Article

Physician numeracy: Essential skills for practicing evidence-based medicine

Department of Pediatrics, UPMC St. Margaret Family Medicine Residency Program and Center for EBM Education, University of Pittsburgh, PA, USA.
Family medicine (Impact Factor: 1.17). 06/2008; 40(5):354-8.
Source: PubMed
ABSTRACT
Teaching evidence-based medicine (EBM) has become common in family medicine residency programs. EBM teaching usually takes the form of journal clubs or encouraging residents to use EBM summaries of original articles. Both have significant limitations. Residents and other physicians recognize that understanding statistics is important for interpreting results. Unfortunately, they report low self confidence in this area reflected by studies that show poor skills. Physician numeracy refers to a broad range of mathematical skills needed for practicing medicine, including the statistical knowledge necessary to interpret original research papers. Numeracy should be given much more emphasis in residency curricula and can form the foundation of EBM teaching. Objectives for a numeracy curriculum based on a recent research article and a curriculum using an EBM framework are described.

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    • "Patient decision aids that are designed to reflect the needs of patients with different levels of health literacy may not meet the needs of patients with different levels of numeracy. Academic institutions that train health professionals, health policymakers, and clinical practice managers need to: (a) support the regular assessment of health professional's numeracy skills and provide training to meet existing deficits, and (b) ensure that health professionals are trained to communicate numerical information to patients in a manner that is easily and accurately understood by patients during the treatment decision making process [7,9]. Health professionals must actively seek to maintain and improve their own numeracy as well as the numeracy of their patients. "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives: To determine what is known from the existing literature about empirical relationships between numeracy and the three stages of the treatment decision making process (information exchange, deliberation, and deciding on the treatment to implement). We also examined if, and how, numeracy was mentioned in relation to health literacy. Methods: A search of four databases returned 2772 records. After de-duplication and three levels of relevance screening, 38 primary studies were included in this review. Results: Relationships between numeracy and the information exchange stage have received greater attention than relationships between numeracy and the deliberation and deciding on the treatment to implement stages. The lack of overlap in the empirical relationships examined in studies, the measure(s) of numeracy used, and the characteristics of study populations, made findings difficult to compare. Multiple knowledge gaps and measurement-related problems were identified. Numeracy and health literacy have largely been treated as separate concepts. Conclusion: More research is needed to better understand the importance of numeracy and health literacy to treatment decision making. Practice implications: Decision aids designed for patients with different levels of health literacy may not meet the needs of patients with different levels of numeracy. The numeracy skills of health professionals require attention.
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    • "Since a large number of studies published in the medical literature have clinical applications, and since proper understanding of these studies and their potential impact on clinical practice is crucial to being a good practitioner, physicians need to develop certain capabilities and information management strategies for handling the volume of new information that they constantly receive from various sources. A number of intellectual competencies, which are necessary " to understand the quantitative aspects of clinical medicine, [and] original research " [13]—generally referred to as " physician numeracy " skills [13] —are indispensable for the practice of modern medicine. Examples of such skills include the ability to interpret standard deviation, relative risk, confidence interval and statistical significance, and p value; recognize power, sample size, and bias; and determine strength of evidence for risk factors [14]. "
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    • "Vor allem Ärztinnen und Ärzte werden gemeinhin als diejenigen gesehen, die zu wenig Zeit für einzelne Patientinnen und Patienten aufbringen, nicht zuhören oder Informationen vorenthalten – aber selten wird hier mangelndes statistisches Wissen betrachtet (z. B. Berwick, Fineberg & Weinstein, 1981; Rao, 2008 "
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