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Axial back, neck pain self-reported history inaccurate 50% of the time after a MVA
Histories were found more invalid when subjects perceived the accident was another person’s fault.
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TORONTO — Patient self-reported axial back and neck pain histories after a motor vehicle accident may not be accurate, according to Stanford University School of Medicine investigators.
Angus S. Don, FRACS, and Eugene J. Carragee, MD, found from a systematic, prospective multi-centered study recently published in the Spine Journal that self-reported patient histories of previous axial pain were generally unreliable if patients were in a motor vehicle accident (MVA) that resulted in 3 months of subsequent axial pain.
“These findings are particularly evident in those who perceived the accident to be the fault of another party,” Don said.
Audited records
For this study, they prospectively identified 702 patients from five Stanford-area hospitals with axial pain before and after a MVA, but without major injuries. They randomly selected 335 subjects, audited their medical records, obtained their self-reported histories and compared results with the two instruments for pre-MVA conditions including axial pain, psychological distress, drug or alcohol abuse, diabetes and hypertension.
They found about 50% of subjects had unreported previous axial pain. “Overall 76% of subjects were found to have one or more pre-existing comorbid condition at audit they did not self-report,” according to Don.
Whose fault?
Study subjects indicated whether they thought the MVA was their own or no one’s fault or someone else’s fault and indicated if a compensation claim was filed for the MVA.
The no-fault group’s medical treatment corresponded to more serious injuries and they had higher hospital admission rates. Their self-reported histories indicated higher rates of job loss and functional disability, Don said.
“On self-reported history, there was a significantly higher proportion in the no-fault group to report previous axial neck and back pain, higher previous alcohol or drug abuse and previous psychological troubles,” and other comorbidities, he explained.
“Conversely, the audit of medical records revealed a higher proportion of previous psychological diagnoses along with one or more comorbidities in the perceived fault group,” Don explained.
For more information:
- Angus S. Don, FRACS, can be reached in the Department of Orthopedic Surgery, Stanford University School of Medicine, Stanford, CA 94305; 650-723-4000; e-mail: angusdon@gmail.com. He has no direct financial interest in any products or companies mentioned in this article.
References:
- Don AS. Is the self-reported history accurate in patients with persistent axial pain following a motor vehicle accident? Presented at the North American Spine Society 23rd Annual Meeting. Oct. 15-18, 2008. Toronto.
- Don AS, Carragee EJ. Is the self-reported history accurate in patients with persistent axial pain following a motor vehicle accident? Spine J. 2009; 9(1):4-12.