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JournalISSN: 0884-8734

Journal of General Internal Medicine

About: Journal of General Internal Medicine is an academic journal. The journal publishes majorly in the area(s): Health care & Population. It has an ISSN identifier of 0884-8734. Over the lifetime, 10130 publication(s) have been published receiving 397876 citation(s). more

Topics: Health care, Population, MEDLINE more

Open accessJournal ArticleDOI: 10.1046/J.1525-1497.2001.016009606.X
Abstract: OBJECTIVE: While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. more

Topics: Criterion validity (58%), Construct validity (58%), Test validity (57%) more

19,000 Citations

Open accessJournal ArticleDOI: 10.1007/S11606-012-2077-6
Glyn Elwyn1, Glyn Elwyn2, Dominick L. Frosch3, Dominick L. Frosch4  +10 moreInstitutions (7)
Abstract: The principles of shared decision making are well documented but there is a lack of guidance about how to accomplish the approach in routine clinical practice. Our aim here is to translate existing conceptual descriptions into a three-step model that is practical, easy to remember, and can act as a guide to skill development. Achieving shared decision making depends on building a good relationship in the clinical encounter so that information is shared and patients are supported to deliberate and express their preferences and views during the decision making process. To accomplish these tasks, we propose a model of how to do shared decision making that is based on choice, option and decision talk. The model has three steps: a) introducing choice, b) describing options, often by integrating the use of patient decision support, and c) helping patients explore preferences and make decisions. This model rests on supporting a process of deliberation, and on understanding that decisions should be influenced by exploring and respecting “what matters most” to patients as individuals, and that this exploration in turn depends on them developing informed preferences. more

Topics: R-CAST (68%), Decision field theory (67%), Decision engineering (63%) more

2,024 Citations

Journal ArticleDOI: 10.1007/BF02640361
Ruth M. Parker1, David W. Baker1, David W. Baker2, Mark V. Williams1  +1 moreInstitutions (3)
Abstract: OBJECTIVE: To develop a valid, reliable instrument to measure the functional health literacy of patients. DESIGN: The Test of Functional Health Literacy in Adults (TOFHLA) was developed using actual hospital materials. The TOFHLA consists of a 50-item reading comprehension and 17-item numerical ability test, taking up to 22 minutes to administer. The TOFHLA, the Wide Range Achievement Test-Revised (WRAT-R), and the Rapid Estimate of Adult Literacy in Medicine (REALM) were administered for comparison. A Spanish version was also developed (TOFHLA-S). SETTING: Outpatient settings in two public teaching hospitals. PATIENTS: 256 English- and 249 Spanish-speaking patients were approached. 78% of the English- and 82% of the Spanish-speaking patients gave informed consent, completed a demographic survey, and took the TOFHLA or TOFHLA-S. RESULTS: The TOFHLA showed good correlation with the WRAT-R and the REALM (correlation coefficients 0.74 and 0.84, respectively). Only 52% of the English speakers completed more than 80% of the questions correctly. 15% of the patients could not read and interpret a prescription bottle with instructions to take one pill by mouth four times daily, 37% did not understand instructions to take a medication on an empty stomach, and 48% could not determine whether they were eligible for free care. CONCLUSIONS: The TOFHLA is a valid, reliable indicator of patient ability to read health-related materials. Data suggest that a high proportion of patients cannot perform basic reading tasks. Additional work is needed to determine the prevalence of functional health illiteracy and its effect on the health care experience. more

Topics: Literacy (50%)

1,821 Citations

Open accessJournal ArticleDOI: 10.1111/J.1525-1497.2005.00291.X
Karen B. DeSalvo1, Nicole Bloser1, Kristi Reynolds1, Jiang He1  +1 moreInstitutions (1)
Abstract: OBJECTIVE: Health planners and policy makers are increasingly asking for a feasible method to identify vulnerable persons with the greatest health needs. We conducted a systematic review of the association between a single item assessing general self-rated health (GSRH) and mortality. DATA SOURCES: Systematic MEDLINE and EMBASE database searches for studies published from January 1966 to September 2003. REVIEW METHODS: Two investigators independently searched English language prospective, community-based cohort studies that reported (1) all-cause mortality, (2) a question assessing GSRH; and (3) an adjusted relative risk or equivalent. The investigators searched the citations to determine inclusion eligibility and abstracted data by following a standarized protocol. Of the 163 relevant studies identified, 22 cohorts met the inclusion criteria. Using a random effects model, compared with persons reporting “excellent” health status, the relative risk (95% confidence interval) for all-cause mortality was 1.23 [1.09, 1.39], 1.44 [1.21, 1.71], and 1.92 [1.64, 2.25] for those reporting “good,” “fair,” and “poor” health status, respectively. This relationship was robust in sensitivity analyses, limited to studies that adjusted for comorbid illness, functional status, cognitive status, and depression, and across subgroups defined by gender and country of origin. CONCLUSIONS: Persons with “poor” self-rated health had a 2-fold higher mortality risk compared with persons with “excellent” self-rated health. Subjects’ responses to a simple, single-item GSRH question maintained a strong association with mortality even after adjustment for key covariates such as functional status, depression, and co-morbidity. more

Topics: Self-rated health (62%), Health policy (53%), Meta-analysis (52%) more

1,720 Citations

Open accessJournal ArticleDOI: 10.1111/J.1525-1497.2004.40153.X
Abstract: OBJECTIVE: To review the relationship between literacy and health outcomes DATA SOURCES: We searched MEDLINE, Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resources Information Center (ERIC), Public Affairs Information Service (PAIS), Industrial and Labor Relations Review (ILLR), PsychInfo, and Ageline from 1980 to 2003 STUDY SELECTION: We included observational studies that reported original data, measured literacy with any valid instrument, and measured one or more health outcomes Two abstractors reviewed each study for inclusion and resolved disagreements by discussion DATA EXTRACTION: One reviewer abstracted data from each article into an evidence table; the second reviewer checked each entry The whole study team reconciled disagreements about information in evidence tables Both data extractors independently completed an 11-item quality scale for each article; scores were averaged to give a final measure of article quality DATA SYNTHESIS: We reviewed 3,015 titles and abstracts and pulled 684 articles for full review; 73 articles met inclusion criteria and, of those, 44 addressed the questions of this report Patients with low literacy had poorer health outcomes, including knowledge, intermediate disease markers, measures of morbidity, general health status, and use of health resources Patients with low literacy were generally 15 to 3 times more likely to experience a given poor outcome The average quality of the articles was fair to good Most studies were cross-sectional in design; many failed to address adequately confounding and the use of multiple comparisons CONCLUSIONS: Low literacy is associated with several adverse health outcomes Future research, using more rigorous methods, will better define these relationships and guide developers of new interventions more

Topics: Health literacy (68%), Literacy (55%), CINAHL (54%) more

1,694 Citations

No. of papers from the Journal in previous years

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Journal's top 5 most impactful authors

Richard L. Kravitz

58 papers, 1.6K citations

Jeffrey L. Jackson

52 papers, 767 citations

Steven M. Asch

47 papers, 2.2K citations

Michael B. Rothberg

29 papers, 494 citations

Carol M. Mangione

29 papers, 1.5K citations

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