Get real: clinical testing of patients' reading abilities

Education of cancer patients is complicated by a number of factors including timing, understanding of medical terms, and anxiety-induced inattention. The concern about patient education has led to the common practice of providing brochures about cancer, responses to cancer, treatment, and management of side effects. This material is often written at reading levels that do not match the reading ability of the patient. Research has indicated that the stated educational level is not equivalent to reading level. Realistic testing of a patient's reading ability thus becomes important in choosing the correct educational materials. This article reviews seven common available tests and discusses in detail the use of the Rapid Estimation of Adult Literacy in Medicine (REALM).