Numeracy and communication with patients: they are counting on us

Abstract

Patient-centered interactive communication between physicians and patients is recommended to improve the quality of medical care. Numerical concepts are important components of such exchanges and include arithmetic and use of percentages, as well as higher level tasks like estimation, probability, problem-solving, and risk assessment--the basis of preventive medicine. Difficulty with numerical concepts may impede communication. The current evidence on prevalence, measurement, and outcomes related to numeracy is presented, along with a summary of best practices for communication of numerical information. This information is integrated into a hierarchical model of mathematical concepts and skills, which can guide clinicians toward numerical communication that is easier to use with patients.

Figure 1

Examples of use of figures to convey the lifetime risk of breast cancer for a 50-year-old woman. (a) Risk is displayed as a frequency with a clear numerator and denominator. (b) This bar graph has no definite denominator; risk is displayed as a proportion rather than a frequency. (c) Multiple bar graphs depicting other comorbidities illustrates that bar graphs are an excellent format for making comparisons. (d) The random highlighting of the matrix makes it difficult to appreciate the numerator, but displays the idea of chance well. From Schapira MM, Nattinger AB, McAuliffe TL, The Influence of Graphic Format on Breast Cancer Risk Communication, Journal of Health Communication 2006;11:569–582, reprinted by permission of the publisher (Taylor & Francis, http://www.informaworld.com).