Many patients misunderstand IPSS, other screening tests

October 23, 2008

A profound gap exists in the understanding of physicians about the literacy levels of their patients related to the efficacy of written screening tools, including the International Prostate Symptom Score, researchers from Emory University School of Medicine, Atlanta, reported.

A profound gap exists in the understanding of physicians about the literacy levels of their patients related to the efficacy of written screening tools, including the International Prostate Symptom Score, researchers from Emory University School of Medicine, Atlanta, reported.

In one study, lead author Viraj A. Master, MD, PhD, pointed out that a cohort of 300 male patients (mean age, 61 years) at Emory, an inner-city hospital, had an average reading level of fourth grade.

“In the seven questions that we asked from the International Prostate Symptom Score, for example, only 16% of patients understood all seven questions, Dr. Master reported at the American College of Surgeons Clinical Congress in San Francisco. “Possibly the most worrisome thing was the number of patients who thought they understood this test-the most commonly used instrument in urology worldwide-but did not.”

In a second study led by Dr. Master, 266 patients with an average age of 58 years completed a validated, three-question Woloshin-Schwartz numeracy quiz. Results showed that only 16% of respondents answered all three questions correctly and 15% answered two correctly.

“Even after controlling for age, race, homelessness, English as a second language, income, and a host of other variables, numeracy was shown to be an independent predictor of misunderstanding,” Dr. Master said. “Being innumerate, in addition to being illiterate, results in high levels of misunderstanding that severely limit access to appropriate health care for millions of patients.”

Look for additional coverage of the American College of Surgeons Clinical Congress in an upcoming issue of Urology Times.