Development and Validation of the Rapid Estimate of Adult Literacy in Vascular Surgery (REAL_VS)

The purposes of this study were to develop and validate the (1) Rapid Estimate of Adult Literacy in Vascular Surgery (REAL_VS) for researchers studying the impact of literacy skills as related to vascular surgery-related knowledge and outcomes and (2) short version of the REAL_VS (REAL_VSs) to allow clinicians to gauge their patients' familiarity with vascular surgery–related terms. A three-phase process was used to identify potential words for inclusion in the REAL_VS, including reviewing Internet-based patient education material content and listening to a random sample of 50 archived audiorecordings of vascular surgeon–patient encounters. The REAL_VS was composed of 75 terms (e.g., stent, gangrene, invasive, aneurysm) of varying pronunciation difficulty. One hundred fifty-two English-speaking patients (≥18 years of age) attending a university-based vascular surgery clinic were recruited to participate in this study (mean age = 61.4 ± 14.6 years). During face-to-face interviews, patients' sociodemographic information was collected, and patients were administered the widely used Rapid Estimate of Adult Literacy in Medicine (REALM) and REAL_VS. Mean scores on the REALM (56.9 ± 14.0) and REAL_VS (63.3 ± 15.6) were highly correlated (Spearmans rank correlation [ρ] = 0.91; p < 0.00). Internal consistency of the REAL_VS (Cronbachs α = 0.98) was excellent. Mean scores on the REAL_VSs (4.1 ± 2.7) were highly correlated with both the REALM (ρ = 0.82; p < 0.00) and REAL_VS (ρ = 0.94; p < 0.00). Internal consistency, measured using Cronbachs α, of the REAL_VSs was 0.86. This study demonstrates that both the REAL_VS and REAL_VSs are both promising tools for use in vascular surgery research and clinical practice, respectively.