Diagnostic accuracy of the Structured Inventory of Malingered Symptomatology (SIMS) in motor vehicle accident patients

Abstract

ABSTRACT The SIMS is used in the medico-legal context to assess people who have suffered a traffic accident without proven scientific evidence to support this procedure. The objective of this research is to evaluate the SIMS’ ability to discriminate instructed malingerers, general population, patients who have suffered a traffic accident, and overreporting patients. A simulation design was used to evaluate a total of 650 subjects divided into the four mentioned groups. Our results indicate that the cut-off scores proposed by the authors of the English and Spanish versions (14 and 16) produce moderate sensitivity and specificity values. With a cut-off score of 10, specificity decreases, but sensitivity significantly increases. These results suggest that the SIMS needs to be adapted to the context’s particularities, either by using the proposed cut-off score and other instruments that compensate for the low specificity or by designing new subscales that include symptoms that are typical for the usual conditions in the context.