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International Journal of Legal Medicine Sep 2021The present review is intended to provide an up-to-date overview of the strategies available to detect malingered symptoms following whiplash. Whiplash-associated... (Review)
Review
OBJECTIVE
The present review is intended to provide an up-to-date overview of the strategies available to detect malingered symptoms following whiplash. Whiplash-associated disorders (WADs) represent the most common traffic injuries, having a major impact on economic and healthcare systems worldwide. Heterogeneous symptoms that may arise following whiplash injuries are difficult to objectify and are normally determined based on self-reported complaints. These elements, together with the litigation context, make fraudulent claims particularly likely. Crucially, at present, there is no clear evidence of the instruments available to detect malingered WADs.
METHODS
We conducted a targeted literature review of the methodologies adopted to detect malingered WADs. Relevant studies were identified via Medline (PubMed) and Scopus databases published up to September 2020.
RESULTS
Twenty-two methodologies are included in the review, grouped into biomechanical techniques, clinical tools applied to forensic settings, and cognitive-based lie detection techniques. Strengths and weaknesses of each methodology are presented, and future directions are discussed.
CONCLUSIONS
Despite the variety of techniques that have been developed to identify malingering in forensic contexts, the present work highlights the current lack of rigorous methodologies for the assessment of WADs that take into account both the heterogeneous nature of the syndrome and the possibility of malingering. We conclude that it is pivotal to promote awareness about the presence of malingering in whiplash cases and highlight the need for novel, high-quality research in this field, with the potential to contribute to the development of standardised procedures for the evaluation of WADs and the detection of malingering.
Topics: Biomechanical Phenomena; Humans; Lie Detection; Malingering; Neuropsychological Tests; Self Report; Symptom Assessment; Whiplash Injuries
PubMed: 33829284
DOI: 10.1007/s00414-021-02589-w -
Cureus Jun 2022Factitious disorder (FD) is a psychiatric illness in which an individual assumes the role of a patient by manifesting physical or psychological symptoms without...
Factitious disorder (FD) is a psychiatric illness in which an individual assumes the role of a patient by manifesting physical or psychological symptoms without conscious or obvious reward. Here, we present the case of a 28-year-old female with a history of endotracheal intubations 19 times secondary to anaphylaxis. During the current hospital visit, she complained of cough, shortness of breath (SOB), arthralgia, wheezing, and rashes over the chest. Serum C1 esterase inhibitor and C4 levels have been negative on multiple occasions. A previous laryngoscopy showed a normal larynx, normal vocal cords, and no obstruction. Due to the patient's history of multiple invasive procedures, malingering was considered a possible differential diagnosis. The patient also has a past psychiatric history of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), adjustment disorder with anxious mood, and anxiety disorder. Her complicated psychiatric history coupled with her multiple endotracheal intubations associated with normal laboratory findings raise the suspicion of factitious disorder. This case is meant to demonstrate the complicated matter of helping a patient whose psychiatric illnesses have put her at risk of serious health complications for the sake of assuming a sick role.
PubMed: 35795523
DOI: 10.7759/cureus.25638 -
PloS One 2021Diagnostic tests for hearing impairment not only determines the presence (or absence) of hearing loss, but also evaluates its degree and type, and provides physicians...
Diagnostic tests for hearing impairment not only determines the presence (or absence) of hearing loss, but also evaluates its degree and type, and provides physicians with essential data for future treatment and rehabilitation. Therefore, accurately measuring hearing loss conditions is very important for proper patient understanding and treatment. In current-day practice, to quantify the level of hearing loss, physicians exploit specialized test scores such as the pure-tone audiometry (PTA) thresholds and speech discrimination scores (SDS) as quantitative metrics in examining a patient's auditory function. However, given that these metrics can be easily affected by various human factors, which includes intentional (or accidental) patient intervention, there are needs to cross validate the accuracy of each metric. By understanding a "normal" relationship between the SDS and PTA, physicians can reveal the need for re-testing, additional testing in different dimensions, and also potential malingering cases. For this purpose, in this work, we propose a prediction model for estimating the SDS of a patient by using PTA thresholds via a Random Forest-based machine learning approach to overcome the limitations of the conventional statistical (or even manual) methods. For designing and evaluating the Random Forest-based prediction model, we collected a large-scale dataset from 12,697 subjects, and report a SDS level prediction accuracy of 95.05% and 96.64% for the left and right ears, respectively. We also present comparisons with other widely-used machine learning algorithms (e.g., Support Vector Machine, Multi-layer Perceptron) to show the effectiveness of our proposed Random Forest-based approach. Results obtained from this study provides implications and potential feasibility in providing a practically-applicable screening tool for identifying patient-intended malingering in hearing loss-related tests.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Audiometry, Pure-Tone; Auditory Threshold; Child; Child, Preschool; Computational Biology; Discrimination Learning; Female; Hearing; Hearing Loss; Humans; Infant; Infant, Newborn; Machine Learning; Male; Middle Aged; Models, Statistical; Neural Networks, Computer; Reproducibility of Results; Republic of Korea; Speech Perception; Speech Reception Threshold Test; Young Adult
PubMed: 34972151
DOI: 10.1371/journal.pone.0261433 -
British Medical Journal Jan 1950
Topics: Emphysema; Humans; Malingering; Pulmonary Emphysema
PubMed: 15404168
DOI: 10.1136/bmj.1.4645.105 -
Journal of Neurology, Neurosurgery, and... Dec 1995
Topics: England; France; Headache; History, 19th Century; Humans; Literature, Modern; Malingering; Medicine in Literature
PubMed: 7500104
DOI: 10.1136/jnnp.59.6.632 -
British Medical Journal Nov 1968
Topics: Audiometry; Auditory Threshold; Cochlea; Hearing Disorders; Humans; Malingering; Meniere Disease; Organ of Corti; Otosclerosis; Speech
PubMed: 5683586
DOI: No ID Found -
The Medico-legal Journal 2011
Review
Topics: Deception; Forensic Psychiatry; Humans; Interview, Psychological; Malingering
PubMed: 21908492
DOI: 10.1258/mlj.2011.011023 -
British Medical Journal Sep 1942
PubMed: 20784448
DOI: 10.1136/bmj.2.4264.359 -
Sensors (Basel, Switzerland) Sep 2020Visual evoked potential (VEP) has been used as an alternative method to assess visual acuity objectively, especially in non-verbal infants and adults with low... (Review)
Review
Visual evoked potential (VEP) has been used as an alternative method to assess visual acuity objectively, especially in non-verbal infants and adults with low intellectual abilities or malingering. By sweeping the spatial frequency of visual stimuli and recording the corresponding VEP, VEP acuity can be defined by analyzing electroencephalography (EEG) signals. This paper presents a review on the VEP-based visual acuity assessment technique, including a brief overview of the technique, the effects of the parameters of visual stimuli, and signal acquisition and analysis of the VEP acuity test, and a summary of the current clinical applications of the technique. Finally, we discuss the current problems in this research domain and potential future work, which may enable this technique to be used more widely and quickly, deepening the VEP and even electrophysiology research on the detection and diagnosis of visual function.
Topics: Adult; Electroencephalography; Evoked Potentials, Visual; Humans; Infant; Vision, Ocular; Visual Acuity
PubMed: 32998208
DOI: 10.3390/s20195542