Table 3.
Diagnostic Test Characteristics of NVS, REALM-R, SILS, and Numeracy Tests (N=435)
| Instrument | Sensitivity % (95% CI) | Specificity % (95% CI) | Positive Likelihood Ratio (95% CI) | Negative Likelihood Ratio (95% CI) |
|---|---|---|---|---|
| NVS ≤ 3, n=428 | 98.0 (93.1-99.8) | 45.7 (40.3-51.3) | 1.81 (1.51-2.17) | 0.04 (0.01-0.17) |
| REALM-R ≤ 6, n=433 | 80.8 (73.2-88.3) | 61.7 (56.5-67.0) | 2.14 (1.64-2.80) | 0.30 (0.19-0.46) |
| Numeracy ≤ 1 | 80.8 (73.2-88.3) | 50.2 (44.8-55.5) | 1.61 (1.30-2.01) | 0.38 (0.24-0.60) |
| SILS ≤ 12, n=433 | 68.0 (59.0-77.07) | 75.5 (70.8-80.1) | 2.78 (1.92-4.02) | 0.42 (0.31-0.57) |
| Help Reading, n=433 | ||||
| 1 – Always | 9.7 (4.0-15.4) | 98.8 (96.9-99.7) | 7.42 (1.13-48.89) | 0.92 (0.86-0.98) |
| 2 – Often | 16.5 (9.3-23.7) | 97.0 (95.1-98.8) | 5.30 (1.59-17.64) | 0.87 (0.79-0.95) |
| 3 – Sometimes | 42.7 (33.2-52.3) | 85.5 (81.7-89.3) | 2.81 (1.65-4.78) | 0.69 (0.58-0.83) |
| 4 – Rarely | 49.5 (39.9-59.2) | 66.1 (61.0-71.2) | 1.49 (1.06-2.08) | 0.75 (0.59-0.96) |
| 5 – Never | 100 | 0.00 | 1.00 | -- |
| Dichotomized* | 42.7 (33.2-52.3) | 85.5 (81.7-89.3) | 2.81 (1.65-4.78) | 0.69 (0.58-0.81) |
| Medical Form Help | ||||
| 1 – Not at all | 14.4 (7.7-21.2) | 98.5 (97.2-99.8) | 9.93 (1.90-52.03) | 0.86 (0.79-0.94) |
| 2 – A little bit | 30.8 (21.9-39.6) | 94.6 (92.1-97.0) | 5.69 (2.38-13.59) | 0.73 (0.64-0.84) |
| 3 – Somewhat | 54.8 (45.2-64.4) | 80.4 (76.1-84.6) | 2.78 (1.80-4.29) | 0.57 (0.45-0.72) |
| 4 – Quite a bit | 74.0 (65.6-82.5) | 55.9 (50.5-61.2) | 1.69 (1.32-2.17) | 0.45 (0.31-0.66) |
| 5 – Extremely | 1.00 | 0.00 | 1.00 | -- |
| Dichotomized* | 54.8 (45.2-64.4) | 80.4 (76.1-84.6) | 2.78 (1.80-4.29) | 0.57 (0.45-0.72) |
| Ability To Read | ||||
| 1 – Very poor or terrible | 6.7 (1.9-11.6) | 100.0 (98.9-100.0) | ||
| 2 – Poor | 14.4 (7.7-21.2) | 99.1 (97.4-99.8) | 16.56 (2.01-136.46) | 0.86 (0.79-0.93) |
| 3 – Okay | 40.4 (31.0-49.8) | 95.5 (93.2-97.7) | 8.58 (3.36-21.87) | 0.64 (0.55-0.76) |
| 4 – Good | 72.1 (63.5-80.7) | 75.2 (70.6-80.0) | 2.83 (1.97-4.08) | 0.40 (0.29-0.55) |
| 5 – Excellent or very good | 1.00 | 0.00 | 1.00 | -- |
| Dichotomized* | 40.4 (31.0-49.8) | 95.5 (92.2-97.7) | 8.58 (3.36-21.87) | 0.64 (0.55-0.76) |
| Physician gestalt, n=309: inadequate or marginally adequate | 52.7 (41.3-64.1) | 70.6 (64.8-76.5) | 1.72 (1.20-2.47) | 0.70 (0.55-0.89) |
*
Dichotomization used the following groupings: help reading (always/often as adequate, other responses as inadequate), medical form help (not at all/a little bit as adequate, other responses as inadequate), ability to read (excellent/very good/good as adequate, other responses as inadequate).
REALM-R = Rapid Estimate of Adult Literacy in Medicine-Revised; NVS = Newest Vital Sign; SILS = Single Item Literacy Screens