title: Evidence does not support clinical screening of literacy.
abstract: Limited health literacy is a significant risk factor for adverse health outcomes. Despite controversy, many health care professionals have called for routine clinical screening of patients' literacy skills. Whereas brief literacy screening tools exist that with further evaluation could potentially be used to detect limited literacy in clinical settings, no screening program for limited literacy has been shown to be effective. Yet there is a noted potential for harm, in the form of shame and alienation, which might be induced through clinical screening. There is fair evidence to suggest that possible harm outweighs any current benefits; therefore, clinical screening for literacy should not be recommended at this time.
authors.affiliation: Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, USA. mpo@bu.edu
authors.forename: Michael K
authors.initials: MK
authors.lastname: Paasche-Orlow
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
mesh_terms: D004522:Educational Status; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening; D010817:Physician-Patient Relations