John P. Lalor|Hao Wu|Li Chen|Kathleen M. Mazor|Hong Yu
ComprehENotes, an Instrument to Assess Patient Reading Comprehension of Electronic Health Record Notes: Development and Validation
University of Massachusetts Amherst|Boston College|Boston College|Reliant Medical Group|University of Massachusetts Chan Medical School|University of Massachusetts Amherst|University of Massachusetts Lowell|University of Massachusetts Chan Medical School|Bedford VA Research Corporation|Edith Nourse Rogers Memorial Veterans Hospital
patient portals widely adopted united states allow millions patients access electronic health records ehrs including ehr clinical notes patients ability understand information ehr dependent overall health literacy although many tests health literacy exist none specifically focuses ehr note comprehensionthe aim paper develop instrument assess patients ehr note comprehensionwe identified 6 common diseases conditions heart failure diabetes cancer hypertension chronic obstructive pulmonary disease liver failure selected 5 representative ehr notes disease condition one note contain natural language text removed questions generated notes using sentence verification technique analyzed using item response theory irt identify set questions represent good test ability ehr note comprehensionusing sentence verification technique 154 questions generated 29 ehr notes initially obtained 83 manually selected inclusion amazon mechanical turk crowdsourcing tasks 55 ultimately retained following irt analysis followup validation second amazon mechanical turk task irt analysis confirmed 55 questions test latent ability dimension ehr note comprehension short test 14 items created along 55item testwe developed comprehenotes instrument assessing ehr note comprehension existing ehr notes gathered responses using crowdsourcing used irt analyze responses thus resulting set questions measure ehr note comprehension crowdsourced responses amazon mechanical turk used estimate item parameters select subset items inclusion test set using irt final set questions first test ehr note comprehension