Abstract: Universal Measures of Support Are Needed: A Cross-Sectional Study of Health Literacy in Dupuytren’s Patients
Bibliographic record
Abstract
PURPOSE: Health literacy (HL) represents the degree to which patients can understand and act upon health information.1 An association between limited HL and poor health status, and all-cause mortality only partially illustrates the profound impact of HL on surgical patients.2 Confronted with a disease that is chronic in nature, associated with frequent recurrences, and has numerous treatment options, Dupuytren’s patients’ understanding of medical information becomes crucial. Our aims were 1) to determine the prevalence of limited HL in Dupuytren’s patients and 2) to identify independent predictors of limited HL. METHODS: This cross-sectional study was performed in a tertiary care center. Patients with a clinical diagnosis of Dupuytren’s and self-reported fluency in English were included. The Newest Vital Sign (NVS), a rapid, validated, and reliable screening tool previously used in the hand surgery literature, was selected to measure HL.3,4 Limited HL was defined as a score of ≤ 3 out of 6. An exploratory multivariable logistic regression model was used to identify possible predictors. RESULTS: A total of 185 patients met eligibility criteria and from those, 44% (n=82) had limited HL. Univariate analyses showed that patients with limited HL were more likely to be older (p=0.006), have a maternal language other than English (p=0.003), and have less education (p=0.002). Multivariable regression analysis revealed that being in the lower three income quintiles had a nearly 5-fold increase in the odds of having limited HL. Having immigrated increased the odds of limited HL by a factor of 3.6. Age, maternal language, education, comorbidities and employment were not independent predictors of limited HL. CONCLUSION: Our study reveals a high prevalence of limited HL (44%) amongst Dupuytren’s patient. It is clear that universal measure of support would be of high value when communicating and caring for all Dupuytren’s patients and potentially in hand surgery and beyond. References: 1. Institute of Medicine (US) Committee on Health Literacy, Nielsen-Bohlman L, Panzer AM, et al. Health Literacy: A Prescription to End Confusion. Washington (DC): The National Academies Press; 2004. 2. Berkman ND, Sheridan SL, Donahue KE, et al. Health literacy interventions and outcomes: an updated systematic review. Evid Rep Technol Assess. 2011:1–941. 3. Weiss BD, Mays MZ, Martz W, et al. Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med. 2005;3:514–522. 4. Shah LC, West P, Bremmeyr K, Savoy-Moore RT. Health literacy instrument in family medicine: the ‘newest vital sign’ ease of use and correlates. J Am Board Fam Med. 2010;23:195–203.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".