TY -的盟Zikmund-Fisher布莱恩J AU - Exe,尼科尔·L AU - Witteman冬青O PY - 2014 DA - 2014/08/08 TI -计算和读写能力独立预测病人的识别能力测试结果超出范围乔- J地中海互联网Res SP - e187六世- 16 - 8 KW -计算KW -识字千瓦病人教育主题KW -电子健康记录AB -背景:越来越多的患者直接访问实验室测试结果以外的临床咨询。这为慢性病的自我管理和提前准备就诊提供了更多的机会，如果患者能够识别超出参考范围的测试结果。目的:我们的目的是评估成年人是否能够识别实验室血液检查值超出参考范围，当以类似于电子健康记录(EHR)系统中实施的一些当前患者门户的格式呈现时。方法:在一项互联网管理的调查中，年龄在40-70岁之间的成年人，大约一半患有糖尿病，被要求想象他们患有2型糖尿病。向他们展示了以标准表格格式显示的实验室检测结果。我们将血红蛋白A1c值随机化为略微(7.1%)或中度(8.4%)超出参考范围，并将其他测试结果随机化为在参考范围内或之外(即多重偏差)。我们评估了(1)受访者是否认为血红蛋白A1c水平超出了参考范围，(2)受访者如何评估血糖控制，(3)他们是否会打电话给他们的医生。我们还测量了计算能力和健康素养。结果:在1817名成年参与者中，查看多重偏差的测试结果增加了识别血红蛋白A1c值超出参考范围的可能性(糖尿病参与者:OR 1.47, 95% CI 1.12-1.92, P= 0.005;无糖尿病受试者:OR 1.50, 95% CI 1.13-2.00, P= 0.005)。 Both numeracy and health literacy were significant predictors of correctly identifying out-of-range values. For participants with diabetes, numeracy OR 1.32 per unit on a 1-6 scale (95% CI 1.15-1.51, P<.001) and literacy OR 1.59 per unit of a 1-5 scale (95% CI 1.35-1.87, P<.001); for participants without diabetes, numeracy OR 1.36 per unit (95% CI 1.17-1.58, P<.001) and literacy OR 1.33 per unit (95% CI 1.12-1.58, P=.001). Predicted probabilities suggested 77% of higher numeracy and health literacy participants, but only 38% of lower numeracy and literacy participants, could correctly identify the hemoglobin A1c levels as outside the reference range. Correct identification reduced perceived blood glucose control (mean difference 1.68-1.71 points on a 0-10 scale, P<.001). For participants with diabetes, increased health literacy reduced the likelihood of calling one’s doctor when hemoglobin A1c=7.1% (OR 0.66 per unit, 95% CI 0.52-0.82, P<.001) and increased numeracy increased intention to call when hemoglobin A1c=8.4% (OR 1.36 per unit, 95% CI 1.10-1.69, P=.005). Conclusions: Limited health literacy and numeracy skills are significant barriers to basic use of laboratory test result data as currently presented in some EHR portals. Regarding contacting their doctor, less numerate and literate participants with diabetes appear insensitive to the hemoglobin A1c level shown, whereas highly numerate and literate participants with diabetes appear very sensitive. Alternate approaches appear necessary to make test results more meaningful. SN - 1438-8871 UR - //www.mybigtv.com/2014/8/e187/ UR - https://doi.org/10.2196/jmir.3241 UR - http://www.ncbi.nlm.nih.gov/pubmed/25135688 DO - 10.2196/jmir.3241 ID - info:doi/10.2196/jmir.3241 ER -