0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

Testing Rules of Thumb and the Science of Health Literacy

Cynthia Baur, PhD; and Nancy Ostrove, PhD
[+] Article and Author Information

From Centers for Disease Control and Prevention, Atlanta, GA 30333, and U.S. Food and Drug Administration, Silver Spring, MD 20993-0002.


Disclaimer: The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention or the U.S. Food and Drug Administration.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-1260.

Requests for Single Reprints: Cynthia Baur, PhD, Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E21, Atlanta, GA 30333; e-mail, cynthia.baur@cdc.hhs.gov.

Current Author Addresses: Dr. Baur: Centers for Disease Control and Prevention, 1600 Clifton Road, MS-E21, Atlanta, GA 30333.

Dr. Ostrove: 5 Norwich Court, Gaithersburg, MD 20878.


Ann Intern Med. 2011;155(2):129-130. doi:10.7326/0003-4819-155-2-201107190-00010
Text Size: A A A

In this issue, the study by Woloshin and Schwartz suggests that lay people understand percents better than natural frequencies when considering information about drug therapies, and Berkman and colleagues' findings address conventional wisdom about the associations between health literacy and some health-related outcomes. This editorial discusses these 2 articles in light of currently accepted ideas about health literacy. The editorialists assert that the findings reinforce a fundamental principle of health literacy: the need to pretest communication materials with the target audience.

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Personalized Medicine Will Require a Paradigm Shift
Posted on July 19, 2011
Betty C. Jung
No Affiliation
Conflict of Interest: None Declared

Drs. Baur and Ostrove raised interesting issues in their editorial regarding importance of health literacy in a complex medical environment Such issues can range from how limited health literacy or numeracy impacts the management of diabetes to improving risk perception with the use of bar graph plus a frequency format diagram when explaining breast cancer risk. Regardless, people vary in their numeracy abilities and thus require different decision making assistance.

While it is true that low health literacy has been found to result in poorer health outcomes, and some methods of communication, such as the use of percentages rather than natural frequencies, are better for explaining risk, personalized medicine will require a paradigm shift to accommodate its implications for the future of Medicine. For example, how can we improve health outcomes when regional and racial differences exist for responses to antihypertensive medications? And, how do we integrate genetic testing into the treatment of heart disease when one-third of the general population possesses the common gene variant, CYP2C19 gene, a gene that makes those who have it non-responsive to clopidogrel, a drug that prevents subsequent heart attacks, strokes and other serious cardiovascular problems in those with cardiovascular disease?

Currents methods for measuring health outcomes based on population- based estimates may no longer be valid once we realize the new parameters that personalized medicine will demand from practitioners who want to offer the best available treatment. Will genetic testing become mandatory in order to receive the best care possible, and if patients refuse testing, will they be considered noncompliant? Think of the ethical and health literacy issues involved with these scenarios. Finally, perhaps the only rule of thumb we can be sure to work is that shoring up individual patients' genetic, psychosocial-behavioral and environmental resources may be the best strategy to addressing the diseases that compromise the integrity of the human body.

Thank you for your time.

Betty C. Jung, RN MPH MCHES

(References available)

Conflict of Interest:

None declared

Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Journal Club
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)