If they are not emotionally invested in the outcome, patients/clients are generally reliable sources of past medical information. When conflicted emotions are involved, recall is materially distorted. Having to prove tortious causation renders self-report unreliable.
If they are not emotionally invested in the outcome, patients/clients are generally reliable sources of past medical information. When patients are reporting past medical history to provide attending physicians with context for their current symptoms, clinical research 1, 2, 3 consistently finds good agreement between information from different sources. Thus correlation is fairly high between contemporaneous interview, retrospective history, health diary and clinical records.
However, mothers newly delivered of infants that were in any way malformed were significantly more accurate reporters of exposure factors during pregnancy 4.
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PRACTICE POINT Whereas anxiety to understand cause can increase reporting accuracy, conflicted emotion materially distorts medical recall |
When conflicted emotions are involved, recall is materially distorted. Recall is noticeably less accurate for behaviours that might be viewed as undesirable, such as ever smoking 1, or drinking more than moderate amounts of alcohol.
International studies consistently show that men report 5 significantly more previous heterosexual partners than do women - up to eight times as many in some US studies.
Both obese and non-obese women in a metabolic unit under-reported nutritional intake in their 24-hour diaries, consistently failing to acknowledge snacks between main meals 6.
Having to prove tortious causation renders self-report unreliable. It is the everyday experience of personal injury litigators that the claimant's recall of symptom evolution is more favourable to the case than are the pre-injury and contemporaneous clinical records.
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PRACTICE POINT Pre-injury as well as contemporaneous clinical records should be routinely examined before symptoms are attributed to injury |
In the client's memory, complaints crucial to causation usually appear, for the first time, immediately after the injury. All too often, the medical records show either a pre-injury pattern of similar symptoms, or a delay of weeks or months between injury and first documentation of the complaint.
Treating physicians and independent medical examiners for the claimant characteristically show insufficient scepticism for the claimant's retrospective account of symptom development.
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PRACTICE POINT Whenever there is any doubt, litigators should challenge treating and independent physicians to explain what leads them to attribute cause, other than the client's recall |
Clinical research on revisionist memory for compensable injury is remarkably sparse.
Compensation for injury caused patients to under-report the presence of prior back pain or neck pain. When they did so report, claimants overwhelmingly attributed previous back pain or neck pain to other compensable injuries 7.
Among hospital employees, 3 out every 5 without back injury acknowledged back discomfort during or after performing everyday tasks. By contrast, only 1 out of every 5 back-injured employees said they had any back symptoms prior to injury 8.
In a similar study 9 of neck pain, only 16% of the employees who had suffered a neck injury acknowledged pre-injury neck discomfort during or after everyday tasks, whereas 34% of uninjured employees reported such discomfort.
Referenced
Articles:
Personal Injury News: Post
Hoc, Volume 4, Issue I, 1998
Copyright © 2008 Electronic Handbook of Legal Medicine