Measuring adult literacy in health care: performance of the newest vital sign

Am J Health Behav. 2007 Sep-Oct:31 Suppl 1:S36-46. doi: 10.5555/ajhb.2007.31.supp.S36.


Objective: To compare performance of the newest vital sign (NVS) with existing literacy measures.

Methods: We administered the NVS and REALM to 129 patients, and NVS and S-TOFHLA to 119 patients all in public clinics.

Results: The NVS demonstrated high sensitivity for detecting limited literacy and moderate specificity (area under the receiver operating characteristic [AUROC] curve 0.71-0.73). The NVS was less effective than the S-TOFHLA for predicting health outcomes.

Conclusion: The NVS is able to identify patients with limited literacy skills, but may misclassify those with adequate literacy according to the REALM and S-TOFHLA. NVS scores were not associated with health outcomes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Educational Status*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Services*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Surveys and Questionnaires*