How accurate are patient histories?

Recently there has been a large increase in the use of emergency rooms and screening clinics for the delivery of primary medical care. In these impersonal health care settings physicians must often rely on medical histories obtained from patients over the course of a few minutes without benefit of old records or previous acquaintance with the patient. Few data are available on the accuracy of these histories. In this preliminary investigation we used the history of past admission to the hospital as a marker for the validity of patient responses in an emergency room. Overall, 71 of 114 patients with known previous admissions gave accurate responses when asked why they had previously been admitted to the hospital (62 +/- 4.5 percent). Disease category appears to be a relevant factor in predicting the accuracy of the response, but the number of patients was too small to evaluate other subgroups of patients. Future studies should involve sufficient patients to evaluate the individual contributions of patient characteristics in predicting the accuracy of medical interviews.