does not automatically guarantee proficiency at that same
level. Patients’ observed reading abilities are usually 3 to 5
grade levels below what they report as grade completed. For
example, among patients receiving warfarin at an anticoagulation
management unit, 53% could not read material written
at the 9th-grade level, while 83% of them reported having
completed the 9th grade or beyond.24 Tailoring readability of
patient information to reported grade completed may result in
inappropriate material.