{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T02:05:01Z","timestamp":1774404301532,"version":"3.50.1"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01HS023328"],"award-info":[{"award-number":["R01HS023328"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess the impact of patient health literacy, numeracy, and graph literacy on perceptions of hypertension control using different forms of data visualization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Participants (Internet sample of 1079 patients with hypertension) reviewed 12 brief vignettes describing a fictitious patient; each vignette included a graph of the patient\u2019s blood pressure (BP) data. We examined how variations in mean systolic blood pressure, BP standard deviation, and form of visualization (eg, data table, graph with raw values or smoothed values only) affected judgments about hypertension control and need for medication change. We also measured patient\u2019s health literacy, subjective and objective numeracy, and graph literacy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Judgments about hypertension data presented as a smoothed graph were significantly more positive (ie, hypertension deemed to be better controlled) then judgments about the same data presented as either a data table or an unsmoothed graph. Hypertension data viewed in tabular form was perceived more positively than graphs of the raw data. Data visualization had the greatest impact on participants with high graph literacy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Data visualization can direct patients to attend to more clinically meaningful information, thereby improving their judgments of hypertension control. However, patients with lower graph literacy may still have difficulty accessing important information from data visualizations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Addressing uncertainty inherent in the variability between BP measurements is an important consideration in visualization design. Well-designed data visualization could help to alleviate clinical uncertainty, one of the key drivers of clinical inertia and uncontrolled hypertension.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocac129","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T05:49:27Z","timestamp":1659678567000},"page":"1829-1837","source":"Crossref","is-referenced-by-count":9,"title":["Patient judgments about hypertension control: the role of patient numeracy and graph literacy"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2533-7115","authenticated-orcid":false,"given":"Victoria A","family":"Shaffer","sequence":"first","affiliation":[{"name":"Department of Psychological Sciences, University of Missouri , Columbia, Missouri, USA"}]},{"given":"Pete","family":"Wegier","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management, and Evaluation, Humber River Hospital & University of Toronto , Toronto, Ontario, Canada"}]},{"given":"K D","family":"Valentine","sequence":"additional","affiliation":[{"name":"Health Decision Sciences Center, Massachusetts General Hospital , Boston, Massachusetts, USA"}]},{"given":"Sean","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Psychological Sciences, University of Missouri , Columbia, Missouri, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6577-8484","authenticated-orcid":false,"given":"Shannon M","family":"Canfield","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Missouri , Columbia, Missouri, USA"}]},{"given":"Jeffery L","family":"Belden","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Missouri , Columbia, Missouri, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8508-7787","authenticated-orcid":false,"given":"Linsey M","family":"Steege","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Wisconsin-Madison , Madison, Wisconsin, USA"}]},{"given":"Mihail","family":"Popescu","sequence":"additional","affiliation":[{"name":"Department of Health Management and Informatics, University of Missouri , Columbia, Missouri, USA"}]},{"given":"Richelle J","family":"Koopman","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Missouri , Columbia, Missouri, USA"}]}],"member":"286","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"issue":"1","key":"2022101107582294700_ocac129-B1","first-page":"e6","article-title":"Heart disease and stroke statistics\u20142013 update: a report from the American Heart Association","volume":"127","author":"Go","year":"2013","journal-title":"Circulation"},{"issue":"1","key":"2022101107582294700_ocac129-B2","first-page":"e2","article-title":"Heart disease and stroke statistics\u20142012 update: a report from the American Heart Association","volume":"125","author":"Roger","year":"2012","journal-title":"Circulation"},{"issue":"45","key":"2022101107582294700_ocac129-B3","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.15585\/mmwr.mm6545a3","article-title":"CDC grand rounds: a public health approach to detect and control hypertension","volume":"65","author":"Merai","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022101107582294700_ocac129-B4","author":"Agency for Healthcare Research and Quality","year":"2019"},{"issue":"12","key":"2022101107582294700_ocac129-B5","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.1161\/CIR.0000000000000558","article-title":"Heart disease and stroke statistics\u20142018 update: a report from the American Heart Association","volume":"137","author":"Benjamin","year":"2018","journal-title":"Circulation"},{"key":"2022101107582294700_ocac129-B6","first-page":"1","author":"Yoon","year":"2015"},{"issue":"17","key":"2022101107582294700_ocac129-B7","doi-asserted-by":"crossref","first-page":"1921","DOI":"10.1001\/archinte.1997.00440380023002","article-title":"Impact of medication non-adherence on coronary disease outcomes: a critical review","volume":"157","author":"McDermott","year":"1997","journal-title":"Arch Intern Med"},{"issue":"1","key":"2022101107582294700_ocac129-B8","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1471-2296-7-21","article-title":"The Single Item Literacy Screener: evaluation of a brief instrument to identify limited reading ability","volume":"7","author":"Morris","year":"2006","journal-title":"BMC Fam Pract"},{"key":"2022101107582294700_ocac129-B9","author":"Office of Disease Prevention and Health Promotion","year":"2022"},{"issue":"12","key":"2022101107582294700_ocac129-B10","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1111\/j.1525-1497.2006.00591.x","article-title":"Factors associated with medication refill adherence in cardiovascular-related diseases","volume":"21","author":"Gazmararian","year":"2006","journal-title":"J Gen Intern Med"},{"issue":"2","key":"2022101107582294700_ocac129-B11","doi-asserted-by":"crossref","first-page":"97","DOI":"10.7326\/0003-4819-155-2-201107190-00005","article-title":"Low health literacy and health outcomes: an updated systematic review","volume":"155","author":"Berkman","year":"2011","journal-title":"Ann Intern Med"},{"issue":"10","key":"2022101107582294700_ocac129-B12","doi-asserted-by":"crossref","first-page":"717","DOI":"10.7326\/0003-4819-148-10-200805200-00004","article-title":"The role of clinical uncertainty in treatment decisions for diabetic patients with uncontrolled blood pressure","volume":"148","author":"Kerr","year":"2008","journal-title":"Ann Intern Med"},{"key":"2022101107582294700_ocac129-B13","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1186\/1471-2296-15-130","article-title":"The concept and definition of therapeutic inertia in hypertension in primary care: a qualitative systematic review","volume":"15","author":"Lebeau","year":"2014","journal-title":"BMC Fam Pract"},{"issue":"4","key":"2022101107582294700_ocac129-B14","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1161\/HYPERTENSIONAHA.111.174367","article-title":"Treatment intensification in a hypertension telemanagement trial: clinical inertia or good clinical judgment?","volume":"58","author":"Crowley","year":"2011","journal-title":"Hypertension"},{"key":"2022101107582294700_ocac129-B15","author":"Kolata","year":"2015"},{"issue":"1","key":"2022101107582294700_ocac129-B16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12911-021-01598-4","article-title":"Home blood pressure data visualization for the management of hypertension: using human factors and design principles","volume":"21","author":"Wegier","year":"2021","journal-title":"BMC Med Inform Decis Mak"},{"issue":"1","key":"2022101107582294700_ocac129-B17","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1186\/s12911-020-01194-y","article-title":"Home blood pressure data visualization for the management of hypertension: designing for patient and physician information needs","volume":"20","author":"Koopman","year":"2020","journal-title":"BMC Med Inform Decis Mak"},{"issue":"3","key":"2022101107582294700_ocac129-B18","doi-asserted-by":"crossref","first-page":"e11366","DOI":"10.2196\/11366","article-title":"Patient judgments about hypertension control: the role of variability, trends, and outliers in visualized blood pressure data","volume":"21","author":"Shaffer","year":"2019","journal-title":"J Med Internet Res"},{"issue":"4","key":"2022101107582294700_ocac129-B19","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1161\/HYPERTENSIONAHA.109.140798","article-title":"Prognostic value of reading-to-reading blood pressure variability over 24 hours in 8938 subjects from 11 populations","volume":"55","author":"Hansen","year":"2010","journal-title":"Hypertension"},{"issue":"8","key":"2022101107582294700_ocac129-B20","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1038\/s41562-017-0145","article-title":"Selective overweighting of larger magnitudes during noisy numerical comparison","volume":"1","author":"Spitzer","year":"2017","journal-title":"Nat Hum Behav"},{"issue":"6","key":"2022101107582294700_ocac129-B21","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1177\/0272989X20940999","article-title":"Use of enhanced data visualization to improve patient judgments about hypertension control","volume":"40","author":"Shaffer","year":"2020","journal-title":"Med Decis Making"},{"issue":"6","key":"2022101107582294700_ocac129-B22","doi-asserted-by":"crossref","first-page":"430","DOI":"10.7326\/M16-1785","article-title":"Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians","volume":"166","author":"Qaseem","year":"2017","journal-title":"Ann Intern Med"},{"issue":"19","key":"2022101107582294700_ocac129-B23","doi-asserted-by":"crossref","first-page":"e127","DOI":"10.1016\/j.jacc.2017.11.006","article-title":"2017 Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association Task Force on clinical practice guidelines","volume":"71","author":"Whelton","year":"2018","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"2022101107582294700_ocac129-B24","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/j.1467-9280.2006.01720.x","article-title":"Numeracy and decision making","volume":"17","author":"Peters","year":"2006","journal-title":"Psychol Sci"},{"issue":"6","key":"2022101107582294700_ocac129-B25","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1037\/a0017327","article-title":"How numeracy influences risk comprehension and medical decision making","volume":"135","author":"Reyna","year":"2009","journal-title":"Psychol Bull"},{"issue":"3","key":"2022101107582294700_ocac129-B26","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.pec.2008.07.023","article-title":"The impact of the format of graphical presentation on health-related knowledge and treatment choices","volume":"73","author":"Hawley","year":"2008","journal-title":"Patient Educ Couns"},{"issue":"1","key":"2022101107582294700_ocac129-B27","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1093\/intqhc\/mzr072","article-title":"Impact of format and content of visual display of data on comprehension, choice, and preferences: a systematic review","volume":"24","author":"Hildon","year":"2012","journal-title":"Int J Qual Health Care"},{"issue":"3","key":"2022101107582294700_ocac129-B28","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1177\/0272989X10373805","article-title":"Graph literacy: a cross-cultural comparison","volume":"31","author":"Galesic","year":"2011","journal-title":"Med Decis Making"},{"issue":"4","key":"2022101107582294700_ocac129-B29","first-page":"173","article-title":"The roles of health literacy, numeracy, and graph literacy on the usability of the VA\u2019s personal health record by veterans","volume":"9","author":"Sharit","year":"2014","journal-title":"J Usability Stud"},{"key":"2022101107582294700_ocac129-B30","year":"2012"},{"issue":"35","key":"2022101107582294700_ocac129-B31","first-page":"703","article-title":"Vital signs: awareness and treatment of uncontrolled hypertension among adults\u2014United States, 2003\u20132010","volume":"61","author":"Centers for Disease Control and Prevention (CDC)","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"11","key":"2022101107582294700_ocac129-B32","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1001\/archinte.163.11.1357","article-title":"Continuity of care and recognition of diabetes, hypertension, and hypercholesterolemia","volume":"163","author":"Koopman","year":"2003","journal-title":"Arch Intern Med"},{"issue":"9","key":"2022101107582294700_ocac129-B33","first-page":"639","article-title":"Undiagnosed obesity: Implications for undiagnosed hypertension, diabetes, and hypercholesterolemia","volume":"36","author":"Diaz","year":"2004","journal-title":"Fam Med"},{"issue":"5","key":"2022101107582294700_ocac129-B34","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1001\/jama.2013.284427","article-title":"2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8)","volume":"311","author":"James","year":"2014","journal-title":"JAMA"},{"issue":"1","key":"2022101107582294700_ocac129-B35","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1097\/HJH.0000000000000772","article-title":"Agreement between ambulatory, home, and office blood pressure variability","volume":"34","author":"Juhanoja","year":"2016","journal-title":"J Hypertens"},{"issue":"5","key":"2022101107582294700_ocac129-B36","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1046\/j.1365-2710.2001.00363.x","article-title":"Patient adherence to treatment: three decades of research. A comprehensive review","volume":"26","author":"Vermeire","year":"2001","journal-title":"J Clin Pharm Ther"},{"issue":"5","key":"2022101107582294700_ocac129-B37","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1177\/0272989X07304449","article-title":"Measuring numeracy without a math test: development of the subjective numeracy scale","volume":"27","author":"Fagerlin","year":"2007","journal-title":"Med Decis Making"},{"key":"2022101107582294700_ocac129-B38","author":"Cokely","year":"2011"},{"issue":"2","key":"2022101107582294700_ocac129-B39","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"GPower 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav Res Methods"},{"issue":"4","key":"2022101107582294700_ocac129-B40","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.3758\/BRM.41.4.1149","article-title":"Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses","volume":"41","author":"Faul","year":"2009","journal-title":"Behav Res Methods"},{"key":"2022101107582294700_ocac129-B41","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2018"},{"issue":"1","key":"2022101107582294700_ocac129-B42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v067.i01","article-title":"Fitting linear mixed-effects models using lme4","volume":"67","author":"Bates","year":"2015","journal-title":"J Stat Soft"},{"key":"2022101107582294700_ocac129-B43","author":"Centers for Disease Control and Prevenion","year":"2021"},{"key":"2022101107582294700_ocac129-B44","author":"Belden","year":"2014"},{"key":"2022101107582294700_ocac129-B45","volume-title":"Visual Queries: The Foundation of Visual Thinking. Knowledge and Information Visualization","author":"Ware","year":"2005"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/29\/11\/1829\/46379353\/ocac129.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/29\/11\/1829\/46379353\/ocac129.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T08:00:59Z","timestamp":1665475259000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/29\/11\/1829\/6655787"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,4]]},"references-count":45,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,8,4]]},"published-print":{"date-parts":[[2022,10,7]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocac129","relation":{},"ISSN":["1067-5027","1527-974X"],"issn-type":[{"value":"1067-5027","type":"print"},{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11,1]]},"published":{"date-parts":[[2022,8,4]]}}}