Are prisoners reliable survey respondents? A validation of self-reported traumatic brain injury (TBI) against hospital medical records.
OBJECTIVE
To compare prisoners' self-reported history of TBI associated with hospital attendance with details extracted from relevant hospital medical records and to identify factors associated with the level of agreement between the two sources.


METHODS
From a sample of prison entrants, this study obtained a history of TBIs for which medical attention was sought at a hospital. Audit tools were developed for data extraction relevant to any possible TBI from records at a total of 23 hospitals located within New South Wales, Australia. The level of agreement between self-report and hospital records was compared in relation to demographic, psychological and criminographic characteristics.


RESULTS
Of the 200 participants in the study, 164 (82%) reported having sustained a past TBI giving a total of 420 separate TBI incidents. Of these, 156 (37%) were alleged to have resulted in attendance at a hospital emergency department including 112 (72%) at a hospital accessible for the validation exercise. For 93/112 (83%) of reported TBIs, a corresponding hospital medical record was located of which 78/112 (70%) supported the occurrence of a TBI. Lower education and a lifetime history of more than seven TBIs were associated with less agreement between self-report and medical record data with regard to specific details of the TBI.


CONCLUSIONS
Overall, these findings suggest that prisoners' self-report of TBI is generally accurate when compared with the 'gold standard' of hospital medical record. This finding is contrary to the perception of this group as 'dishonest' and 'unreliable'.
Neuropsychiatry Service, Hunter New England Health, NSW, Australia. peter.schofield@hnehealth.nsw.gov.au
Peter
P
Schofield
Tony
T
Butler
Stephanie
S
Hollis
Catherine
C
D'Este
D001930:Brain Injuries / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008499:Medical Records; D009483:Neuropsychological Tests; D009517:New South Wales / Q000453:epidemiology; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014342:Truth Disclosure / Q000941:ethics*