QuikLitE, a Framework for Quick Literacy Evaluation in Medicine: Development and Validation

Journal of Medical Internet Research
Jiaping Zheng, Hong Yu

Abstract

A plethora of health literacy instruments was developed over the decades. They usually start with experts curating passages of text or word lists, followed by psychometric validation and revision based on test results obtained from a sample population. This process is costly and it is difficult to customize for new usage scenarios. This study aimed to develop and evaluate a framework for dynamically creating test instruments that can provide a focused assessment of patients' health literacy. A health literacy framework and scoring method were extended from the vocabulary knowledge test to accommodate a wide range of item difficulties and various degrees of uncertainty in the participant's answer. Web-based tests from Amazon Mechanical Turk users were used to assess reliability and validity. Parallel forms of our tests showed high reliability (correlation=.78; 95% CI 0.69-0.85). Validity measured as correlation with an electronic health record comprehension instrument was higher (.47-.61 among 3 groups) than 2 existing tools (Short Assessment of Health Literacy-English, .38-.43; Short Test of Functional Health Literacy in Adults, .34-.46). Our framework is able to distinguish higher literacy levels that are often not measured by...Continue Reading

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Software Mentioned

REALM
QuikLitE
ComprehENotes
Rapid
TOFHLA

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