Effects of text enhancement on visual differentiation performance of Chinese look-alike drug names: an event-related potential study

Confusion between look-alike drug names is one of the major causes of medication errors. Text enhancement (i.e., changing font attributes of differing letters in look-alike drug names) has been proposed and widely applied as a crucial strategy to mitigate this issue. While prior research has extensively examined the effectiveness of text enhancement for distinguishing similar drug names in English, studies focusing on Chinese drug names remain limited. This study aimed to examine the effects of text enhancement (boldface, red, contrast, larger font-size, and no enhancement) on visual differentiation performance of Chinese look-alike drug names based on a single-factor, within-group experimental design. Participants (n = 30) were instructed to perform a series of visual differentiation tasks based on a masked-priming paradigm. Dependent measures included response time, accuracy, perceived confidence in differentiation, and event-related potential (ERP) component measures. The results indicated that all four text enhancement methods yielded a higher accuracy rate and a higher level of perceived confidence in differentiation, compared with no enhancement. Larger font size also achieved a significantly shorter response time than no enhancement, and it evoked a higher amplitude of P3 in the parietal and central-parietal areas compared with contrast. Our study is the first to quantitatively examine the effects of text enhancement on Chinese drug name differentiation using the ERP technique. The findings provide empirical evidence to guide the selection of an optimal text enhancement method to reduce confusion between Chinese look-alike drug names to improve patient safety. • Text enhancement can be used to facilitate visual differentiation of Chinese look-alike drug names. • Boldface, red, contrast, and larger font-size significantly improved differentiation accuracy. • A larger font size achieved a significantly shorter response time than the control. • Larger font size evoked a higher amplitude of P3 than contrast. • ERP technique can be used to elucidate viewers' cognitive processes under different text enhancement conditions.