You Say NOAC, I Say DOAC: Medicine’s Love of Confusing Jargon
You Say NOAC, I Say DOAC: Medicine’s Love of Confusing Jargon
Source: Medscape Commentary– August 20, 2025
Key Themes in Medical Nomenclature
1. Names Shape Perception
• Medical terminology lacks consistency.
• Example: “Heart attack” vs. “myocardial infarction” vs. “acute coronary syndrome.”
• Same condition, different names → confusing for patients and trainees.
2. TAVI vs. TAVR
• Europe/Asia: TAVI (implantation).
• U.S.: TAVR (replacement).
• “Implantation” is technically more accurate, since the valve is pushed aside, not removed.
3. ‘Brain Attack’ vs. Stroke
• “Brain attack” never caught on as a term for stroke.
• CVA (cerebrovascular accident) is misleading; stroke is not an “accident.”
• Endpoints often use MACE, or MACCE to include cerebrovascular events.
4. Renal Terminology Changes
• “Renal failure” → renamed to “renal insufficiency.”
• Suggestion: apply similar shift from “heart failure” → “heart insufficiency.”
• This may better reflect HFpEF patients whose hearts haven’t fully “failed.”
The NOAC vs. DOAC Debate
5. Terminology Confusion
• NOAC (novel oral anticoagulant) → rebranded as DOAC (direct oral anticoagulant).
• CHEST still uses NOAC; ISTH favors drug-specific names.
• No universal agreement.
6. Rejected Alternatives
• TSOAC, ODI, SODA → add confusion, not clarity.
• Some argue “N” in NOAC meant “non-vitamin K,” but that’s revisionist.
Other Renaming Trends
7. Liver Disease
• NAFLD renamed to MASLD (metabolic dysfunction–associated steatotic liver disease).
• More accurate cause-based naming, though “fatty liver” still used.
Language, Culture & Medicine
8. Inconsistency is Normal
• Language evolves chaotically, often shaped by history.
• Example: after the Norman conquest of England (1066):
• Animals alive → cow, pig, sheep (Anglo-Saxon).
• As food → beef, pork, mutton (French).
• Shows that inconsistency is a natural part of language — and medical terms (e.g., NOAC vs. DOAC, TAVI vs. TAVR) are no exception.
Takeaway
• Medicine struggles with inconsistent jargon, just like language in general.
• Some renaming efforts succeed (MASLD), others fail (“brain attack,” PASC).
• Patients care more about outcomes than what we call their disease — clarity matters more than perfect consistency.
