To the Editor:
The Lancet’s new design includes color coding for the three sections of each issue (1). While the value of such coding leaves me lukewarm, the choice of colors must be criticized.
Why did you choose to use both red and green? Approximately 6% of ethnically western European men have a diminished capacity to distinguish red from green (2). In some Scottish villages the prevalence of color perception deficiencies is as high as 25% in males and 9% in females (3) (4).
Lists of colors having high contrast with each other, and suitable for use in color deficient persons, are available (5). Alternatively, a texture could be added to color.
Color deficiency has about the same prevalence in men as left-handedness. It would be unthinkable to introduce a feature that frustrated left-handed readers, and it should be equally unthinkable to do the same for color deficient readers.
(1) Anonymous. The Lancet 2004: design, contents, and access. Lancet. 2004;364:2.
(2) On-line Mendelian Inheritance in Man. (Accessed 18 July 2004). OMIM 303800
(3) Haughey A, Haughey AE. A study of colour vision defect in a valley population in the West of Scotland. Med Prob Ophthalmol. 1976;17:158-160. PubMed 1085862
(4) Cobb SR. On a possible explanation of the unusually high rate of colour vision defects in some West of Scotland primary schools. Med Hypoth. 1984;14:127-130. PubMed 6611477
(5) Coding design requirements. Section 18.104.22.168 in: National Aeronautics and Space Administration. Man-Systems Integration Standards. NASA-STD-3000, Revision B, July 1995.