Patient History After Car Accident Doesn't Match Up With Medical Records

An accurate patient history after motor vehicle accidents is important when planning the best and most appropriate treatment. Anyone with a prior history of neck or back pain may need a different approach. Social research confirms that anyone with a psychologic profile, history of alcohol or other drug use, or mental illness will likely need special attention.

But getting at that information can be tougher than it looks. Despite taking a thorough patient history, patients don't always reveal important facts from their past. In this study, researchers at Stanford University School of Medicine attempt to see how accurate patient self-report is after an accident.

They compared the information given by patients experiencing chronic neck or back pain following a car accident with data in their medical records on the same patients. They were expecting that the information would match up.

But what they actually found was that patients frequently (half the group) underreported previous bouts of neck and back pain. And they denied ever having treatment for these problems even when the medical records clearly showed they did have treatment at some time in the past.

Not only that, but the patients who were not at fault (the accident was caused by someone else) were much more likely to fail to report previous back and neck pain problems. Patients with a history of psychologic problems were seven times more likely to underreport information on those problems. These patients didn't just leave out a small portion of their history. Often, they omitted the entire history.

To make sure this wasn't just a general underreporting of all problems (including health conditions unrelated to an accident), the authors also included two control conditions: hypertension and diabetes. Consistent with the idea that the underreporting was conscious or deliberate, no one failed to tell the examiner about other health concerns of this type.

Why do patients give inaccurate histories? The authors suggest in the case of psychologic issues, the patients may have the feeling that it will be a strike against them. Everyone will think they are faking or exaggerating because they have a mental health history. Whether or not this is true was not tested or proven in this study.

Secondly, other studies done by these same authors have shown that underreporting occurs more often in cases where the patient was not at fault and who hired a lawyer. It's easy to assume the patient is out for secondary gain (i.e., get all they can from this one accident).

But there may be other explanations for this behavior. For example, maybe the people who underreported past history just couldn't think straight and didn't remember past injuries. Maybe they didn't have the emotional or psychologic strength to deal with all the questions, the finances, and all the paperwork.

Regardless of the reasons, it's clear that patient histories related to neck and back pain taken after motor vehicle accidents are not valid or accurate. Involvement in a compensation claim may be a key risk factor for this type of underreporting. Health care workers must keep this in mind when trying to interview or help patients who have recently been involved in a car accident.

Other studies show that patients with a previous history of treatment for neck or back pain are much more likely to have a poor prognosis. Management of the problem may be approached quite differently under these circumstances. Not knowing this information could compromise quality of care.

Angus S. Don, FRACS, and Eugene J. Carragee, MD. Is the Self-Reported History Accurate in Patients with Persistent Axial Pain After a Motor Vehicle Accident? In The Spine Journal. January 2009. Vol. 9. No. 1. Pp. 4-12.



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Comments

I've heard something @ news

I've heard something @ news that he was in a Jeep Levittown when the crash happened, and if it wasn't for that car..I don't think that he would be alive at all. It's all at psychological level - it's very important to know how to control your mind, to think in the way that it should be bringing just the good stuff back to you.

Denver

Denver Chiropractors

Interesting study and interesting correlations. I think the author should have took into the consideration other parasite variables like age, sex or level of education. I also think that the time should be an other condition of a group.

Yes there are many cases

Yes there are many cases where record doesn't match.
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That is why I think that

That is why I think that having health care insurance and accidental insurance is a must. While paying the premium you do feel that it is all a waste but when the time comes it is all very useful.

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An accident recovery is not

An accident recovery is not an easy process, depending on the severity of the accident it can take months to heal and recover. But you will at some point have to return to work and start leading as normal a life as you can. You do life with the risk of aggravating the injury, at the same time you can take some precautions to not allow the injury to flare up because of work.

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it is quite common for a sportsperson to get injured. From Players like Tiger Woods to Rafal Nadal have picked up career threatening injuries. If you have a good Sports PR agency as your representative then handling the media can be a lot easier.

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It happened in the winter of

It happened in the winter of 1999. I drove my friend's car. We were going out for something to eat. Driving along a motorway we hit some ice and I lost control. After sliding 500 feet we flipped over into a ditch. Neither of us was wearing a seat belt. I ended up lying across my friend's lap unable to move. At the hospital I was diagnosed with a fracture of the C5 vertebra and a badly injured vertebral canal. The doctors told me "You will never be able to walk again.Used Car India

A thorough diagnostic tests

A thorough diagnostic tests and follow-up examinations must be done in a timely manner. My brother had card accident, had a spinal injury and he uses a special mesh office chairs for his back, while at work. We observed him for any seizures and signs of infection. The doctor advised also advised us to have MRI just to be sure that there aren't any fractures or lacerations in the brain.

In the event of an injury or

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This is the correct blog for anybody who desires to find out about this topic.

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It is absolutely right that

It is absolutely right that previous medical record are essential in deciding the best treatment method. If every one follows the safety rules during driving it would be easier to avoid accidents. Also keeping a toolbox in the car is vital so that when it breaks down it could be fixed promptly.

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