A comparison of response error by adolescents and adults: findings from a health care study

Most assessments of response error have focused only on reports by adult respondents; we know little about the propensity to misreport or the magnitude or direction of response error for self-reports by adolescents. To the extent that adults and adolescents differ in the magnitude or direction of response error, comparisons between adults and adolescents will be confounded. This study compares the quality of self-response among adolescents and adults in their reporting of health conditions and health care utilization.

Approximately 2,000 members of an HMO were interviewed, and by use of medical record information, the accuracy of their responses was assessed for several measures: number of outpatient visits, date of the most recent outpatient visit, site of care, type of professional seen during the last visit, and an indicator as to whether the respondent had asthma.

The findings indicate that both the magnitude and the direction of response error vary by the age of the respondent. In multivariate models predicting erroneous response, adolescents were more likely to misreport than were adult respondents. In addition, among erroneous respondents, adolescents tended to err in the direction of overreporting, whereas adult respondents tended to err in the direction of underreporting.

Although the results should be viewed cautiously because of limitations in both the sample design and the survey topic, the findings suggest that substantive comparisons of health care utilization between adolescents and adults may be confounded by differential measurement error.