Risk literacy assessment of general practitioners and medical students using the Berlin Numeracy Test

BACKGROUND: The responsibility for helping patients understand potential health benefits and risks, especially regarding screening tests, falls largely to general practitioners (GPs). The Berlin Numeracy Test (BNT) specifically measures risk literacy (i.e., the ability to understand different aspects of statistical numeracy associated with accurate interpretation of information about risks). This study explored the association between risk literacy levels and clinical experience in GPs vs. medical students. Additionally, the effect of GP risk literacy on evaluation of the predictive value of screening tests was examined. METHODS: The participants were 84 GPs and 92 third-year medical students who completed the BNT (total score range 0–4 points). The GPs received an additional case scenario on mammography screening as a simple measure of performance in applying numeracy skills. RESULTS: Despite having an average of 25.9 years of clinical experience, GPs scored no better than medical students on risk literacy (GPs: 2.33 points, 95% confidence interval [CI] 2.08–2.59; students: 2.34, 95% CI 2.07–2.61; P = .983). Of all GPs, 71.6% (n = 58) greatly overestimated the real predictive value. CONCLUSIONS: In this study, we found no difference in risk literacy between current students and current GPs. GPs lack risk literacy and consequently do not fully understand numeric estimates of probability in routine screening procedures.