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Allied Health: Articles of Interest

Validity of self-reported data in research
By Karissa M. Luckett, RN, BSN, MSW, AE-C

The use of self-reported data in research can be viewed as a slippery slope. Numerous studies have questioned the validity of self-reported data, especially within the areas of compliance with medication, and data reports from children. Others make the argument that it is a logical progression that if a patient’s own reported medical history is considered valid and critical to the development of a treatment plan, why would it not be valuable in research as well? It can be a valid component of research especially when some special consideration is taken in the manner and type of information collected.

A few things to consider:

  1. What kind of self-reported data is being requested from the patients? McQuaid et al discuss low validity when assessing medication adherence in children with self-reported data alone. Validity increased when objective measures such as weighing canisters or other electronic monitors were utilized instead.(1) Others suggest if one is designing a study assessing medication adherence, self reports should be used in conjunction with objective measures to achieve the highest possible validity. Higher validity has also been noted in reports of healthcare utilization when compared to actual claims data.(2) Reports of healthcare utilization have long been a standard measure set in the study of chronic disease states such as asthma and diabetes; so it is encouraging that there are many studies that validate the general accuracy with which patients report this data.

  2. What is the time frame in which patients are asked to recall information?

    Most researchers agree that higher validity is gained when asking patients to recall data within shorter time periods, such as 14 days or less. It is also noted that data collected via prospective diary entries results in less recall bias.(3)

    To improve accuracy researchers should review entries with patients to reinforce the importance of the data they are collecting and to clarify any questionable data.

  3. The method of self-reported data collection is important. Higher validity is noted when a structured interview is utilized. Norwick et al highlighted the additional protection of data integrity offered by the utilization of repeated measures.(4) When using repeated measures the data supplied by a subject is trended, and compared to the other responses given by the same patient over time. Thus the actual rating in whatever scale that is used is less meaningful than the changes over time. Structured interviews are also thought to produce data of higher caliber due to the clarity and precision that can be assured among the data collected between participants. The use of end-measure testing in conjunction with a structured interview is thought to produce the greatest validity. Many studies have demonstrated the effectiveness of this combination.(5,6)

Utilizing self-reported data does require a careful research design and deliberate planning. The time and work which some feel this type of information requires may tend to discourage its use. Norwick et al are quick to reiterate that “there is no excuse for dismissing a potentially important source of insight into human experience just because it requires care to put in into practice.”(4)

1. McQuaid E, Kopel S, Klein R, Fritz G. Medication adherence in pediatric asthma: reasoning, responsibility, and behavior. Journal of Pediatric Psychology 2003;28(5) 323-333.

2. Lynne D. Diabetes disease management in managed care organizations. Disease Management 2004: 7(1) 47-60.

3. Hensley MJ, Chalmers A, Clover K, Gibson PG, et al. Symptoms of asthma: comparison of a parent completed retrospective questionnaire with a prospective daily symptom diary. Pediatric Pulmonology 2003: 36, 509-513.

4. Norwick R, Choi S, Ben-Shachar, T. In defense of self reports. OBSERVER 2002: [on-line] http://www.psychologicalscience.org/observer/getArticle.cfm?id=911

5. Put C, Van de Buergh O, Demedts M, Verleden G. A study of the relationship among self-reported noncompliance, symptomology, and psychological variables in patients with asthma. Journal of Asthma. 2000: 37(6) 503-510.

6. Christensen AE, Tobiassen M, Jensen TK, Wielandt H, et al. Repeated validation of parental self-reported smoking during pregnancy and infancy: a prospective cohort study of infants at high risk for allergy development. Paediatric Perinatal Epidemiology 2004: 18(1) 73-79.

7. Baker AJ, Soden LM, The challenges of parent involvement research. ERIC Digest 1998: 134 [on-line] http://www.ericdigests.org/1998-3/parent.html

8. Guevara JP, Wolf FM, Grum CM, Clark NM. Effects of educational interventions for self management of asthma in children and adolescents: systematic review and meta-analysis, BMJ 2003: 326, 1308-1314.

9. Young B, Fitch GE, Dixson-Woods M, Lambert PC, Brooke AM. Parents’ accounts of wheeze and asthma related symptoms: a qualitative study. ARCH Dis Child 2002: 87, 131-134.

10. NIH Policy and Guidelines on the inclusion of children as participants in research involving human subjects. 1998 [on-line] http://grants.nih.gov//grants/guide/notice-files/not98-024.html

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