Introduction: Self-reported methodologies are a primary source in healthcare despite the fact that patient misrepresentation and omission are significant challenges throughout the healthcare system. This issue is particularly critical in neurosurgery where patient conveyed misinformation can compromise efficacy of surgical procedures, disease management, and outcomes. One example of many is misrepresentation of smoking cigarettes which has been widely recognized as a hindrance for appropriate fracture healing and a causal agent in nonunion and musculoskeletal degenerative disorders. Yet patients routinely misrepresent smoking related information.
Methods: We analyzed three studies to illuminate types and recurring patterns of patient misrepresentation and omission in reported health data: 1) 15 year longitudinal study of 176 Traumatic Brain Injury (TBI); 2) five year study of health threats for 197 firefighters and police officers; and 3) a comparison of reported symptomatology for 31 individuals with Parkinson’s disease (PD) and their caregivers (CG). We used the pattern of findings to create a model to illustrate caution areas for assessing patient self-reported data.
Results: Analysis for all groups comparing what patients reported to their physician compared with reports to researchers in follow-up calls revealed striking differences with reports to physicians showing a more favorable pattern of health threats than those reported to researchers over the telephone. Comparisons of lab reports with those of self-reports indicated numerous differences such as half of the people who sustained TBI whose lab reports indicated drugs or alcohol, claimed to never have used drugs or alcohol. Further, comparisons of reported symptoms from PD individuals and their CG showed those with PD reporting far more favorable symptoms than CG.
Conclusions: Recognizing the pattern of multidimensional factors where patient misrepresentation is most likely to occur can facilitate awareness of the hazards inherent in using self-reported data.
Patient Care: Offer a model to increase awareness of hazards of patient misrepresentation and omission.
Learning Objectives: 1) Discuss the various threats to neurosurgery from patient misrepresentation and omission.
2) Identify patterns of patient misrepresentation and omission.
3) Increase knowledge base regarding the frequency of patient misrepresentation and omission.