Table 1.

Characteristics of the Health Literacy (HL) Tests: The “Test of Functional Health Literacy in Adults” (TOFHLA), the “Newest Vital Sign” (NVS), and the “Rapid Estimate of Adult Literacy in Medicine” (REALM)

Test	Year	Measure	Skills assessed	Scoring	Short form	Adaptations
TOFHLA	1995	Common medical materials (e.g., prescription labels) followed by comprehension questions using the Cloze procedure—a technique that omits every 5–7 words in a sentence 22min to administer	Reading comprehension (50 items) Numeracy (17 items)	0–59: inadequate HL 60–74: marginal HL 75–100: adequate HL <75: limited HL	S-TOFHLA	UK-TOFHLA translations: Korean Serbian French Italian German Portuguese
NVS	2005	A 6-item test based on the ability to read and apply information from an ice cream nutrition label 3min to administer	Reading comprehension Numeracy	<2: greater than a 50% chance of having marginal or inadequate HL 2–4: possibility of limited HL >4: adequate HL		Translation: Turkish
REALM	1991	66 medical words ranging from “fat,” “flu”, and “pill” to “obesity,” “osteoporosis,” and “impetigo,” which the participant is instructed to read out loud 2–3min to administer	Word recognition Pronunciation	Reading level according to score: 0–18: ≤3rd grade 19–44: 4–6th grade 45–60: 7–8th grade 61–66: ≥9th grade <61: limited HL	REALM-SF REALM-R	Translation: Turkish