Measuring numeracy and health literacy in the emergency department.
Measuring numeracy and health literacy in the emergency department.
复制标题
测量急诊科的算术能力和健康素养。
DOI：
10.1111/acem.12426
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Wallston,Ken
中科院分区：
文献类型：
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作者：
McNaughton,Candace;Rothman,Russell;Storrow,Alan;Wallston,Ken
我们在研究的设计和执行中遵循了 STARD 指南，尽管没有明确声明。急诊就诊后计算健康素养和算术水平。少数族裔患者的比例反映了我们当地地理区域的种族分布。教育水平和识字水平因人口和地理位置而异。因此，随着阳性和阴性预测值的波动，识别有限健康素养的最佳阈值可能会根据研究目标和低健康素养的患病率而变化。在 Chew 最初的验证研究中，有 4.5% 的人健康素养不足，7.5% 的人健康素养处于边际。 4我们使用S-TOFHLA>22（足够的健康素养）作为比较（合金）标准。 Carpenter 的工作重点是识别有限健康素养（健康素养不足或边缘，即 S-TOFHLA<22）的测试特征。为了说明参考标准的定义对测试特征解释的影响，在我们的研究中，S-TOFHLA < 23（即健康素养不足和边际）的受试者操作特征 (AUROC) 的曲线下面积为 0.26，而 S-TOFHLA > 22（即足够的健康素养）的 AUROC 为 0.74。（这些分析的详细表格，包括敏感性和特异性的测量，可在线或通过电子邮件获取坎迪斯·麦克诺顿@范德比尔特大学）。同样，当我们将主观计算能力的测量值与 WRAT4 测量的低于平均计算能力的测量值进行比较时，AUROC 为 0.23；识别足够计算能力的 AUROC 为 0.77。
We followed STARD guidelines in our study's design and execution, although this was not declared explicitly. Health literacy and numeracy levels were computed after the ED visit. The proportion of minority patients reflects the racial distribution of our local geographic area. Education level and literacy levels vary by population and geography. Thus, optimal thresholds for identifying limited health literacy may vary according to study goals and prevalence of low health literacy, as positive and negative predictive values fluctuate. There was 4.5% inadequate and 7.5% marginal health literacy in Chew's original validation study. 4We used S-TOFHLA> 22 (adequate health literacy) as the comparison (alloy) standard. Carpenter's work focused on the test characteristics for identifying limited health literacy (inadequate or marginal health literacy, ie, S-TOFHLA< 22). To illustrate the impact definition of the reference standard has on interpretation of test characteristics, the area under the curve for the receiver operating characteristics (AUROC) for S-TOFHLA< 23 (ie, inadequate and marginal health literacy) was 0.26 in our study, versus AUROC of 0.74 for S-TOFHLA> 22 (ie, adequate health literacy).(Detailed tables of these analyses including measures of sensitivity and specificity are available online or by emailing candace. mcnaughton@ vanderbilt. edu). Similarly, when we compared our measure of subjective numeracy against less than average numeracy measured by the WRAT4, the AUROC was 0.23; the AUROC was 0.77 for identifying adequate numeracy.