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Citizens have inadequate medical knowledge

Clinical bottom line

Most citizens have little medical knowledge.


Reference

LA Bachmann et al. Do citizens have minimum medical knowledge? A survey. BMC Medicine 2007 5:14.

Background

Even those of us who know a thing or two are more than happy to trust the doctor when something goes wrong. Trouble is, that requires us to recognise that there is a need to see the doctor in the first place. Particularly for conditions like heart attack or stroke, we may need to recognise signs and symptoms, because immediate care is needed to minimise damage.

Suppose you could define a set of minimum medical knowledge requirements that might be regarded as sensible for lay people to know. What would be your guess for the proportion of the public that had that minimum medical knowledge? For Switzerland, at least, we know the answer.

Study

First the authors developed a questionnaire to measure minimum medical knowledge, based on four illnesses with major impact on health status and economics. These were chronic obstructive pulmonary disease (COPD), HIV, heart attack, and stroke. Experts were challenged to come up with the most common set of symptoms that should be known by everyone. These became two or three questions for each illness, and these are shown in Table 1, which also describes how the minimum medical knowledge score was calculated. They then recruited members of the public at random in Zurich, and asked them to complete the questionnaire.

Table 1: Minimum medical knowledge questions


Number
Question
Correct answers
1
What risk factors are mainly responsible for developing COPD? Smoking, environmental and genetic factors
2
What are the symptoms of COPD? Cough, expectoration (sputum)
3
Do you know the symptoms of a stroke? Palsy, speech disorder
4
What diseases, habits and life circumstances increase, according to your opinion, the risk of having a stroke? Smoking, high blood pressure, abnormal blood fat, diabetes, cardiac arrhythmia
5
Is there a difference between HIV and AIDS? Yes
6
How can one protect oneself from HIV infection? Condom, sexual abstinence, no direct contact with body fluids
7
Is HIV infection curable? No
8
What can be symptoms of a heart attack? Chest pain, radiating pain, unconsciousness
9
What diseases, habits and life circumstances increase, according to your opinion, the risk of having a heart attack? Smoking, high blood pressure, abnormal blood fat, diabetes, genetic factors
Minimal medical knowledge is computed in the following way. There are nine questions where the minimal correct answer varies between one and five responses. The total number of possible correct answers is 25. The MMK of a person is the total number of correct replies divided by 25, multiplied by 100 to give a percentage score. Please note that MMK measures only the minimum knowledge. Additional knowledge that could be important or relevant is not measured.

Results

Of 272 people asked, 185 (68%) took part. The average age was 37 years (range 17-88 years), half were women, 46% had been to university, about 20% had some medical education, and half were affected by one or more of the conditions.

The average minimum medical knowledge score was 32%, with a range from 0% to 72%. Possession of a university degree, some medical education, or being affected by one or more of the conditions made little difference.

Comment

There is not a lot known about the medical knowledge of our populations. Perhaps we assume very little, and this study would indicate that to be a sensible starting point, even for those with higher education or some medical education. Two important issues follow:

  1. Why is it that more knowledge and better education even with a medical component) does not increase significantly the minimal medical knowledge?
  2. How does this low level of minimum medical knowledge impact on our ability to get over healthy living messages?