Patient Doctor Lies

Study Overview
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Brief Summary
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Accurate patient information disclosure is critical to provide optimal treatment. Methods that can detect and then increase the truthfulness of information are relatively unknown. To investigate the impact of communication about privacy, benefits, and risk on patient truthfulness, the investigators test two new methods to detect patient truthfulness and demonstrate the effects of privacy notices (e.g. HIPPA statements). Participants include a national online sample randomly assigned to one of six treatment statements that might be typically given before health information was requested. The assigned treatments include one or mix of the following: privacy notice, statement of the benefits of accurate disclosure, and statement of the risks of inaccurate disclosure and control of no statement before being asked typical health questions. The investigators propose that based on elaboration likelihood model, statements reminding participants of their privacy will increase lying. The investigators hypothesis the use of a new biometric mouse movement lie detection method and answer adjustment can measure patient lies. The investigators hypothesis that reminders of the risk of not telling the truth will reduce lying due to risk aversion. Lastly the investigators hypothesis that statements of benefits of answering truthfully will increase truthfulness.

Detailed Description
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After agreeing to an IRB-approved modified consent form designed to hide the true purpose of the study to detect lying, all participants will complete the CESD-10 depression scale. This validated measure of depression was used in order to simulate the false pretense of the experiment. This online survey randomly assigns participating adults to one of six intervention statements after which they are asked eight typical questions about their health. The statements include: control (no stimuli) benefit (statement about the benefits of accurate information disclosure) risk (statement about the risks of inaccurate information disclosure) privacy (a traditional medical privacy notification and seal image) privacy + benefit privacy + risk After this intervention participants are asked to disclose eight items of personal health information, including their weight, height, alcohol intake, illegal drug use, prescription drug abuse, smoking, exercise, and sexual activity. We do not assess these actual numbers. They will be the basis for assessing truthfulness by answer adjustment or biometric mouse-movement. An example of an intervention benefit statement followed by a health question about weight reads: What is your weight? Accurately answering this will increase the likelihood of a correct diagnosis. A risk statement reads: What is your weight? Inaccurately answering this will increase the likelihood of an incorrect diagnosis. A privacy statement read: What is your weight? We will not share or sell this personal health information with anyone. We will comply with all HIPPA regulations regarding the protection of your data. The dependent variable - patient truthfulness, will be measured in two ways. First measure of truthfulness will be a biometric mouse-movement measure. As participants answer the health care questions coded programming will measure the mouse-movement arc distance and time to response for biometric lie detection. This measurement is completed when participants move to their response to each health question. Second measure of truthfulness will be the answer adjustment method. Participants will be given a summary of their answers from their health questions in a read-only format and asked to indicate how OVER of UNDERSTATED each initial response was (e.g., You indicated that your current weight is 185 lbs. How overstated or understated is that value?) on a scale from -5 (understated) to 5 (overstated). The absolute value of their scaled response represents the extent to which participants' initial response deviated from the truth. This the unit of measure to be used in analysis. The answer adjustment values and the mouse tracking results provide a more holistic measure of truthfulness than one alone. No personal identifiers are collected. Age and gender are collected.

Official Title
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Patient Doctor Lies: When is Privacy Assurance a Bad Thing? A Randomized Clinical Trial

Conditions
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Patient Lying, Privacy Statements, Risk Statements, Benefit Statements, Patient Lie Detection

Intervention / Treatment
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* Behavioral: Benefit statement
* Behavioral: Risk Statement
* Behavioral: Privacy Statement
* Behavioral: Benefit + Privacy
* Behavioral: Risk + Privacy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults Individuals 18-80 years English speaking Live in the United States Exclusion Criteria: Participants that do not complete the survey

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants are randomly assigned one of 1 intervention statements and then asked health care questions. This is a between subject 6 cell study, the dependent variable is the amount of lying as measured by answer adjustment and biometric mouse-movement under each intervention statement.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>No statement is provided before asking the health care question. Example: What is your weight in pounds? | |
| Experimental: Benefit Statement<br>A statement of benefit will be given (see intervention) after the health question. | Behavioral: Benefit statement<br>* The participant reads this statement after asked one of eight health questions What is your height in inches? What is your weight in pounds? How many days out of the last 2 weeks did you drink alcohol? How often a month do you use other substance such as marijuana, cocaine, ecstasy, or other drugs How often a month do you use Rx or non-Rx medications to excessive amounts? When was the last time you smoked a cigarette? How many days in the last 2 weeks did you engage in more than 30 min exercise? How many times did you engage in sexual activity in the last month with another individual? . The statement reads: Accurately answering this will increase the likelihood of a correct diagnosis. An example of this with one of the 8 health questions is... What number of days in the last 2 weeks you engaged in >30 minutes of exercise? Accurately answering this will increase the likelihood of a correct diagnosis.<br>|
| Experimental: Risk Statement<br>A statement of risk will be given (see intervention) after the health question. | Behavioral: Risk Statement<br>* The participant reads this statement after being asked one of eight health questions. The statement reads: Inaccurately answering this will increase the likelihood of an incorrect diagnosis.<br>|
| Experimental: Privacy Statement<br>A statement of privacy will be given (see intervention) after the health question. | Behavioral: Privacy Statement<br>* The participant reads this statement after being asked one of eight health question for example. We will not share or sell this personal health information with anyone. We will comply with all HIPPA regulations regarding the protection of your data.<br>|
| Experimental: Benefit + Privacy statement<br>A statement of benefit and privacy will be given (see intervention) after the health question. | Behavioral: Benefit + Privacy<br>* The statement reads Accurately answering this will increase the likelihood of a correct diagnosis. We will not share or sell this personal health information with anyone. We will comply with all HIPPA regulations regarding the protection of your data.<br>|
| Experimental: Risk + privacy statement<br>A statement of risk and privacy will be given (see intervention) after the health question. | Behavioral: Risk + Privacy<br>* The statement reads Inaccurately answering this will increase the likelihood of an incorrect diagnosis. We will not share or sell this personal health information with anyone. We will comply with all HIPPA regulations regarding the protection of your data.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient truthfulness - biometric mouse-movement distance | The measure of the distance (mm) the mouse travels to the response. | The time frame of data collection will be from when the survey is opened by the participant until it is completed and submitted. This will take 10 - 20 minutes. | 
| Patient truthfulness - biometric mouse-movement time | The measure of the time (ms) the mouse travels to the response. | The time frame of data collection will be from when the survey is opened by the participant until it is completed and submitted. This will take 10 - 20 minutes. | 
| Patient truthfulness Weight - answer adjustment from -5 to 5 for each health question | Participants will be given a summary of their answers from their health questions in a read-only format and asked to indicate how over- or understated each initial response was (e.g., You indicated that your current weight is 185 lbs. How overstated or understated is that value?) on a scale from -5 (understated) to 5 (overstated). The absolute value of their response represents the extent to which participants' initial response deviated from the truth. Participant's actual response to the health questions are NOT an outcome measure but rather how much they adjust their answer on a scale of (-5 to +5). | The time frame of data collection will be from when the survey is opened by the participant until it is completed and submitted. This will take 10 - 20 minutes. | 
| Patient truthfulness Height - answer adjustment from -5 to 5 for each health question | Participant will be shown a summary of their answer from their health question (What is your height in inches) and then respond to how much they under represented the information (-5) to being accurate (0) to overstated the information (+5). Participant response will be on a sliding scale -5 to +5 | The time frame of data collection will be from when the survey is opened by the participant until it is completed and submitted. This will take 10 - 20 minutes. | 
| Patient truthfulness Drink Alcohol - answer adjustment from -5 to 5 for each health question | Participant will be shown a summary of their answer from their health question (How many days out of the last 2 weeks did you drink alcohol? (1 = 0 time; 6 = 13-14 times)) and then respond to how much they under represented the information (-5) to being accurate (0) to overstated the information (+5). Participant response will be on a sliding scale -5 to +5 | The time frame of data collection will be from when the survey is opened by the participant until it is completed and submitted. This will take 10 - 20 minutes. | 
| Patient truthfulness Drug Activity - answer adjustment from -5 to 5 for each health question | Participant will be shown a summary of their answer from their health question (How often a month do you use other substance such as marijuana, cocaine, ecstasy, or other drugs (1 = never; 6 = all the time)) and then respond to how much they under represented the information (-5) to being accurate (0) to overstated the information (+5). Participant response will be on a sliding scale -5 to +5 | The time frame of data collection will be from when the survey is opened by the participant until it is completed and submitted. This will take 10 - 20 minutes. | 
| Patient truthfulness Prescription Use - answer adjustment from -5 to 5 for each health question | Participant will be shown a summary of their answer from their health question (How often a month do you use Rx or non-Rx medications to excessive amounts? (1 = never; 6 = all the time)) and then respond to how much they under represented the information (-5) to being accurate (0) to overstated the information (+5). Participant response will be on a sliding scale -5 to +5 | The time frame of data collection will be from when the survey is opened by the participant until it is completed and submitted. This will take 10 - 20 minutes. | 
| Patient truthfulness Cigarette Smoking- answer adjustment from -5 to 5 for each health question | Participant will be shown a summary of their answer from their health question (When was the last time you smoked a cigarette? (1 = 6+ weeks ago to 6 = today)) and then respond to how much they under represented the information (-5) to being accurate (0) to overstated the information (+5). Participant response will be on a sliding scale -5 to +5 | The time frame of data collection will be from when the survey is opened by the participant until it is completed and submitted. This will take 10 - 20 minutes. | 
| Patient truthfulness Exercise Activity- answer adjustment from -5 to 5 for each health question | Participant will be shown a summary of their answer from their health question (How many days in the last 2 weeks did you engage in more than 30 min exercise? (1 = 13-14 times; 6 = 0 times)) and then respond to how much they under represented the information (-5) to being accurate (0) to overstated the information (+5). Participant response will be on a sliding scale -5 to +5 | The time frame of data collection will be from when the survey is opened by the participant until it is completed and submitted. This will take 10 - 20 minutes. | 
| Patient truthfulness Sexual Activity - answer adjustment from -5 to 5 for each health question | Participant will be shown a summary of their answer from their health question (How many times did you engage in sexual activity in the last month with another individual? (1 = 0; 6 = 20+ times)) and then respond to how much they under represented the information (-5) to being accurate (0) to overstated the information (+5). Participant response will be on a sliding scale -5 to +5 | The time frame of data collection will be from when the survey is opened by the participant until it is completed and submitted. This will take 10 - 20 minutes. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gender | Participants will record their gender they identify with - Male or Female | The time frame of data collection will be from when the survey is opened by the participant until it is completed and submitted. This will take 10 - 20 minutes. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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risk, privacy, benefits, patient lies, lie detection