Are parent-supplied health history reliable?

USA: A study is throwing into question the accuracy of parent-supplied health history in a dental setting.

In the study published in the Journal of the American Dental Association, the researchers conducted a retrospective chart review on 863 paediatric patients in which parent-reported histories were compared with subsequent physician-to-dentist consultations.

Wide variations in sensitivity

Among the six health conditions included in the research analysis, they found wide variations in sensitivity – with the highest sensitivity involving children with mental and behavioural disorders.

Based on their findings, the researchers are cautioning dentists against solely relying on parents when obtaining health histories of paediatric patients.

“To ensure up-to-date and accurate documentation of patients’ health histories, dentists should obtain medical consultations before providing dental treatment for patients with incomplete medical histories of special health care needs,” the study authors wrote, led by Dr Christine Chiao, MPH, of Boston University.

Parent groups and medical categories

The study group consisted of 226 children (99 girls, 127 boys), with a mean age of 10.35 years. The patients were divided into 2 groups based on the medical status of their children (healthy vs medically compromised).

For the medically compromised children, parents had high sensitivity reporting rates (>75% sensitivity) for only 2 out of the 9 medical categories.

For both groups, less than half of the “medicine, allergy, and need for prophylaxis” categories recorded sensitivity rates above 75%. Failure-to-report rates of 40% to 60% were common, with some as high as 80%. Weighted failure-to-report rates were consistently higher for medically compromised children compared to healthy children.

The collected data focused on knowledge of the child’s medical conditions, current medications, allergies, immunization status, and need for prophylactic antibiotics. Corresponding data were collected from the child’s medical chart.

Sensitivity of parental reporting by category

Varying accuracy levels of parental reports of pediatric patients’ health histories were observed across the medical categories.

The sensitivity of parental reporting were recorded for each category: Mental and behavioral health disorders (75.1%); nervous system diseases (63%); respiratory conditions (47.9%); congenital conditions (46.3%); and cardiovascular conditions (25%). The lowest sensitivity was for hematologic conditions (12.2%).

Based on previous research, some causes of inaccurate parental reporting have been suggested, including lack of communication between parents; confusion; forgetfulness and poor recall; lack of knowledge; shame and stigma; and intentional concealment so that desired outcomes are more likely.

The researchers also noted a lack of cultural and linguistic services at both dental and medical offices that may have hindered clear communication between patients and the healthcare providers.