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ComprehENotes, an Instrument to Assess Patient Reading Comprehension of Electronic Health Record Notes: Development

John P Lalor1, Hao Wu2, Li Chen2

  • 1College of Information and Computer Sciences, University of Massachusetts, Amherst, MA, United States.

Journal of Medical Internet Research
|April 27, 2018
PubMed
Summary

Researchers developed ComprehENotes, a new tool to measure how well patients understand their electronic health records (EHR) clinical notes. This innovation addresses a gap in health literacy assessment for EHR note comprehension.

Keywords:
crowdsourcingelectronic health recordshealth literacypsychometrics

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Area of Science:

  • Health Informatics
  • Patient Education
  • Psychometrics

Background:

  • Patient portals provide access to electronic health records (EHRs), including clinical notes.
  • Patient comprehension of EHR notes is influenced by health literacy.
  • Existing health literacy tests do not specifically assess EHR note understanding.

Purpose of the Study:

  • To develop an instrument for assessing patient comprehension of EHR clinical notes.

Main Methods:

  • Generated questions from EHR notes of common diseases using Sentence Verification Technique.
  • Utilized item response theory (IRT) for question analysis and selection.
  • Employed Amazon Mechanical Turk for crowdsourced data collection and validation.

Main Results:

  • Developed a 55-item test (ComprehENotes) to measure EHR note comprehension.
  • Confirmed the test assesses a latent ability dimension for EHR note comprehension.
  • Created a shorter 14-item version of the assessment.

Conclusions:

  • ComprehENotes is the first instrument specifically designed to assess EHR note comprehension.
  • Crowdsourcing and IRT are effective methods for developing and validating such assessments.
  • This tool can help identify patients needing support for understanding their health information.