Validation of the Rapid Estimate of Adult Literacy in Vascular Surgery (REAL_VS) in a Veteran Patient Population
Tania Gupta, Kedar Lavingia, Michael F Amendola, Kathryn Fong
VA Medical Center/VCU, Richmond, VA
INTRODUCTION:
Health care literacy has been linked to patient health and outcomes1-4. Health literacy tests (HLT) are hampered by the required time and specialty specific utility. The 75-word Rapid Estimate of Adult Literacy in Vascular Surgery (REAL_VS) and revised reduced assessment (REAL_VSs), were each developed from the more an extensive HLT (REALM;Rapid Estimate of Adult Literacy in Medicine). We aim to validate the use of the REAL_VS and REAL_VSs in a veteran population, using the as the REALM as the gold standard.
METHODS:
Vascular surgery patients were examined utilizing all three HLTs at a level 1A VA hospital. Sociodemographic information was also collected. Spearmans rank correlations (⍴) and area under the receiver operating characteristics (ROC) curves with corresponding 95% confidence intervals (CI) were calculated for a sixth grade educational threshold (6TH).
RESULTS:
178 patients (mean age = 69 ± 11.9 years) were enrolled in the study. Both REAL_VS and REAL_VSs scores were highly correlated with REALM scores (⍴=0.86 and 0.77; p<0.001, respectively). Mean REAL_VS and REAL_VSs score were also highly correlated (⍴=0.93;p<0.001). REAL_VS predicting <6TH was ROC=0.985 with CI=0.97-1.00. A REAL_VS score of 54 corresponded to the established REALM 6TH score of 44 with a sensitivity of 0.875 and a specificity of 0.96. ROC=0.91 (CI=0.84-0.99) for REAL_VSs for predicting <6TH.
CONCLUSION:
Our study demonstrates that the REAL_VS and REAL_VSs may be used to accurately assess the health literacy in Veteran patients undergoing vascular surgery consultation and may aid in assessing specialty specific health literacy.
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