Primer helps patients interpret medical information
In a study published in the Feb. 20 issue of the Annals of Internal Medicine,
researchers with Dartmouth Medical
School (DMS) and the Veterans Affairs Outcomes Group at the White River
Junction, Vt., Veterans
Affairs Medical Center have tested whether a primer, which the researchers
also wrote, helped people better understand information about health risks and
interventions meant to reduce those risks.
From left: H. Gilbert Welch, Lisa Schwartz, and Steven Woloshin have found that
the use of a primer is an effective, economical way to increase patient
understanding of health risks associated with medical procedures. (Photo by
Joseph Mehling '69)
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"We wrote the primer because while people are bombarded with messages
about health risks and treatment benefits, little is done to prepare them to
understand these messages," says Steven Woloshin, one of the authors on
the paper and associate professor of community and family medicine at DMS.
Woloshin and his co-authors Lisa Schwartz and H. Gilbert Welch, all of whom
are affiliated with Dartmouth's Center for the Evaluative Clinical
Sciences and the Veterans Affairs Outcomes Group, tested more than 500
people with varying levels of education. They found that the primer improved
medical interpretation skills, regardless of educational background.
"This is one of the first studies we know of to go beyond simply
exploring the fact that there are problems with how well people understand
numbers and quantitative messages," says Schwartz. "This study
considers one concrete effort to teach people how to understand risk."
The authors tested two parallel, randomized groups of people, one involving
about 200 patients, 50 percent of whom had a high school degree or less formal
education, and another group of about 300 patients who were college graduates.
In both groups, participants were given either the primer "Know Your
Chances: Understanding Health Risks," or a general health booklet
developed by the U.S. Department of Health and Human Services Agency for Health
Care Research and Quality.
After reading the materials, participants were asked to answer questions
testing their ability to interpret medical data. In the group with less
education, 44 percent of those using the primer passed the test, compared to 26
percent of those receiving the general health booklet. The corresponding
numbers in the college-educated group were 74 percent versus 56 percent. The
researchers point out that, while good data interpretation skills are needed to
make good decisions, they did not directly test the effect of the primer on
actual decision-making.
"We don't know of any other generic educational interventions like
this," says Woloshin. "It's simple, low-tech, inexpensive, and we're
happy to learn that it's also effective."
This study was supported by funds from the Robert Wood Johnson Foundation, the Department of Veterans Affairs, and the National Cancer Institute.
By SUSAN KNAPP
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