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. 2023 Aug 25;5(6):793-798.
doi: 10.1016/j.jhsg.2023.07.009. eCollection 2023 Nov.

Statistical Literacy in Hand and Upper-Extremity Patients

Shahid Manzar  1 , Jad El Koussaify  1 , Victoria C Garcia  1 , Yagiz Ozdag  1 , Anil Akoon  1 , C Liam Dwyer  1 , Joel C Klena  1 , Louis C Grandizio  1
Affiliations

Statistical Literacy in Hand and Upper-Extremity Patients

Shahid Manzar et al. J Hand Surg Glob Online. .

Abstract

Purpose: Statistical literacy is the ability of a patient to apply basic statistical concepts to their health care. Understanding statistics is a critical component of shared decision making. The purpose of this investigation was to define levels of statistical literacy in an upper-extremity (UE) patient population. We aimed to determine if patient demographics would be associated with statistical literacy.

Methods: An electronic survey was administered to a consecutive series of UE patients at a single institution. We recorded baseline demographics, Single Assessment Numeric Evaluation scores, the Berlin Numeracy Test (BNT), and General Health Numeracy Test. We also included a surgical risk question, which asked: "Approximately 3% of patients who get carpal tunnel surgery develop an infection. If 100 patients get this surgery, how many would you expect to develop an infection?" A covariate-controlled adjusted odds ratio reflecting the association between each statistical literacy outcome measure and patient characteristics was reported.

Results: A total 254 surveys were administered, 148 of which were completed and included. Fifty percent of respondents had a high-school education or less. For the BNT, 78% scored in the bottom quartile, and 52% incorrectly answered all questions. For the General Health Numeracy Test, 34% answered 0 or 1/6 questions correctly. For the surgical risk question, 24% of respondents answered incorrectly. Respondents who had a college or graduate degree had 2.62 times greater odds (95% confidence interval, 1.09-6.32) of achieving a BNT score in a higher quartile than patients who did not have a college or graduate degree.

Conclusions: Overall levels of statistical literacy are low for UE patients.

Clinical relevance: When engaging in management discussions and shared decision making, UE surgeons should assume low levels of statistical literacy. Consideration of alternative formats, such as frequencies, video-based materials, and pictographs, may be warranted when discussing outcomes and risks of surgical procedures.

Keywords: Berlin Numeracy Test; General Health Numeracy Test; Hand surgery; Health literacy; Statistical literacy.

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Figures

Figure 1
Figure 1
The BNT.
Figure 2
Figure 2
The GHNT-6.
See this image and copyright information in PMC

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