Table 4. Comparison of Single-Item Literacy Screener/Brief Health Literacy Screen (SILS/BHLS) Model Identification of Limited Health Literacy With Objective Health Literacy Measures (Rapid Estimate of Adult Literacy in Medicine, Revised, and Newest Vital Sign^*)

Models^*	Limited Health Literacy n (%)		Adequate Health Literacy n (%)		Kappa	95% CI	Misclassified (%)	Sensitivity	Specificity	Positive Likelihood Ratio	Negative Likelihood Ratio
Difficulty with written information (SILS) and demographics model^*
REALM-R limited health literacy	132	62.0	81	38.0	0.43	0.35–0.51	28.1	0.62	0.81	3.26	0.47
REALM-R adequate health literacy	47	19.4	195	80.6
NVS limited health literacy	233	81.5	53	18.5	0.49	0.41–0.57	23.7	0.82	0.68	2.56	0.26
NVS adequate health literacy	55	32.5	114	67.5
Brief Health Literacy Screen and demographics model^*
REALM-R limited health literacy	171	80.3	42	19.7	0.42	0.34–0.50	29.5	0.80	0.62	2.11	0.32
REALM-R adequate health literacy	92	38.0	150	62.0
NVS limited health literacy	221	77.3	65	22.7	0.48	0.40–0.56	24.8	0.77	0.72	2.75	0.32
NVS adequate health literacy	48	28.4	121	71.6

↵* Models control for age, sex, race, and education.
NVS, Newest Vital Sign; REALM-R, Rapid Estimate of Health Literacy in Medicine, Revised.