.0001) and more quickly (P < 0.05) when changes were presented in Tallman lettering, though the benefits were more pronounced for healthcare providers (p < 0.05). Familiarity with both drug names in a confusable pair mitigated the benefit of Tallman lettering. Results are discussed in terms of bottom-up and top-down attentional systems for processing of information in the context of the varied healthcare environments.


Drug labeling; Look-alike sound-alike drug names; Medication error; Name differentiation; Tallman lettering; Text differentiation

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