Doctors could take a lesson from the communication style of pilots and air traffic controllers, U.S. researchers say.

Richard M. Frankel of the Indiana University School of Medicine, the Regenstrief Institute and the Veterans Affairs Center of Excellence, said the medical literature review from 1975 to April 2010 found less than 1 percent of the 327,219 randomized controlled studies published included patient-centered care trials.

Frankel uses an analogy from aviation where safety is given the highest priority.

"When the air traffic controller gives an instruction to the pilot, the pilot's response must be phrased to indicate understanding of the air traffic controller's message. We don't have that in medicine," Frankel said in a statement.

"The doctor speaks to the patient and generally does not solicit a response that clearly indicates the patient understood what the doctor wished to convey."

The exchange at the hospital bedside or in the doctor's office requires communication of complex information in stressful circumstances and in both aviation and medicine, good communication is critical to safety, Frankel said.

The findings are published in the Journal of General Internal Medicine.