Existing health numeracy measures have primarily been developed using classical test theory (CTT) and in majority populations ( 20– 27). A valid measurement of health numeracy supports the potential to tailor communication and shared decision making to the level of understanding of a given patient or population ( 2, 19). The ability to measure health numeracy among individuals or populations has both research and clinical applications in the field of health communication and medical decision making. Although the mechanism has not been fully delineated, health numeracy has been associated with increased self-efficacy ( 12), improved self-management of chronic disease ( 13– 15), and the assessment of values and preferences in the context of shared decision making ( 16– 18). A growing body of evidence supports the role of health numeracy in the adoption of health protective behaviors ( 7, 8, 12– 15). Further, numeric skills such as risk perception, estimates of probabilistic outcomes, and the ability to weigh risks and benefits, are central to theoretical frameworks of health behavior such as the health belief model and normative theories of medical decision making ( 9– 11). Knowledge and understanding regarding the cause, incidence, and natural history of disease are associated with health numeracy ( 6– 8). Numbers and numeric based concepts are integrated throughout the spectrum of health related communication and decision making. No cash balance or cash flow is included in the calculation.Health numeracy can be defined as the ability to understand medical information presented with numbers, tables and graphs, probability, and statistics and to apply numerical information for the purpose of communicating with health care providers, taking care of one’s health, and participating in medical decisions ( 1– 5). Please note all regulatory considerations regarding the presentation of fees must be taken into account. Backtested results are adjusted to reflect the reinvestment of dividends and other income and, except where otherwise indicated, are presented gross-of fees and do not include the effect of backtested transaction costs, management fees, performance fees or expenses, if applicable. Actual performance may differ significantly from backtested performance. Further, backtesting allows the security selection methodology to be adjusted until past returns are maximized. Since trades have not actually been executed, results may have under- or over-compensated for the impact, if any, of certain market factors, such as lack of liquidity, and may not reflect the impact that certain economic or market factors may have had on the decision-making process. Specifically, backtested results do not reflect actual trading or the effect of material economic and market factors on the decision-making process. Backtested performance is developed with the benefit of hindsight and has inherent limitations. This information is provided for illustrative purposes only. No representations and warranties are made as to the reasonableness of the assumptions. Certain assumptions have been made for modeling purposes and are unlikely to be realized. Changes in these assumptions may have a material impact on the backtested returns presented. General assumptions include: XYZ firm would have been able to purchase the securities recommended by the model and the markets were sufficiently liquid to permit all trading. Backtested results are calculated by the retroactive application of a model constructed on the basis of historical data and based on assumptions integral to the model which may or may not be testable and are subject to losses. The results reflect performance of a strategy not historically offered to investors and does not represent returns that any investor actually attained. Backtested performance is not an indicator of future actual results. Disclaimer: The TipRanks Smart Score performance is based on backtested results.
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