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Inability of patients to self-diagnose wound infections
Abstract:
At the time of follow-up wound inspection or suture removal, 433 patients were questioned about signs of wound infection. Patients' answers were compared to evaluations by medical examiners. Patients frequently failed to recognize infection and signs of inflammation. When asked if wound infection was present, patients' false positive diagnostic rate was only 8%, but the false negative diagnostic rate was 48%. Medical examiners diagnosed wound infection in 21 wounds, and patients correctly identified their infections in only 11 of these cases. These results indicate that for the population studied, patients cannot be expected to recognize infection in their own wounds using verbal or printed instructions. Clinical investigators of wound healing should not use patient-reported data about wound infection that is obtained by telephone interview or other means.
Insights
Patients often fail to recognize wound infections, even with instructions. Medical professionals should not rely on patient self-reports for diagnosing wound infections in clinical research.
Area of Science:
- Surgical Site Infections
- Patient-Reported Outcomes
- Wound Healing Research
Background:
- Accurate identification of surgical site infections (SSIs) is crucial for patient outcomes.
- Patient self-assessment of wound status is increasingly used in remote monitoring and clinical trials.
- The reliability of patient-reported data for detecting wound complications requires validation.
Purpose of the Study:
- To evaluate the accuracy of patient self-diagnosis of wound infection compared to medical examiner assessments.
- To determine the false positive and false negative rates of patient-reported wound infection.
- To inform best practices for data collection in wound healing studies.
Main Methods:
- A prospective study involving 433 patients undergoing wound inspection or suture removal.
- Patients were questioned about signs of wound infection.
- Patient responses were compared against objective evaluations by medical examiners.
Main Results:
- Patients demonstrated a high rate of failure in recognizing wound infection and inflammation.
- The false negative diagnostic rate for patient self-reporting was 48%.
- Patients correctly identified only 11 out of 21 infections diagnosed by medical examiners.
Conclusions:
- Patients cannot reliably detect their own wound infections based on verbal or printed instructions.
- Patient-reported data on wound infection, especially via telephone, is unreliable for clinical investigators.
- Relying on patient self-assessment for wound infection diagnosis in research settings is not recommended.