Inaccurate Self-reporting Research Articles

Abstract 11710: The Integrative Experimental and Computational Approach to Assess Patient Lipid-Lowering Drug Adherence for Coronary Artery Disease Risk Diagnostics

Background: Statins, lipid-lowering drugs, are the first-line pharmaceutical therapy against Atherosclerotic Cardiovascular Disease (ASCVD). The emphasis on providing statin treatment as a preventive measure before the first cardiac event burdens low-risk individuals with adverse side effects. Furthermore, inaccurate self-reporting of statin use by patients or their poor adherence to statins complicates the monitoring of long-term benefits and side effects of statins and ASCVD risk assessment. New sensitive, multiplexed and high throughput methods to confirm actual statin use by patients are urgently needed. Methods: We used 690 plasma samples from individuals with known number of diseased vessels, established lipid profiles, and medication records of statin use. The samples were obtained from the CATHeterization GENetics (CATHGEN) sample archive. The levels of 7 statins (atorvastatin, simvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, and fluvastatin) in the plasma samples were determined by a 4-minute-long Liquid Chromatography-Mass Spectrometry Method (LC-MS/MS). Nominal logistic regression algorithms were employed to model coronary artery disease (CAD) outcomes with the incorporation of statin use, phenotypic, and lipid profile characteristics. Results: Our LC-MS/MS analysis has revealed discrepancies between the reported statin medication use and the detected statin levels in plasma. The reported statin use history was confirmed for 212 out of 261 patients. Among 429 specimens without a recorded history of statin use, statin was detected in 198 specimens. Comparison of logistic regression models built with statin use data as a covariate and with stratification by statin users and non-users revealed significant differences in covariate corrected mean lipid profile measures and their association with predicted atherosclerosis outcomes. Conclusion: In summary, high-throughput multiplexed LC-MS/MS analysis is highly applicable to uncover discrepancies between the self-reported and actual use of statins. By combining LC-MS/MS with statistical modeling, we showed that these discrepancies may significantly affect the modeled association between lipid profile measures and ASCVD outcome.

Agreement between self-reported and researcher-measured height, weight and blood pressure measurements for online prescription of the combined oral contraceptive pill: an observational study

Objective(s)To compare agreement between self-reported height, weight and blood pressure measurements submitted to an online contraceptive service with researcher-measured values and document strategies used for self-reporting.DesignAn observational study.SettingAn online sexual...

Underreporting of alcohol use in trauma patients: A retrospective analysis

Background This study assessed the inconsistencies between self-reported alcohol consumption and blood alcohol content (BAC) in trauma patients. We aimed to identify the incidence of positive BAC in trauma patients who reported a zero score on the Alcohol Use Disorders Identification Test (AUDIT). We also sought to identify characteristics of individuals who were likely to negate alcohol use, yet yielded a positive BAC, to improve our ability to provide alcohol screening and healthcare to these at-risk alcohol consumers. Methods: We conducted a retrospective study from 2010 to 2018 at a university-based, level-one trauma emergency department. We identified 2581 adult trauma patients who reported a zero score on the AUDIT from the trauma registry. We collected BAC, age, gender, race, education level, mechanism of injury, language and injury severity score (ISS) from patient charts, and used descriptive analyses and multivariate logistic regression to analyze the data. Results: One hundred and thirty-one (5.08%) trauma patients who reported AUDIT of zero had a positive BAC. We found that being male (OR 1.53), assaulted or injured from a penetrating mechanism (OR 2.29) and having an ISS greater than 25 (OR 3.76) were independent positive predictors of trauma patients who reported an AUDIT of zero and had a positive BAC. Age (OR 0.99) was an independent negative predictor of trauma patients who reported an AUDIT of zero and had a positive BAC in this cohort. Conclusions: Inaccurate self-reporting of alcohol drinking behavior does exist in trauma patients. A composite of objective alcohol screening modalities, in addition to AUDIT, is needed to screen for alcohol use in this population. Healthcare providers should remain highly suspicious of alcohol-related injuries in individuals with the identified characteristics.

Can You Believe Your Patients If They Say They Have Quit Smoking?

To determine the reliability of self-reported smoking status in the orthopaedic trauma population and determine if certain patient factors might predispose inaccurate self-reported smoking cessation. Prospective. Level I trauma center. Two hundred forty-seven orthopaedic trauma patients were included in the study. In-office measurement of exhaled carbon monoxide (CO). Self-reported smoking cessation with exhaled CO measurements. A total of 906 self-reported surveys were completed over 4 follow-up visits. Of the responses indicating smoking cessation (n = 174), 12.6% [95% confidence interval (CI), 0.081-0.185] reported smoking cessation with positive CO readings, suggesting inaccurate self-reporting of smoking status. Over 20% of those patients inaccurately reporting abstinence did so more than once. The odds of inaccurate self-reporting was 3 times higher in patients with no insurance or government insurance [odds ratio (OR), 3.5; 95% CI, 1.1-11.0; P = 0.043] and in the unemployed (OR, 3.3; 95% CI, 0.97-8.57; P = 0.049). Self-reported smoking status in the orthopaedic population is fairly reliable, with 13% of patient's inaccurately self-reporting smoking cessation despite knowing their smoking status was being measured. Clinicians should be aware of the potential for inaccuracy in self-reported smoking cessation, particularly in patients with the identified socioeconomic factors. Point-of-care testing before elective trauma procedures to confirm smoking status might have a role if the procedure outcome is highly dependent on smoking status. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

An Evaluation of Self-Reported Publications in Orthopaedic Sports Medicine Fellowship Applications.

Background:Orthopaedic sports medicine fellowship positions are increasing in popularity, as evidenced by the increasing number of applicants to these programs. As positions have become more competitive, greater emphasis has been placed on an applicant’s research experience. However, there has been a lack of research evaluating the accuracy of self-reported publications from fellowship applications.Purpose:To evaluate the accuracy of self-reported research publications and the outcomes of studies submitted for publication by applicants to an Accreditation Council for Graduate Medical Education (ACGME)–accredited sports medicine fellowship in the United States (US).Study Design:Cross-sectional study.Methods:Demographic and research publication data were retrospectively collected from 435 applications to an ACGME-accredited orthopaedic sports medicine fellowship program at a single high-volume academic institution from 2013 to 2017. All self-reported manuscript publications and studies in progress were analyzed with a minimum 2-year follow-up. “Submitted” publications were reviewed by searching the originally submitted journal and all publicly available sources. Publications were verified on PubMed, MEDLINE, and other open access journals. Journal impact factors were collected through use of InCites Journal Citation Reports.Results:Only 5.7% (85/1504) of papers reported as “completed” were inaccurately self-reported, with 44 (51.8%) remaining unverified and 41 (48.2%) reporting discordant authorship, in which the published study listed a different author order than reported on the application. Further, 28.3% (197/696) of papers self-reported as “submitted” remained unpublished, 21.8% (152/696) were published in a different journal than originally reported, and 7.6% (53/696) were published with a different authorship order than reported. Among 95 applicants whose papers were published in different journals than originally reported, the mean impact factor of the final accepting journal was significantly lower than that of the journal of original submission (0.97 ± 0.13 vs 3.91 ± 0.79, respectively; 95% CI of the difference, 1.34-4.54; P < .01). Univariate analysis showed no significant relationships between variables of interest (age, sex, US Medical Licensing Examination Step 1 score, American Orthopaedic Association membership, medical school ranking, and advanced degree) and the presence of an inaccuracy.Conclusion:There is a low rate of inaccurate self-reporting of “completed” publications on applications for orthopaedic sports medicine fellowships. The majority of papers listed as “submitted” on these applications were not published in the journals to which they were originally submitted.

Trends in dermatology practices and the implications for the workforce

The American Academy of Dermatology (AAD) practice profile surveys have been conducted for more than a decade to gauge trends in our workforce supply and demand. To update the trends and current workforce issues for the field of dermatology. The AAD Practice Profile Survey is sent by both e-mail and postal mail to a random sample of practicing dermatologists who are AAD members. Shifts are noted in the primary practice setting; fewer dermatologists are in solo practice and more are in group practices than in previous years. Teledermatology use trended upward from 7% to 11% between 2012 and 2014. The implementation of electronic health records increased from 51% in 2011 to 70% in 2014. There is potential for response bias and inaccurate self-reporting. Survey responses collected may not be representative of all geographic areas. The demand for dermatology services remains strong. Shifts in the practice setting may berelated to increases in overhead costs that are partially associated with the implementation of technology-based medical records. Integration of electronic health records and utilization of telemedicine are increasing.

Responding to the Threat of Reputation Loss: Inaccurate Self-Reporting in US Nursing Homes

Because third-party evaluation systems, such as ratings and rankings, increasingly serve as a basis for firms’ reputations, organizations pay a great deal of attention to ensuring that they perform well according to such evaluation systems. However, while such systems are intended to incentivize firms to improve in a variety of substantive areas, firms may instead opt to bolster their standing by engaging in various forms of “gaming the system.” In cases where third-party evaluators rely on the organizations being assessed to self-report the data that form the basis for their rating/ranking, “gaming” may include providing false or misleading information. Relatively little work has investigated the conditions under which this is likely to occur. In this paper, we theorize factors that cause rated firms to vary in the reputational incentives they face, leading to differences in the likelihood of reporting false or misleading data. We test our predictions in the context of the U.S. nursing home industry, finding that not-for- profit firms, those with better previous reputations and those facing greater localized competition are more likely to report misleading data. We discuss implications for both consumers and designers of ratings.

Factors Associated with Inaccurate Self-Reporting of Olfactory Dysfunction in Older US Adults.

Self-reported olfactory function has poor sensitivity (i.e., people with measured olfactory dysfunction are unlikely to accurately report it). We aimed to identify factors associated with lack of awareness of smell dysfunction. Objective odor identification was evaluated using a validated 5-item test in respondents from the National Social Life, Health, and Aging Project, a representative sample of home-dwelling, US adults ages 57-85 (n = 1468). Self-reported olfaction was assessed with a 5-point Likert scale. Using multivariate logistic regression, we tested factors that might influence inaccuracy of self-reported olfaction, including age, gender, race/ethnicity, education, marital status, cognition, comorbidity, smoking, depression, anxiety, self-rated mental and physical health, and social activity. Among older US adults, 12.4% reported their sense of smell as fair or poor, while 22.0% had objective olfactory dysfunction (≤3 items correct out of 5). Among those with measured olfactory dysfunction, 74.2% did not recognize it; these individuals were more likely to be older, Black, never married, and to have worse cognitive function compared to individuals who recognized their dysfunction (P < 0.05, all). Individuals who lacked awareness of their olfactory dysfunction had the greatest cognitive impairment at 5-year follow-up, followed by individuals aware of their dysfunction and finally normosmics (P < 0.001). Older Americans with measured olfactory dysfunction are unlikely to report it, and those who lack awareness of this dysfunction have distinct demographic, social, and cognitive characteristics. Therefore, clinicians should objectively test patients. Individuals who lack awareness of their olfactory dysfunction have poor cognitive outcomes and should receive additional clinical scrutiny.

Hepatitis C testing and status among opioid substitution treatment clients in New South Wales

In Australia about half of the people who inject drugs (PWID) are hepatitis C (HCV) antibody positive (anti-HCV+). The prevalence among opioid substitution treatment (OST) clients specifically is unclear, despite OST clinics being a potential setting for HCV care. This study aimed to report the prevalence of HCV among a large sample of NSW OST clients, understand whether HCV testing is translating into knowledge of status, and identify the correlates of inaccurate self-reporting of HCV status. Participants completed an interview that included self-reported HCV status. Participants also provided a blood sample that was tested for HCV IgG antibodies, and for viral load using a quantitative real-time reverse-transcriptase polymerase chain reaction. Valid interviews and viable blood sample were provided by 1,484 participants. Logistic regression modelling was used to identify independent predictors of knowledge of HCV antibody status. Overall, 84% of participants were anti-HCV+. Of these, 65% were RNA+. Four per cent of anti-HCV negative participants were RNA+. One-quarter of anti-HCV+ participants did not know their status or reported it incorrectly, compared with 14.5% of anti-HCV negative participants. The prevalence of HCV in this sample was higher than that found among other samples of people who inject drugs, suggesting the need for greater prevention efforts with OST clients. Anti-HCV+ individuals are less accurate at reporting their HCV status than those who are anti-HCV-. Inaccurate knowledge is associated with different variables for anti-HCV+ vs. anti-HCV- individuals. There are opportunities to improve knowledge of HCV status and to therefore improve health outcomes and reduce transmission among this at-risk population.

Biochemically-verified Smoking Rate Trends and Factors Associated with Inaccurate Self-reporting of Smoking Habits in Korean Women

Lung cancer is a major cause of Korean female mortality and is clearly associated with smoking. The Korean National Health and Nutrition Examination Survey (KNHANES IV-2,3), which included both self-reports of smoking and urinary cotinine data, revealed a significant discrepancy between the prevalence of self-reported and biochemically-verified female smokers. The factors associated with accurate self-reporting of current smoking status remain poorly understood, however. We assessed the prevalence of smoking in KNHANES using both self-report and urinary cotinine data. Subsequently, using univariate and multivariate tests, we assessed whether age, intensity of smoking, marital status, relationship with cohabitants, education, occupation, residential area, or annual household income were associated with inaccurate self- reporting in Korean females. We also investigated whether the prevalence of inaccurate self-reports changed over the survey period, 2008-2009. The prevalence of self-reported smoking was 47.8% in males and 6.6% in females. By contrast, the prevalence of smoking as assessed by urinary cotinine levels was 52.2% in males and 14.5% in females. Of the 746 females with urinary cotinine levels >50 ng/ml, 407 (56.0%) provided inaccurate self-reports. In a multivariate model, age group(40-49: OR 3.54, 95%CI 1.42-8.86, p=0.007; ref :20- 29), cotinine intensity(OR 0.999, 95%CI 0.998-0.999, p<0.001), marital status (married but without spouse: OR 0.37, 95%CI 0.15-0.94, p=0.037; ref :never married), relationship with cohabitants (living with a spouse and unmarried child: OR 2.63, 95%CI 1.44-4.80, p=0.002; living with 2 generations except unmarried child: OR 2.53, 95%CI 1.09-5.87, p=0.030; living with ≥ 3 generations: OR 3.25, 95%CI 1.48-7.10, p=0.003; ref :spouse only) and education(college or higher: OR 2.73, 95%CI 1.04-7.18, p=0.042; ref :elementary or less) were independently associated with inaccurate self-reports. The trend of smoking prevalence of Korean females is likely to decrease. However, an elevated prevalence of inaccurate self-reports by females remains. Factors related to the intensity of smoking and family status appear to influence whether a Korean female provides an accurate self-report when asked about smoking behavior.

An Overview of the Complexities in Obesity

A recent survey, even one limited to human studies, found considerable “publication scatter” in that more than 250 different professional journals publish articles on obesity. Over the years, and particularly since the 1970s and 1980s when the so-called obesity epidemic began, there has been an explosion of clinical interest in a field that encompasses general medicine, pediatrics, surgery, psychiatry, and almost every subspecialty. And rightly so, since even by 2008, there were an estimated 1.46 billion adults worldwide who were overweight, and of these, 502 million were in the obese category, all of which translate into major public health consequences. Despite many highly publicized studies, why do we not have a greater understanding about obesity than we do? It is certainly not from a lack of trying. This article presents an overview of the limitations and challenges, that is, complexities, due to discrepant frameworks and diverse conceptualizations of obesity; potential flaws inherent in its clinical studies; and particularly, impediments due to difficulties in the measurement of body composition (and particularly adipose accumulation), food intake, and physical activity, as well as to notoriously inaccurate self-reporting by subjects. As a result, clinicians remain limited in issuing recommendations to their patients.

Alcohol use before and during pregnancy and factors influencing change among Swedish women

To investigate alcohol intake during pregnancy among women, to assess health cares providers' advice to the women and the relative importance of different factors on changes in the women's drinking. Questionnaire study. Linkoping, Sweden. A total number of 1,533 women registered at a maternity health care center in Linkoping during a one-year period, from 1 April 2005 to 31 March 2006. Mailed anonymous questionnaire with a response rate of 61%. Drinking behavior and information sources. During pregnancy, 94% (n=869) of the responding women abstained from alcohol, including 13% (n=117) who were already abstainers. Six percent (n=55) continued drinking during the pregnancy. Those who continued drinking during pregnancy were older, had more often given birth and drank more frequently before pregnancy than the women who abstained. Half of the respondents (n=428) believed that decreases in alcohol intake during pregnancy reported in previous studies could be due to inaccurate self-reporting. The main message from maternity health care providers was perceived to be complete abstinence from alcohol during pregnancy (85%; n=777), although 8% (n=76) claimed that they had not received any advice regarding this. Media attention concerning risks associated with drinking during pregnancy was seen as slightly more important to achieve reduced alcohol intake during pregnancy than advice from maternity health care providers. A majority of women in this study reported abstaining from alcohol during pregnancy.

Are oral surgeons as good as they think they are?

Objective To see if poor self-assessment of surgical performance during removal of mandibular third molars is influenced by self-deception (lack of insight) and impression management (trying to convey a favourable impression). Design A prospective study of 50 surgeons, surgically removing a lower third molar tooth. Setting One UK dental school over a two year period. Methods The surgeons' surgical skills were assessed (by two assessors) and self assessed using check-list and global rating scales. Post-operatively, surgeons completed validated deception questionnaires which measured both self-deception enhancement (lack of insight), and impression management (the tendency to deliberately convey a favourable impression). Main outcome measures Reliability between assessors, and between assessors' and surgeons' self-assessments were calculated. Discrepancies between assessors' and surgeons' scores were correlated with surgeons' deception scores. Results Reliability between assessors was excellent for checklist (0.96) and global rating scales (0.89) and better than the reliability between assessors and surgeons (0.51 and 0.49). There was a statistically significant correlation (r=0.45 p=0.001 checklist, r= 0.48 p<0.001 global) between over/ under-rating of their surgical performance by surgeons and their impression management scores. No statistically significant correlation was found between this inaccuracy in self-assessment and surgeons' individual self-deception scores. Conclusion The majority of surgeons scored themselves higher than their assessors for surgical skill in removing a single mandibular third molar tooth. Impression management (the tendency to deliberately convey a favourable impression) may contribute to a surgeon's inaccurate self-reporting of performance. Lack of insight appears to be much less important as a contributing factor. The authors speculate that pressure to provide evidence of good performance may be encouraging surgeons to manage their image and over-score themselves.

The influence of self-deception and impression management upon self-assessment in oral surgery

To see if poor self-assessment of surgical performance during removal of mandibular third molars is influenced by self-deception (lack of insight) and impression management (trying to convey a favourable impression). A prospective study of 50 surgeons, surgically removing a lower third molar tooth. One UK dental school over a two year period. The surgeons' surgical skills were assessed (by two assessors) and self-assessed using check-list and global rating scales. Post-operatively, surgeons completed validated deception questionnaires which measured both self-deception enhancement (lack of insight), and impression management (the tendency to deliberately convey a favourable impression). Reliability between assessors, and between assessors' and surgeons' self-assessments were calculated. Discrepancies between assessors' and surgeons' scores were correlated with surgeons' deception scores. Reliability between assessors was excellent for checklist (0.96) and global rating scales (0.89) and better than the reliability between assessors and surgeons (0.51 and 0.49). There was a statistically significant correlation (r=0.45 p=0.001 checklist, r= 0.48 p<0.001 global) between over/ under-rating of their surgical performance by surgeons and their impression management scores. No statistically significant correlation was found between this inaccuracy in self-assessment and surgeons' individual self-deception scores. The majority of surgeons scored themselves higher than their assessors did for surgical skill in removing a single mandibular third molar tooth. Impression management (the tendency to deliberately convey a favourable impression) may contribute to a surgeon's inaccurate self-reporting of performance. Lack of insight appears to be much less important as a contributing factor. The authors speculate that pressure to provide evidence of good performance may be encouraging surgeons to manage their image and over-score themselves.

Validity of self-report of illicit drug use in young hypertensive urban African American males

Inaccurate self-reporting is the primary threat to the validity and utility of self-report in the research on illicit drug use. The purpose of this study was to estimate the sensitivity and specificity of self-report of drug use, using urine toxicity screening as a criterion variable, and to explore the individual characteristics associated with false reporting in a sample of urban African American males. Baseline data from urine tests and a questionnaire about self-report of illicit drug use were obtained from 290 hypertensive African American males enrolled in an ongoing hypertension clinical trial. Sensitivity and specificity of self-report were estimated, and multivariate logistic regression analysis was conducted to examine factors associated with true or false reporting of drug use. Result: The sensitivity and specificity of self-report were 0.87±0.019 and 0.63±0.02, respectively. Members of the underreporting group were more likely to be older, more educated, employed, living with family, and having experience with jail. Jail experience (OR, 2.0) and living with friends or family (OR, 1.7) were the two strongest predictors of false reporting. This study further confirms that social desirability and fear of the consequences of drug use are major contributing factors in underreporting of drug use.