Measuring Numeracy without a Math Test: Development of the Subjective Numeracy Scale
Abstract
Background. Basic numeracy skills are necessary before patients can understand the risks of medical treatments. Previous research has used objective measures, similar to mathematics tests, to evaluate numeracy. Objectives. To design a subjective measure (i.e., self-assessment) of quantitative ability that distinguishes low- and high-numerate individuals yet is less aversive, quicker to administer, and more useable for telephone and Internet surveys than existing numeracy measures. Research Design. Paper-and-pencil questionnaires. Subjects. The general public (N = 703) surveyed at 2 hospitals. Measures. Forty-nine subjective numeracy questions were compared to measures of objective numeracy. Results. An 8-item measure, the Subjective Numeracy Scale (SNS), was developed through several rounds of testing. Four items measure people's beliefs about their skill in performing various mathematical operations, and 4 measure people's preferences regarding the presentation of numerical information. The SNS was significantly correlated with Lipkus and others' objective numeracy scale (correlations: 0.63—0.68) yet was completed in less time (24 s/item v. 31 s/item, P < 0.05) and was perceived as less stressful (1.62 v. 2.69, P < 0.01) and less frustrating (1.92 v. 2.88, P < 0.01). Fifty percent of participants who completed the SNS volunteered to participate in another study, whereas only 8% of those who completed the Lipkus and others scale similarly volunteered (odds ratio = 11.00, 95% confidence interval = 2.14—56.65). Conclusions. The SNS correlates well with mathematical test measures of objective numeracy but can be administered in less time and with less burden. In addition, it is much more likely to leave participants willing to participate in additional research and shows much lower rates of missing or incomplete data.
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Numeracy skills were measured using the Subjective Numeracy Scale, a self-report measure of perceived ability to perform mathematical tasks and preference for numerical information.
“To measure numeracy skills, we employed the Subjective Numeracy Scale [38], which is a self-report measure of perceived ability to perform various mathematical tasks and preference for the use of numerical information.”
From Dealing with Uncertainty: Understanding the Impact of Prognostic Versus Diagnostic Tasks on Trust and Reliance in Human-AI Decision Making (2024) · cites this paper as [38]
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- Authors
- Fagerlin, A., Zikmund-Fisher, B. J., Ubel, P. A., Jankovic, A., Derry, H. A., & Smith, D. M.
- Affiliations
- University of Michigan (US)
- VA Health Services Research & Development Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, Center for Behavioral and Decision Sciences in Medicine, Ann Arbor, Michigan, Division of General Internal Medicine, University of Michigan, Ann Arbor, Michigan
- Corresponding author
- Fagerlin, Angela
- Venue
- Medical Decision Making
- Publisher
- SAGE Publications
- Published
- 2007-09
- Volume
- 27
- Issue
- 5
- Pages
- 672-680
- ISSN
- 0272-989X (ISSN-L)
- 1552-681X
- OpenAlex
- W2143417015
- Cited by
- 960
- References
- 19
- Citations by year
- 2026: 47 · 2025: 48 · 2024: 55 · 2023: 66 · 2022: 75 · 2021: 61 · 2020: 70 · 2019: 72 · 2018: 80 · 2017: 62 · 2016: 44 · 2015: 63 · 2014: 59 · 2013: 48 · 2012: 40
- FWCI
- 28.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Decision Making (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- National Cancer Institute (R01CA087595, 1 P50 CA10145-01, R01 CA87595-01A1)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Keywords
- numeracy, self-assessment, subjective numeracy, mathematical ability, risk communication, patient understanding, scale development, survey burden
- MeSH terms
- Adult, Aged, Aged, 80 and over, Educational Measurement, Female, Hospitals, Veterans, Humans, Male, Mathematics, Middle Aged, Patient Education as Topic, Patient Participation, Surveys and Questionnaires, United States, Comprehension
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