Cognitive Aspects of Recalling and Reporting Health-related Events: Papanicolaou Smears, Clinical Breast Examinations, and Mammograms

Abstract

This paper reports an examination of cognitive processes used by 178 women aged 50 years and older in retrieving information about the frequency with which they received Papanicolaou smears, mammograms, and clinical breast examinations. Women were selected from a health maintenance organization in which they had been enrolled for at least 5 1/2 years. The literature suggested that reporting of regular events such as these kinds of tests is likely to be based on schemas, which is an estimation technique in which events are reported in a format with generic content. Thus, if the procedure is believed to occur annually, the respondent will report receiving five tests in 5 years. The study attempted to evaluate whether use of episodic recall, in which respondents are forced to report individual events, would be more accurate than reports based on estimation using a schema format. The results indicated that most of the errors occurred in Papanicolaou smear reporting, which is consistent with the literature, and that the fewest errors occurred with mammograms. Regardless of the questionnaire format, respondents persisted in using schemas based on the date of annual physical examination. Most reporting errors occurred because the interval between examinations was estimated incorrectly.

Validation of Self-reported Colorectal Cancer (CRC) Screening in a Study of Ethnically Diverse First-Degree Relatives of CRC Cases

“…For subjects who had an endoscopy, multiple physicians may have been involved in the process (e.g., primary care physician made the referral, whereas gastroenterologist conducted the procedure); however, we sought validation from only one physician. The overreporting of all three tests that was observed in our study is generally supported by the literature (1,2,(4)(5)(6)11).…”

“…However, prior research has found that self-report of cancer screening may be inaccurate and prone to biases (1,2). Therefore, validation of self-reports through medical chart audit has long been viewed as the ''gold standard'' for assessing the veracity of self-reports.…”

“…Therefore, validation of self-reports through medical chart audit has long been viewed as the ''gold standard'' for assessing the veracity of self-reports. Most validation studies have focused on breast and cervical cancer screening, and therefore, relatively little information is available about the accuracy of self-report for colorectal cancer (CRC) screening (1). Results of the handful of validation studies focused on CRC screening have yielded inconsistent results.…”

The agreement between self-reported cervical smear abnormalities and screening programme records

“…A number of studies have assessed the accuracy of selfreporting of cervical screening attendance, [5][6][7][8][9][10][11][12][13][14][15][16] but the available data on the accuracy of self-reporting of the occurrence of smear abnormalities are limited. 17,18 Studies examining the accuracy of the self-reporting of screening attendance have consistently found it to be a sensitive method of assessment, but it has a low specificity (i.e.…”

Human papillomavirus and cervical cancer behavioral surveillance in the US

“…62 The highest rates of over-reporting were found among studies conducted in county health departments and public health clinics, and with ethnic populations. Possible reasons for over-reporting include: respondents' use of schemas (eg, associating behavior with a pattern of events such as a regular check-up) 67 and cultural differences. 68 Recent studies have called into question the completeness of medical records in certain settings.…”