The reliability of medical illness reporting in a randomized clinical trial.

<h4>Background/objective</h4>Reported medical disorders from population surveys, medical records, and clinical trials, may not be accurate and methods are needed to improve confirmation. We report the accuracy of reported prevalence of medical disorders in a clinical trial and comparison...

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Main Authors: Rachelle Morgenstern, Avi Reichenberg, Benjamin Kummer, Nathalie Jette, Mark J Kupersmith
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0320759
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author Rachelle Morgenstern
Avi Reichenberg
Benjamin Kummer
Nathalie Jette
Mark J Kupersmith
author_facet Rachelle Morgenstern
Avi Reichenberg
Benjamin Kummer
Nathalie Jette
Mark J Kupersmith
author_sort Rachelle Morgenstern
collection DOAJ
description <h4>Background/objective</h4>Reported medical disorders from population surveys, medical records, and clinical trials, may not be accurate and methods are needed to improve confirmation. We report the accuracy of reported prevalence of medical disorders in a clinical trial and comparison with potential verification methods.<h4>Methods</h4>We report the prevalence of 11 medical disorders, utilizing prospectively collected data from 729 participants in an eight-country multicenter clinical treatment trial on non-arteritic anterior ischemic optic neuropathy (NAION). We chose disorders where the medical history was potentially verifiable. We determined the prevalence using four methods: Method (M)1: Participant and medical health record reporting; M2: Physical examination, clinical tests; M3: Medication indications; M4: Combining M2 and M3. We estimated concordance between M1 and the other methods using Cohen's kappa (K) statistic.<h4>Results</h4>Prevalence of the medical disorders based on M1 were lower than for either M2 or M3, depending on the disorder, and consistentlly lower for M4. For M1 and M4, moderate concordance (K ≥ 0.50) was observed only for psychiatric disorders (K = 0.52) and prior NAION (K=0.67). The prevalence and concordance for M1 and M4 for anemia, hypertension, diabetes and psychiatric disease were the only disorders that differed between females and males. For all methods, the prevalence varied widely across countries. Concordance for M1 and M4 varied and moderate concordance occurred for psychiatric disorders and prior NAION.<h4>Conclusion</h4>Even with prospective, rigorously collected data, medical histories do not reliably identify all medical disorders. Adding the results of physical examination, laboratory tests, and medications increases the accuracy of reporting. This strategy could be adapted for clinical trials and electronic medical record disease-prevalence data mining.
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spelling doaj-art-ceee08ee81e4459db78a54386fee12912025-08-20T02:01:24ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01204e032075910.1371/journal.pone.0320759The reliability of medical illness reporting in a randomized clinical trial.Rachelle MorgensternAvi ReichenbergBenjamin KummerNathalie JetteMark J Kupersmith<h4>Background/objective</h4>Reported medical disorders from population surveys, medical records, and clinical trials, may not be accurate and methods are needed to improve confirmation. We report the accuracy of reported prevalence of medical disorders in a clinical trial and comparison with potential verification methods.<h4>Methods</h4>We report the prevalence of 11 medical disorders, utilizing prospectively collected data from 729 participants in an eight-country multicenter clinical treatment trial on non-arteritic anterior ischemic optic neuropathy (NAION). We chose disorders where the medical history was potentially verifiable. We determined the prevalence using four methods: Method (M)1: Participant and medical health record reporting; M2: Physical examination, clinical tests; M3: Medication indications; M4: Combining M2 and M3. We estimated concordance between M1 and the other methods using Cohen's kappa (K) statistic.<h4>Results</h4>Prevalence of the medical disorders based on M1 were lower than for either M2 or M3, depending on the disorder, and consistentlly lower for M4. For M1 and M4, moderate concordance (K ≥ 0.50) was observed only for psychiatric disorders (K = 0.52) and prior NAION (K=0.67). The prevalence and concordance for M1 and M4 for anemia, hypertension, diabetes and psychiatric disease were the only disorders that differed between females and males. For all methods, the prevalence varied widely across countries. Concordance for M1 and M4 varied and moderate concordance occurred for psychiatric disorders and prior NAION.<h4>Conclusion</h4>Even with prospective, rigorously collected data, medical histories do not reliably identify all medical disorders. Adding the results of physical examination, laboratory tests, and medications increases the accuracy of reporting. This strategy could be adapted for clinical trials and electronic medical record disease-prevalence data mining.https://doi.org/10.1371/journal.pone.0320759
spellingShingle Rachelle Morgenstern
Avi Reichenberg
Benjamin Kummer
Nathalie Jette
Mark J Kupersmith
The reliability of medical illness reporting in a randomized clinical trial.
PLoS ONE
title The reliability of medical illness reporting in a randomized clinical trial.
title_full The reliability of medical illness reporting in a randomized clinical trial.
title_fullStr The reliability of medical illness reporting in a randomized clinical trial.
title_full_unstemmed The reliability of medical illness reporting in a randomized clinical trial.
title_short The reliability of medical illness reporting in a randomized clinical trial.
title_sort reliability of medical illness reporting in a randomized clinical trial
url https://doi.org/10.1371/journal.pone.0320759
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