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Medical Decision Making
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Can Patients Interpret Health Information? An Assessment of the Medical Data Interpretation Test

Lisa M. Schwartz, MD, MS

VA Outcomes Group, White River Junction, VT, and the Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, NH, Lisa.Schwartz{at}Dartmouth.edu

Steven Woloshin, MD, MS

VA Outcomes Group, White River Junction, VT, and the Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, NH

H. Gilbert Welch, MD, MPH

VA Outcomes Group, White River Junction, VT, and the Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, NH

Objective. To establish the reliability/validity of an 18-item test of patients’ medical data interpretation skills. Design. Survey with retest after 2 weeks. Subjects. 178 people recruited from advertisements in local newspapers, an outpatient clinic, and a hospital open house. Results. The percentage of correct answers to individual items ranged from 20% to 87%, and medical data interpretation test scores (on a 0- 100 scale) were normally distributed (median 61.1, mean 61.0, range 6-94). Reliability was good (test-retest correlation = 0.67, Cronbach’s alpha = 0.71). Construct validity was supported in several ways. Higher scores were found among people with highest versus lowest numeracy (71 v. 36, P < 0.001), highest quantitative literacy (65 v. 28, P < 0.001), and highest education (69 v. 42, P = 0.004). Scores for 15 physician experts also completing the survey were significantly higher than participants with other postgraduate degrees (mean score 89 v. 69, P < 0.001). Conclusion. The medical data interpretation test is a reliable and valid measure of the ability to interpret medical statistics.

Key Words: numeracy • decision making • patient education

Medical Decision Making, Vol. 25, No. 3, 290-300 (2005)
DOI: 10.1177/0272989X05276860
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