On average only 6.8% of the participants found it difficult to understand the meaning of EL used in the English data. The findings show that participants’ attitudes towards the use of EL in online medical information differ in the six excerpts: while three excerpts with EL were preferred by most, the other three with non-EL were also favoured. On average, a neutral attitude emerged: close to a half of participants preferred EL and the other half non-EL. Twelve frames generated from the data explain why the participants made their choices as regards EL, non-EL, both or neither. The frames are categorised into three groups: language-focused, language-user-focused and diseased-focused. The first grouping consists of six frames: fluidity, informativeness, relevance, accuracy, clarity, and discourse management. They all adhere closely to cooperative principles and relevance theory framework . The second grouping consists of five frames: trustfulness, folk–individual, lay–professional, voluntary–involuntary and indifference. The third grouping is disease focused: choices were made closely linked to the nature of six diseases. This grouping is specific to medical communication.