Assessment of human comprehension by an automated agent

A method of automatically evaluating an assessment of a patient's health literacy in order to present therapeutic instructions which are understandable by the patient, comprising:

• using an automated agent having a form of instructions carried out by at least one electronic processor, the automated agent acting to:
• access health literacy data from members of a population of at least 100 individuals, wherein the health literacy data indicates that members of the population understand health-related information and health-related words;
• access demographic data from the members of the population corresponding to age, race, and level of education;
• collect skills data from the patient corresponding to a set of questions presented to the patient relating to skills needed for understanding therapeutic instructions;
• collect personal data relating to the age, race, and level of education of the patient;
• assign a health literacy level to the patient using a polytomous logistic regression with i) the health literacy of members of the population, ii) the demographic data of members of the population, iii) the skills data of the patient, and iv) the personal data of the patient,
• wherein the health literacy level is one of a plurality of groups based upon the abilities, skills and knowledge (ASK) predictors of Tests of Functional Health Literacy in Adults (TOFHLA), wherein the plurality of groups include;
• proficient includes individuals who can, at least, independently read text at a high school level;
• intermediate includes individuals who can, at least, independently read text at an eighth-grade level;
• basic includes individuals who can, at least, read sentences below the eighth-grade level;
• and
• below basic includes individuals who can read words but cannot understand sentences;
• and
• select a communication strategy for the patient corresponding to the assigned health literacy level of the patient, by a computer, to enable the patient to have a communication of therapeutic instructions when the patient has responded to the set of questions, wherein the communication of therapeutic instructions is based upon the assigned health literacy of the patient to include:
• for a below basic health literacy level, use of at least one of graphics, audio narration, and repetition;
• for a basic health literacy level, use of single step instructions with text in sentences below a reading competence of the eighth-grade level;
• for an intermediate health literacy level, use of multi-step instructions;
• and
• for a proficient health literacy level, use of multi-step instructions and additional content in written form.