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Rapid estimate of adult literacy in medicine: a shortened screening instrument.
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1993
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The Rapid Estimate of Adult Literacy in Medicine (REALM) is a screening tool used in public health and primary care to identify patients with reading levels below ninth grade. This study aimed to validate a shortened version of the REALM. The REALM was administered in one to two minutes by minimally trained personnel to 203 clinic patients and 100 prison inmates, who also completed three other standardized reading tests for comparison. The shortened REALM showed excellent concurrent validity (correlation coefficients 0.97, 0.96, and 0.88 with PIAT‑R, SORT‑R, and WRAT‑R, respectively) and high test‑retest reliability (0.99), confirming it as a practical instrument for busy primary care settings.
This study was conducted to validate a shortened version of the Rapid Estimate of Adult Literacy in Medicine (REALM). This screening instrument is designed to be used in public health and primary care settings to identify patients with low reading levels. It provides reading grade estimates for patients who read below a ninth-grade level. The REALM can be administered in one to two minutes by personnel with minimal training.Two hundred and three patients in four university hospital clinics (internal medicine, family practice, ambulatory care, and obstetrics/gynecology) were given the REALM and three other standardized reading tests: the reading recognition section of the Peabody Individual Achievement Test-Revised (PIAT-R), the Wide Range Achievement Test-Revised (WRAT-R), and the Slosson Oral Reading Test-Revised (SORT-R). One hundred inmates at a state prison were also given the REALM twice, one week apart, to determine test-retest reliability.The REALM correlated well with the three other tests. (Correlation coefficients were 0.97 [PIAT-R], 0.96 [SORT-R], and 0.88 [WRAT-R].) All correlations were significant at P < .0001. Test-retest reliability was 0.99 (P < .001).The REALM provides an estimate of patient reading ability, displays excellent concurrent validity with standardized reading tests, and is a practical instrument for busy primary care settings.