Richard T. Griffey|Andrew T. Melson|Margaret J. Lin|Christopher R. Carpenter|Melody S. Goodman|Kimberly A. Kaphingst
Does Numeracy Correlate With Measures of Health Literacy in the Emergency Department?
Jewish Hospital|Barnes-Jewish Hospital|Washington University in St. Louis|Saint Louis University|Harvard Affiliated Emergency Medicine Residency|Beth Israel Deaconess Medical Center|Jewish Hospital|Barnes-Jewish Hospital|Washington University in St. Louis|Washington University in St. Louis
objective quantify correlation general numeracy health literacy emergency department ed settingthis prospective crosssectional convenience sample study adult patients urban academic ed 97000 annual visits general numeracy evaluated using four validated questions health literacy using three commonly used validated screening tools short test functional health literacy adults stofhla rapid estimate adult literacy medicinerevised realmr newest vital sign nvs scores dichotomized health literacy tests limited low marginal versus adequate health literacy proportion patients answering numeracy questions correctly calculated mean proportion correct responses groups correlation numeracy scores scores health literacy screening tools evaluated using spearmans correlationa total 446 patients enrolled performance questions evaluating general numeracy universally poor 18 patients 4 answered numeracy questions correctly 88 patients 20 answered zero questions correctly overall median number correct answers one interquartile range iqr 1 2 among patients limited health literacy lhl three screening tools used mean number correct numeracy answers approximately half patients adequate health literacy however even among adequate health literacy average number correct answers numeracy questions ranged 16 24 depending screening test used dichotomized answered 50 versus 50 numeracy questions correctly significant difference lhl scored 50 numeracy health literacy screening results correlated general numeracy low moderate range stofhla rs 0428 p 00001 realm rs 0400 p 00001 nvs rs 0498 p 00001correlations measures general numeracy measures health literacy low moderate range performance numeracy testing nearly universally poor even among patients performing well health literacy screens substantial proportion latter patients unable answer half numeracy items correctly insofar numeracy considered subset health literacy results suggest commonly used health literacy screening tools edbased studies inadequately evaluate overestimate numeracy suggests potential need separate numeracy screening skills important health outcomes interest providers sensitive potential numeracy deficits among may otherwise normal health literacy