Past medical history (PMH) in oncology: Which is the best source, the doctor or the patient? A prospective double blind study

e17539 Background: The usual way in which Argentinean doctors (Dr) register a patient’s (Pt) PMH in the Clinical record (CR) is the anamnesis. It has proved to be quite heterogeneous. At the Instituto Oncológico Henry Moore (IOHM) a PMH form was designed to be filled out by the Pt before the interview. The objective of this paper is to compare and contrast the amount and quality of PMH information registered by Pt and Dr through a double blind study in order to assess the usefulness of the PMH form. Methods: Between Dec 13th and Dec 20th, 2012, data was collected from all new Pt assisted at the IOHM. In the case that the PMH registered a severe pre-existing condition that was not present in the CR, the physician in charge was made aware of this fact. By indication of the IRB, an interim analysis had to be carried out a week after the study had begun. If the quantity of information proved to be 25% greater or the quality proved to be 5% greater in favor of Pt, the study should be finished. Results: A total of 73 P were included in a prospective double blind study. Sex: 42 males/31 females; Mean age 58.7y (range 21-88); Tumor diagnosis: urological 24, gynecological 17, gastrointestinal 11, other 21. PMH forms filled out by Pt showed 878 pre-existing medical conditions: mean 12 (range 1-35); the CR filled out by Dr showed 453 pre-existing medical conditions: mean 6 (range 0-21). In 3 CR, Dr registered data that Pt had not. A total of 67 CR (92%) showed less data than the PMH, Mean 6 (range 1-21). Quality analysis demonstrated that 15% of the unregistered data could be relevant in medical decisions. Due to the overwhelming differences between registries, the study was finished and the Pt´s PMH form was included as part of the CR at the IOHM. Conclusions: 1) The quality and quantity of data acquired by using the PMH form far exceeds that of the data registered by doctors in CR. 2) In 15% of all the cases, this information could be relevant in medical decision making. 3) In only 3 cases, doctors registered more data than patients using the PMH form. 4) A form filled out by the patient and reviewed by the doctors could be a significant tool on preventing malpractice.