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Related Experiment Videos

Assessing values for health: numeracy matters.

S Woloshin1, L M Schwartz, M Moncur

  • 1VA Outcomes Group, White River Junction, Vermont 05009, USA.

Medical Decision Making : an International Journal of the Society for Medical Decision Making
|September 29, 2001
PubMed
Summary
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Low numeracy can hinder accurate patient health value assessments. Standard gamble and time trade-off methods are less valid for individuals with limited quantitative skills.

Area of Science:

  • Health economics
  • Decision analysis
  • Patient-reported outcomes

Background:

  • Patient values are crucial for health economic and decision-making models.
  • Standard methods for assessing health state utility rely on quantitative skills.
  • Low numeracy can impede meaningful participation in utility assessments.

Purpose of the Study:

  • To investigate the impact of numeracy on the validity of health utility assessments.
  • To compare the performance of different utility measurement techniques across numeracy levels.

Main Methods:

  • In-person interviews and surveys with 96 women volunteers (ages 50-79).
  • Numeracy assessed using a validated 3-item scale.
  • Utility for current and imagined health states measured via standard gamble, time trade-off, and visual analog scale techniques.

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Main Results:

  • Utility assessment validity varied by numeracy level and method used.
  • Standard gamble and time trade-off showed poor correlation with self-reported health in low-numeracy individuals.
  • Visual analog scale demonstrated substantial correlation across all numeracy levels.
  • Lower numeracy individuals were less likely to associate feared diseases with lower utility.

Conclusions:

  • The validity of utility assessments, particularly standard gamble and time trade-off, is influenced by a patient's numeracy.
  • Limited numeracy presents a significant barrier to accurately capturing patient values in health economic evaluations.
  • The visual analog scale may be a more robust method for assessing health utility across diverse numeracy levels.