Brett C. Neill|Nicholas Golda|Edward W. Seger|Jo Wick|Jacob Whitsitt|Alison Huber|Thomas Chu|Geoffrey F. Potts|Peter Chow|Sarah K. Moore|Joseph W. Fakhoury|Anand Rajpara|Thomas L. Hocker
Determining patient understanding of commonly used dermatology terms: A multicenter cross-sectional survey
University of Kansas Medical Center|University of Missouri|University of Kansas Medical Center|University of Kansas Medical Center|University of Kansas Medical Center|University of Missouri|Wayne State University|Wayne State University|University of Kansas|University of Kansas|Wayne State University|University of Kansas Medical Center|University of Kansas Medical Center
editor disparities health literacy associated poorer use health care services worse health outcomes1berkman nd sheridan sl donahue ke et allow health literacy health outcomes updated systematic reviewann intern med 2011 155 97107crossref pubmed scopus 2104 google scholar part due providers incorrectly assessing patient comprehension technical jargon2kelly pa haidet p physician overestimation patient literacy potential source health care disparitiespatient educ couns 2007 66 119122crossref pubmed scopus 200 google scholar treatment outcomes influenced whether patients understand diagnosis treatment instructions would helpful providers informed patients understanding basic dermatology terms sought compare patients confidence frequently used dermatology terms versus accuracy understanding institutional review boardapproved singleblinded multicenter survey conducted patients 18 years older recruited academic dermatology clinics participants completed inperson survey 11 dermatology terms frequently used patient care term presented along sentence using term context see supplementary material available via mendeley httpsdoiorg1017632sx6kn3dx8p1 httpsdoiorg1017632tfs9bm98pm1 participants rated level confidence understanding term using 5point likerttype scale perceived understanding defined term using words two blinded physicians graded definitions using 5point scale accuracy understanding student tests chisquare tests pearson coefficients used identify associations perception accuracy understanding p 05 considered statistically significant median fisher exact tests substituted parametric assumptions could verified total 313 respondents completed survey 85 response rate table average term perceived understanding 37 12 5 average term accuracy 38 14 5 reviewer concordance 932 women confident 40 12 vs 35 12 higher accuracy men p 01 table definition accuracy positively associated education level p 001 previous experience medical field p 0001 age associated perception r 03 p 65 accuracy r 007 p 23 patients reported confident confident term 201 instances 756 patients reported confident confident term least 1 time survey comparison accuracy 1 2 5 reported 242 cases table itable ioverall term understanding confidencepatient recruitment university kansas n 113 university missouri n 43 wayne state university n 157 age 1834 n 28 3554 n 68 55 years n 203 education defined highest level completed demographic comparisons excluded low sample size education level less high school diploma n 3 hispanic ethnicity n 5 ethnicity n 4 overall confidence understanding location effect 2 1024 p 0001 overall physiciangraded accuracy location effect 2 152 p 001participant characteristicsnoverall score mean sdnot confident selfexamination overall percentage terms patient reported value 1 2 5low accuracy physician grading overall percentage instances physician graded term value 1 2 5overestimation selfpatientreported scores confidence physicianreported scores accuracy reported average sd based 15 scales see supplementary materialphysicianpatientreported scores confidence physicianreported scores accuracy reported average sd based 15 scales see supplementary materialoverallthe percentage instances patient reported confidence higher physiciangraded accuracywhen confidentthe percentage instances patient reported term confidence 4 5 5 received physiciangraded accuracy less hisher reported scoreoverall31337 1238 14201242205217sex male21735 1237 14231261202222 female9640 1240 14135199211207education high school16132 1135 14311323179193 college10241 1041 1499174226226 graduate school4744 0942 1268128244238race white15442 1140 13103180249258 black15031 1036 13295303158127experience working medical field yes4645 0942 1361158257255 no26735 1238 14227257196206sd standard deviation patient recruitment university kansas n 113 university missouri n 43 wayne state university n 157 age 1834 n 28 3554 n 68 55 years n 203 education defined highest level completed demographic comparisons excluded low sample size education level less high school diploma n 3 hispanic ethnicity n 5 ethnicity n 4 overall confidence understanding location effect 2 1024 p 0001 overall physiciangraded accuracy location effect 2 152 p 001 patientreported scores confidence physicianreported scores accuracy reported average sd based 15 scales see supplementary material overall percentage terms patient reported value 1 2 5 overall percentage instances physician graded term value 1 2 5 percentage instances patient reported confidence higher physiciangraded accuracy percentage instances patient reported term confidence 4 5 5 received physiciangraded accuracy less hisher reported score open table new tab sd standard deviation patients higher perceived understanding graded accuracy overestimation 205 cases table overestimation increased higher education levels 244 graduate degrees vs 179 high school diplomas previous medical experience 257 vs 196 without previous experience table patients confident understanding reporting values 4 5 overestimated even higher rates 217 overall instances table white patients overestimated frequently black patients 249 vs 159 overall table patients least confident accurate terms pathology metastasis table iitable iitermspecific understanding confidencethe confidence accuracy individual terms defined patients physicians values reported follow explanations defined table itermsoverall score mean sdnot confident selfexamination low accuracy physician grading overestimation selfphysicianoverallwhen confidentgeneral terms biopsy41 0944 096151150197 excision31 1437 16326246112163 lesion37 1033 138028844458 outpatient47 0647 0910649690 pathology30 1528 15428457306512 topical37 1343 141851507070cancerrelated terms benign38 1339 17208256272141 malignant38 11427 13105134147180 melanoma36 1238 1519234221463 metastasis30 1533 17406345157223 precancer35 1235 15227339288384sd standard deviation confidence accuracy individual terms defined patients physicians values reported follow explanations defined table open table new tab sd standard deviation conclusion patients frequently understand common dermatology terms moreover overestimation increased education confidence suggesting patients medical knowledge may particularly risk less likely seek clarification understanding jargon providers cognizant barriers whenever possible take time elaborate reaffirm understanding terminology used thank zoe smith jeremy grekin wayne state university school medicine assistance missing mark patient comprehensionjournal american academy dermatologyvol 84issue 2previewto editor read great interest discussion neill et al1 patient comprehension commonly used terms dermatology fulltext pdf