Medical records don’t always match what patients say

From Reuters:

Symptoms that patients describe to doctors may not always be documented in electronic medical records, a small U.S. study suggests.

To test out how well the records match reality, researchers compared symptoms that 162 patients checked off on paper-based questionnaires with the information entered in patients’ electronic charts at eye clinics.

Roughly one-third of the time, data on blurry vision from the paper questionnaires didn’t match the electronic records, researchers report in JAMA Ophthalmology. Symptom information also didn’t match for glare 48 percent of the time and was discordant in 27 percent of cases for pain and 25 percent for redness.

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