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Can we count on written symptom scores: Impact of numeracy on patient access to appropriate healthcare
S112
Surgical Forum Abstracts
RESULTS: A pure NOTES partial cystectomy was performed using an endoscope, two endoscopic loop devices and electrocautery. The full-thickness intact specimen was removed transorally. CONCLUSIONS: We describe the first NOTES transgastric partial cystectomy. Our technique seals both specimen and bladder lumens preventing abdominal tumor spillage and efficiently closes the bladder incision simultaneously. Concurrent transurethral visualization would ensure proper margins. Potential advantages over our transurethral NOTES partial cystectomy approach may include better visualization of adjacent structures, access to bladder sites difficult to reach transurethrally and lymph node sampling. However, there may be increased morbidity with a gastrotomy. Further investigation in survival models will be required to determine if this technique could be safely adapted to humans.
J Am Coll Surg
the IPSS. However, because the IPSS consists of both written and numeric information, we hypothesized that numeracy may be an independent predictive factor of patient misunderstanding of the IPSS. METHODS: This prospective cohort study enrolled male patients older than 40 years who completed a validated, 3-question numeracy test once and the IPSS twice, self- and then intervieweradministered. These two responses were compared by calculating correlation coefficients and weighted statistics to assess patient understanding of the IPSS. Multivariate logistic regression analyses examined the association between patient characteristics and poor understanding of the symptom index, defined as understanding fewer than 4 questions, by calculating the OR and corresponding 95% CI.
Timothy V Johnson BS, Viraj A Master MD, PhD, Ammara Abbasi, Samantha S Ehrlich, Renee S Kleris, Evan D Schoenberg, Ashli Owen-Smith, Michael Goodman MD, MPH Emory University School of Medicine, Atlanta, GA
RESULTS: 266 patients completed the study, with an average age of 58 years and a mean education level of 13.5 years. Innumerate patients (score⫽0) were twice as likely to misclassify their symptom severity (28.6%) compared to numerate patients (score⫽3) (15.6%). On multivariate analysis, after adjusting for education, literacy level, and demographics, innumerate respondents were 4.39 times as likely to misunderstand the IPSS compared to numerate patients (p⫽.045).
INTRODUCTION: Health literacy consists of document, prose, and quantitative literacy, also known as numeracy. Using the International Prostate Symptom Score (IPSS) as a model, we previously reported that low document and prose literacy is an independent predictor of misunderstanding and symptom misrepresentation of
CONCLUSIONS: Innumeracy is endemic in our patient population. Regardless of education or literacy level, a significant number of patients misunderstood the IPSS, resulting in misclassification of their symptoms, which may limit their access to appropriate healthcare.
Can we count on written symptom scores: Impact of numeracy on patient access to appropriate healthcare
Surgical Forum Abstracts
RESULTS: A pure NOTES partial cystectomy was performed using an endoscope, two endoscopic loop devices and electrocautery. The full-thickness intact specimen was removed transorally. CONCLUSIONS: We describe the first NOTES transgastric partial cystectomy. Our technique seals both specimen and bladder lumens preventing abdominal tumor spillage and efficiently closes the bladder incision simultaneously. Concurrent transurethral visualization would ensure proper margins. Potential advantages over our transurethral NOTES partial cystectomy approach may include better visualization of adjacent structures, access to bladder sites difficult to reach transurethrally and lymph node sampling. However, there may be increased morbidity with a gastrotomy. Further investigation in survival models will be required to determine if this technique could be safely adapted to humans.
J Am Coll Surg
the IPSS. However, because the IPSS consists of both written and numeric information, we hypothesized that numeracy may be an independent predictive factor of patient misunderstanding of the IPSS. METHODS: This prospective cohort study enrolled male patients older than 40 years who completed a validated, 3-question numeracy test once and the IPSS twice, self- and then intervieweradministered. These two responses were compared by calculating correlation coefficients and weighted statistics to assess patient understanding of the IPSS. Multivariate logistic regression analyses examined the association between patient characteristics and poor understanding of the symptom index, defined as understanding fewer than 4 questions, by calculating the OR and corresponding 95% CI.
Timothy V Johnson BS, Viraj A Master MD, PhD, Ammara Abbasi, Samantha S Ehrlich, Renee S Kleris, Evan D Schoenberg, Ashli Owen-Smith, Michael Goodman MD, MPH Emory University School of Medicine, Atlanta, GA
RESULTS: 266 patients completed the study, with an average age of 58 years and a mean education level of 13.5 years. Innumerate patients (score⫽0) were twice as likely to misclassify their symptom severity (28.6%) compared to numerate patients (score⫽3) (15.6%). On multivariate analysis, after adjusting for education, literacy level, and demographics, innumerate respondents were 4.39 times as likely to misunderstand the IPSS compared to numerate patients (p⫽.045).
INTRODUCTION: Health literacy consists of document, prose, and quantitative literacy, also known as numeracy. Using the International Prostate Symptom Score (IPSS) as a model, we previously reported that low document and prose literacy is an independent predictor of misunderstanding and symptom misrepresentation of
CONCLUSIONS: Innumeracy is endemic in our patient population. Regardless of education or literacy level, a significant number of patients misunderstood the IPSS, resulting in misclassification of their symptoms, which may limit their access to appropriate healthcare.
Can we count on written symptom scores: Impact of numeracy on patient access to appropriate healthcare