自我报告中数字偏好的影响

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Objective Simple forms of blood pressure (BP) telemonitoring require patients to text readings to central servers creating an opportunity for both entry error and manipulation. We wished to determine if there was an apparent preference for particular end digits and entries which were just below target BPs which might suggest evidence of data manipulation. Design Prospective cohort study Setting 37 socioeconomically diverse primary care practices from South East Scotland. Participants Patients were recruited with hypertension to a telemonitoring service in which patients submitted home BP readings by manually transcribing the measurements into text messages for transmission (‘patient-texted system’). These readings were compared with those from primary care patients with uncontrolled hypertension using a system in which readings were automatically transmitted, eliminating the possibility of manipulation of values (‘automatic-transmission system’). Methods A generalised estimating equations method was used to compare BP readings between the patient-texted and automatic-transmission systems, while taking into account clustering of readings within patients. Results A total of 44 150 BP readings were analysed on 1068 patients using the patient-texted system compared with 20 705 readings on 199 patients using the automatic-transmission system. Compared with the automatic-transmission data, the patient-texted data showed a significantly higher proportion of occurrences of both systolic and diastolic BP having a zero end digit (OR 2.1, 95% CI 1.7 to 2.6) although incidence was <2% of readings. Similarly, there was a preference for systolic 134 and diastolic 84 (the threshold for alerts was 135/85) (134 systolic BP OR 1.5, 95% CI 1.3 to 1.8; 84 diastolic BP OR 1.5, 95% CI 1.3 to 1.9). Conclusion End-digit preference for zero numbers and specific-value preference for readings just below the alert threshold exist among patients in self-reporting their BP using telemonitoring. However, the proportion of readings affected is small and unlikely to be clinically important. Trial registration number ISRCTN72614272; Post-results.

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Digit preference is the habit of reporting certain end digits more often than others. If such a misreporting pattern is a concern, then measures to reduce digit preference can be taken and monitoring changes in digit preference becomes important. We propose a two‐dimensional penalized composite link model to estimate the true distributions unaffected by misreporting, the digit preference pattern and a trend in the preference pattern simultaneously. A transfer pattern is superimposed on a series of smooth latent distributions and is modulated along a second dimension. Smoothness of the latent distributions is enforced by a roughness penalty. Ridge regression with an L1 ‐penalty is used to extract the misreporting pattern, and an additional weighted least squares regression estimates the modulating trend vector. Smoothing parameters are selected by the Akaike information criterion. We present a simulation study and apply the model to data on birth weight and on self‐reported weight of adults.

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Left-digit bias is a cognitive bias wherein individuals assess the magnitude of numbers by emphasizing the leftmost digit. For instance, people often perceive the difference between $9.99 and $10.00 larger than that between $10.00 and $10.01, given the distinct left digits in the former two numbers. This study associates self-reported height with this cognitive bias. Taller stature is frequently associated with desirable attributes such as higher earnings and leadership positions; individuals may aspire to be taller and, consequently, report a height greater than their actual measurement. We posit that this inclination is more pronounced when combined with left-digit bias. In other words, individuals whose actual height ends in nine, such as 169 cm, are more likely to report their height as 170 cm than individuals with an actual height of 170 cm who report it as 171 cm. To conduct this analysis, we used data from an annual health survey of adolescents in grades 7-12. Our findings indicate that male adolescents exhibit a left-digit bias in reporting their height, whereas female adolescents do not. We contribute to the literature by providing new evidence of left-digit bias.

Background: censuses in developing countries are prone to errors of age misreporting due to ignorance, low literacy levels and other social, economic and cultural factors. Ages are commonly rounded with great affinity for 0 or 5. This tendency to digit preference and/or avoidance results in age heaping or concentration of ages at certain digits. This study examined the extent of digit preference in the Nigerian census data of 1991 and 2006. Methods: this study utilized age data from the 1991 and 2006 Nigerian censuses reported in single years. The Whipple and Myers indices were used to determine the extent of digit preference. Results: both the 1991 and 2006 census data showed the expected pattern of errors, with Whipple and Myers indices being beyond acceptable levels. The Whipple index for 1991 and 2006 was 293 and 251 respectively, while the Myers index was 62.3 and 67.1 respectively. There was a strong preference for terminal digits 0 and 5, followed by 8 whereas terminal digits 1 and 9 were strongly avoided. Conclusions: the quality of age data in Nigerian census data is poor as a result of misreporting and no significant improvement or difference was observed between 1991 and 2006 censuses.

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Abstract Objective To assess the quality and consistency of reported age patterns of female genital mutilation in self- and proxy-reported survey data. Methods We used 10 Demographic and Health Surveys (DHS) from 2005 to 2023 in Senegal. These surveys contained information on female genital mutilation status and age at experiencing this practice for women who reported data on themselves and daughters for whom data were reported by their mothers. We assessed data quality by completeness of information on age at female genital mutilation in a logistic regression analysis. We compared the occurrence of age heaping across DHS and individual survey characteristics such as education, age cohort and completeness of date of birth reporting. We estimated the median age at female genital mutilation of daughters and women to assess the consequences of differences in data quality for the interpretation of survey data on this practice. Findings Self-reported data were more prone to incomplete reporting of age at female genital mutilation and age heaping than proxy-reported data. These findings held true across individual survey characteristics and different DHS. The estimates for median age at female genital mutilation were susceptible to differences in data quality of age at female genital mutilation of daughters and women. Conclusion Self-reported data on age at female genital mutilation are of lower quality than proxy-reported data. These differences potentially distort trend estimates of age at female genital mutilation. Caution is needed when combining self- and proxy-reported survey data on female genital mutilation.

ABSTRACT: The procedure used to analyse a data set which includes only censored or incomplete spells is examined in this paper. First of all, the distributions of incomplete spell durations are analysed without explanatory variables (such as age, gender, and so on), assuming that unobserved completed spells have a Weibull distribution. The relationships between the mean of the incomplete spells and the mean of the completed spells are reported for first-job seekers, unemployed, employed and self-employed workers. Given that the unobserved completed spells are Weibull-distributed, the unobserved heterogeneity is introduced on the scale parameter of the Weibull. The heterogeneity, considered as a variable, is analysed for a binomial or Weibull distribution. As the beginning of a spell is a retrospective datum, the recall errors are modelled including the heaping effect. Using some proportional hazards models, the methodology to study the influences of explanatory variables on spell distributions is then described, once again including both the heterogeneity and the heaping effect. On this basis, the lengths of on-going spells of unemployment for first-job seekers and unemployed workers are modelled, as well as the current job tenures of employed and self-employed workers.

Abstract Background Objectively defined early onset hypertension, based on repeated blood pressure measurements, is a strong risk factor for cardiovascular disease (CVD). We aimed to assess if also self-reported hypertension onset age is associated with hypertension-mediated organ damage (HMOD). Additionally, we evaluated the agreement between self-reported and objectively defined hypertension onset age. Methods We studied 2,649 participants (50 ± 4 years at the time of outcome assessment, 57% women) of the Coronary Artery Risk Development in Young Adults (CARDIA) study who underwent measurements for echocardiographic left ventricular hypertrophy (LVH), left ventricular diastolic dysfunction (LVDD), coronary calcification, and albuminuria. We divided the participants into groups according to self-reported hypertension onset age (<35 years, 35–44 years, ≥45 years, and no hypertension). We used multivariable-adjusted logistic regression models to assess the relation between self-reported hypertension onset age with the presence of HMOD, with those who did not report hypertension as the referent group. Results Compared with individuals without self-reported hypertension, self-reported hypertension onset at <35 years was associated with LVH (odds ratio (OR), 2.38; 95% confidence interval (CI), 1.51–3.76), LVDD (OR, 2.32; 95% CI, 1.28–4.18, coronary calcification (OR, 2.87; 95% CI, 1.50–5.47), and albuminuria (OR, 1.62; 95% CI, 0.81–3.26). Self-reported hypertension onset at ≥45 years was only associated with LVDD (OR, 1.81; 95% CI, 1.06–3.08). The agreement between self-reported and objectively defined hypertension onset age groups was 78–79%. Conclusions Our findings suggest that self-reported hypertension onset age, a pragmatically feasible assessment in clinical practice, is a reasonable method for assessing risk of HMOD and CVD.

BackgroundPrevious studies of the reproducibility of self-reported age at menarche have been limited because of small study samples, short follow-up and the limited age span of the women included.MethodsThe present study assessed the reproducibility of age at menarche in 6731 women with a wide variation of age when giving the information about age at menarche. The women reported age at menarche in a self-administered questionnaire, both in 1986–1987 and 1994–1995. They were all residents of Tromsø, Norway, and aged 25–73 in 1994–1995. In order to investigate the agreement between self-reported age at menarche at the two points in time, Pearson’s correlation coefficient was applied to assess the linear correlation between the reported menarcheal age at the two occasions. Analyses were stratified for age. A Bland-Altman plot was produced and limits of agreement computed.ResultsWe found a high correlation and a strong agreement between self-reported age at menarche in 1986–1987 and 1994–1995. The overall Pearson’s correlation coefficient was 0.84 and was not attenuated by increasing age of the women. The Bland-Altman plot showed a strong agreement in self-reported age at menarche. The mean difference between self-reported age at menarche was 0.01 years with limits of agreement −1.52 to 1.54.ConclusionWe found high reproducibility of self-reported age at menarche. The mean menarcheal age in the two surveys was identical (13.2 years) with 95% of the women reporting the same age at menarche or with a difference of 1 year. Only 0.7% of the women reported age at menarche with a difference of more than 2 years in 1986–1987 and 1994–1995.

BackgroundChild abuse is common and several studies have linked it to health outcomes throughout the lifecourse. Recent information about timing of abuse reported retrospectively is underrepresented in the literature, despite its importance to informing target populations for primary prevention of child abuse and studying effects of child abuse. This study uses data from Wave IV (2008–2009) of The National Longitudinal Study of Adolescent Health to Adult Health (N = 14,776) to describe distributions of retrospectively self-reported age of onset of childhood emotional, physical, and sexual abuse perpetrated by parents/adult caregivers and sexual abuse perpetrated by other individuals. Information on childhood abuse history was collected when participants were between 24 and 32 years old.FindingsParental/adult caregiver perpetrated abuse frequently started in early childhood, particularly sexual abuse. Non-parental/adult caregiver sexual abuse motivated by physical force also started early in boys (median age = 7.21 years (95% CI: 5.92, 9.05)). Earlier onset of some types of abuse was associated with male sex, not being raised by both biological parents, and low childhood household income.ConclusionsFuture studies should further examine timing of childhood abuse onset and include diverse measures of abuse, including those derived from longitudinal studies and validated reports. If these results are replicated, they suggest that abuse, particularly sexual abuse perpetrated by parents/adult caregivers, often starts in early childhood, and preventive interventions should be designed to protect younger children.

Synopsis Despite being questioned as a survey measurement tool, self-reported age at marriage appeared valid in rural India, where a lack of birth records persists.

Reliability of self-reported age at onset of major depressive disorder was studied in a sample of 335 subjects who were ascertained from a large epidemiologic survey conducted in several U.S. communities and who were interviewed blindly at two different times. Reliability was generally good for these subjects who met DSM-III criteria for depression at two interviews. A large proportion of the variability in the difference of test-retest values can be accounted for by recency of last episode of depression and interactions of age with duration of illness, having been treated for a mental health problem, and comorbidity of other mental disorders. Interactions between duration and comorbidity and between geographic region and treatment were also significant. Contrary to previous studies which do not consider the interval between current age and age at onset and which suggest that reliability diminishes with age, our findings show that older respondents tend to systematically decrease and not increase age at onset across the two interviews. These findings do not support the hypothesis that recently reported secular changes in major depression, including a decreased age at onset and higher rates in younger as compared to older cohorts, can be explained by a differential reporting effect. Furthermore, the findings suggest that factors which contribute to variability in an individual's age at onset should be incorporated in genetic and clinical studies of major depression.

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Objective Age at menarche is critical in research and clinical settings, yet there is a dearth of studies examining its reliability in adolescents. We examined age at menarche during adolescence, specifically, 1) average method reliability across three years, 2) test-retest reliability between time points and methods, 3) intra-individual variability of reports, and 4) whether intraindividual variability differed by setting or individual characteristics. Methods Girls (n = 253) were enrolled in a cross-sequential study in age cohorts (11, 13, 15, and 17 years). Age at menarche was assessed using three annual, in-person clinician interviews followed by nine quarterly phone interviews conducted by research assistants. Results Reliability of age at menarche across time was moderate and varied by method. In-person interviews showed greater reliability [intraclass correlation coefficient (ICC) = .77)] versus phone interviews (ICC = .64). Test-retest reliability in reports did not decrease across time. However, average differences in reported age varied as much as 2.3 years (SD = 2.2 years), with approximately 9% demonstrating differences greater than 4.5 years. Pubertal timing category (i.e., early, late) changed for 22.7% if categorized at the final versus the first report of age at menarche. Conclusions Reliability was moderate, but average differences in reported age are notable and concerning. Using in-person clinician interviews may enhance reliability. Researchers and clinicians should be cognizant of the implications of using different methods measuring age at menarche when interpreting research findings.

Smoking, drinking, and illicit drug use are leading causes of morbidity and mortality, both during adolescence as well as later in life. The determination of how well national and local policy and intervention efforts address teen substance use depends largely on the collection of valid and accurate data. Assessments of substance use rely heavily on retrospective self-report measures, but the reliability and validity, however, may be limited by various sources of measurement error. This study utilizes four waves of data from the National Longitudinal Survey of Youth spanning eight years. Results from multiple linear regression analyses showed that the single most consistent variable associated with telescoping was the number of years since the substance was first reported. Time since first report was the single consistent variable and was strongly associated with telescoping in each wave-to-wave comparison for all three substances under study. Implications for policy and research are discussed.

We examined consistency in self-reports of age at first vaginal sex among 9,399 male and female respondents who participated in Waves III and IV (separated by approximately seven years) of the National Longitudinal Study of Adolescent Health (Add Health). Respondents were coded as consistent if they reported an age at first vaginal intercourse at Wave IV that was within one year of the age they reported at Wave III. Sociodemographic, behavioral, and cognitive predictors of consistency were examined using bivariate and multivariate logistic regression. Overall, 85.43% of respondents were able to provide consistent reports. Among both males and females, consistency was associated with age, years since first vaginal intercourse, race/ethnicity, and lifetime number of other-sex partners in final multivariate models. Respondents who were older and had more recently had their first sexual experience were more likely to be consistent. For females only, those who reported a history of nonparental, physically forced sex were less likely to be consistent. Most young adults consistently report age at first vaginal intercourse, supporting the credibility of retrospective self-reports about salient sexual events such as timing of first vaginal intercourse.

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Due to the higher costs and selection bias of directly measuring weight, the majority of body weight data are based on survey responses. However, these statements are subject to systematic biases of social desirability; therefore, it is important to evaluate the magnitude of bias through indirect indicators such as rounding of weights. Data from seven rounds of the Spanish National Health Survey from 1995 to 2017 were included in the study, with 113,284 subjects. A general rounding index of weights terminating in 0 and 5, and a partial rounding index that estimated the bias direction, were used to estimate the bias distribution in the self-reporting of body weight. All body weights were systematically rounded, although more strongly in the lower weights and even more so in the higher weights. Lower weights were rounded up, and the higher weights rounded down. Regarding gender, men had higher rounding indices than women. The subjects generally reported a weight closer to the socially desirable weight. Rounding allows estimating the historical evolution of this bias in health and nutrition surveys, having more accurate information by population segments and designing public policies against obesity aimed at the more affected social segments.

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Likert response surveys are widely applied in marketing, public opinion polls, epidemiological and economic disciplines. Theoretically, Likert mapping from real-world beliefs could lose significant amounts of information, as they are discrete categorical metrics. Similarly, the subjective nature of Likert-scale data capture, through questionnaires, holds the potential to inject researcher biases into the statistical analysis. Arguments and counterexamples are provided to show how this loss and bias can potentially be substantial under extreme polarization or strong beliefs held by the surveyed population, and where the survey instruments are poorly controlled. These theoretical possibilities were tested using a large survey with 14 Likert-scaled questions presented to 125,387 respondents in 442 distinct behavioral-demographic groups. Despite the potential for bias and information loss, the empirical analysis found strong support for an assumption of minimal information loss under Normal beliefs in Likert scaled surveys. Evidence from this study found that the Normal assumption is a very good fit to the majority of actual responses, the only variance from Normal being slightly platykurtic (kurtosis ~ 2) which is likely due to censoring of beliefs after the lower and upper extremes of the Likert mapping. The discussion and conclusions argue that further revisions to survey protocols can assure that information loss and bias in Likert-scaled data are minimal.

Partisans often offer divergent responses to survey items ostensibly unrelated to politics. These gaps could reveal that partisanship colors perception or, alternatively, that in answering survey questions, individuals communicate partisan proclivities by providing insincere, or “expressive” responses, to send a partisan message. This study tests two techniques for reducing expressive responding that (1) avoid criticisms about using monetary incentives for accuracy, which have reduced measured partisan differences for objective facts; and (2) can be used in contexts where incentives are infeasible, such as when objective benchmarks for correct responses are unavailable. This study experimentally tests these techniques in replicating a study that found that partisanship affected attractiveness evaluations. These interventions, which allow partisans to express their partisan sentiments through other survey items, substantially reduce apparent partisan differences in beauty evaluations and show that standard survey items likely confound sincere partisan differences with elements of expressive responding.

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A huge portion of what we know about how humans develop, learn, behave, and interact is based on survey data. Researchers use longitudinal growth modeling to understand the development of students on psychological and social-emotional learning constructs across elementary and middle school. In these designs, students are typically administered a consistent set of self-report survey items across multiple school years, and growth is measured either based on sum scores or scale scores produced based on item response theory (IRT) methods. Although there is great deal of guidance on scaling and linking IRT-based large-scale educational assessment to facilitate the estimation of examinee growth, little of this expertise is brought to bear in the scaling of psychological and social-emotional constructs. Through a series of simulation and empirical studies, we produce scores in a single-cohort repeated measure design using sum scores as well as multiple IRT approaches and compare the recovery of growth estimates from longitudinal growth models using each set of scores. Results indicate that using scores from multidimensional IRT approaches that account for latent variable covariances over time in growth models leads to better recovery of growth parameters relative to models using sum scores and other IRT approaches. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Objectives Social desirability bias is often speculated to influence survey responses but seldom studied in healthcare. The objective was to explore whether social desirability scores (SDS) or the presence of interview observers is associated with inaccurate recall and overestimation of antenatal care (ANC) services. Design Longitudinal validation study comparing recalled receipt of ANC services and nutrition components of ANC against direct observations of care. An adapted short form Marlowe-Crowne questionnaire was used to generate an SDS, and the presence of interview observers was treated as a separate exposure. We assessed accuracy and overestimation of recalled receipt of ANC services against observed receipt using log-binomial regression, adjusting for age, education, first-pregnancy and socioeconomic status. Setting Rural Southern Nepal with recruitment from five government health posts. Participants 401 pregnant women. Results Social desirability scores did not significantly predict accuracy or overestimation of most types of ANC care except counselling on nausea. Higher SDS was associated with more accurate recall (adjusted RR, aRR 1.08 (95% CI 1.03, 1.12)) and less overestimation (aRR 0.85 (0.80, 0.91)). The presence of mothers-in-law or husbands during interviews was associated with greater overestimation of the number of ANC visits received by more than three visits (aRR 2.07 (1.11, 3.84)) and (aRR 4.19 (2.17, 8.10)), respectively. Those interviewed with friends present tended to overestimate the receipt of counselling on nausea, avoiding alcohol and not smoking. Conclusion The presence of observers can lead to overestimation of the receipt of ANC care and support the conduct of interviews in private settings despite challenges of doing so in village contexts. Findings that the SDS did not predict the accuracy of most types of ANC care might reflect a reality that such questions may not be sensitive from a social-norms perspective. Additional local adaptation of SDS is recommended.

This paper addresses the challenge of ensuring response quality when using item sets with Likert scales in travel surveys. Particularly for capturing psychology, such item sets play an important role in travel behavior research. A challenge with this kind of data is the identification of response bias. An example is straightlining, which describes selecting the same response category for each item. Since there is no universal indicator in the literature to identify unusual or strategic response patterns, we apply various indicators, compare the results and develop a new indicator based on correlations which encounters plausible straightlining. © 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Peer-review under responsibility of the International Steering Committee for Transport Survey Conferences (ISCTSC).

Background Breast cancer is the most frequent cancer in women all over the world, and it is one of the leading causes of cancer-related deaths in women. A pathologist's partiality for the last digit of a patient's name can lead to errors in the measurement of malignancies. This means that, rather than recording the exact measurement of a tumor, a pathologist might round it off to his preferred terminal digit. Methods It is a retrospective cross-sectional study in which data on primary tumor resection for 1000 breast cancer patients was obtained from KRL Hospital's patient directory from November 2016 to December 2020. The tumors were measured in cm to one decimal point along their longest dimension. Ki-67 markers were used to categorize the tumors into nine categories. Terminal digit preference was evaluated using Benford's law. Results The recording of the Ki-67 index revealed evidence of pentameric preference. The numbers three, five, and six appeared more frequently in the histogram of the Ki-67 index distribution measured in percentage. The frequency of nine dropped dramatically. However, the influence of tumor size terminal digits on Ki-67 staining scores (low proliferative vs high proliferative) assessed using the Mann–Whitney U Test demonstrated that tumor size terminal digits had no significant effect on Ki-67 staining scores (p = 0.114). Conclusion The Ki-67 index shows evidence of pentameric preference for digits three, five, and six. The frequency of nine has dropped dramatically. The influence of tumor size on terminal digits on staining scores (low proliferative vs. high proliferative) was assessed using the Mann–Whitney U Test.

Abstract Objectives: Women diagnosed with breast cancer are offered treatment and therapy based on tumor characteristics, including tumor diameter. There is scarce knowledge whether tumor diameter is accurately reported, or whether it is unconsciously rounded to the nearest half-centimeter (terminal digit preference). This study aimed to assess the precision (number of digits) of breast cancer tumor diameters and whether they are affected by terminal digit preference. Furthermore, we aimed to assess the agreement between mammographic and histopathologic tumor diameter measurements. Material and Methods: This national registry study included reported mammographic and registered histopathologic tumor diameter information from the Cancer Registry of Norway for invasive breast cancers diagnosed during 2012–2016. Terminal digit preference was assessed using histograms. Agreement between mammographic and histopathologic measurements was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman plots. Results: Mammographic, histopathologic, or both tumor measurements were available for 7792, 13,541 and 6865 cases, respectively. All mammographic and 97.2% of histopathologic tumor diameters were recorded using whole mm. Terminal digits of zero or five were observed among 38.7% and 34.8% of mammographic and histopathologic measurements, respectively. There was moderate agreement between the two measurement methods (ICC = 0.52, 95% CI: 0.50–0.53). On average, mammographic measurements were 1.26 mm larger (95% limits of agreement: −22.29–24.73) than histopathologic measurements. This difference increased with increasing tumor size. Conclusion: Terminal digit preference was evident among breast cancer tumor diameters in this nationwide study. Further studies are needed to investigate the potential extent of under-staging and under-treatment resulting from this measurement error.

Objective: Digit preference refers to rounding blood pressure (BP) values more often than would occur by chance. Studies show that practices with high digit preference are linked to fewer antihypertensive prescriptions, and patients attending such practices have an increased cardiovascular (CV) event risk. The objective is to investigate how the fraction BP digit preference in hypertensive patients in primary health care centres relates to future CV events. Design and method: From the Swedish Primary Care Cardiovascular Database, 74,751 patients (41,728 women) in 48 primary care centers in Sweden with a recorded diagnosis of hypertension during 2001–2008 were included. The fraction of systolic and diastolic BP values ending in 5 or 10 during 2007–08 at each center was calculated. Cox regression analysis assessed the relation between digit preference at each primary health care center and CV events (ischemic heart disease, cerebrovascular disease, CV death) during 2009–2013, i.e. follow-up was 1–5 years. Covariates included age, gender, income, diabetes, ischemic heart disease cerebrovascular disease, and region. Results: Patient mean age in 2008 was 70±14 years. The fraction of digit preference varied between 32% and 100% between centres (Figure 1). There was a significant association between the utilization of digit preference at a primary health care centre and risk for future CV events for these patients (Figure 2). A proxy for quality of care by centre was estimated as fractions of patients with lipids, creatinine, and microalbuminuria assessed during 2007–2008. This revealed no association between markers of quality of care and prevalence of digit preference. Conclusions: BP digit preference is associated with future CV events. This may be attributed to inaccurate measurements procedures for BP measurements, faulty evaluation of actual BP levels and risk, treatment not offered appropriately, or other means of possible inappropriate quality of care.

Background Accurate information regarding age is necessary for demographic studies, policy formulation, and planning for development. Age data in the census suffers from secondary data due to preferential digit biases and age heaping, contributing to inconsistencies and reliability of Nepal's census data. These discrepancies emphasize the need for a systematic data quality assessment. Methods The present study uses secondary data from the National Population and Housing Census 2021 using a descriptive analytical approach. Whipple's, Myer's Blended index and UN age-sex accuracy index were used to evaluate the quality of age data. These indices can be measures to examine the degree of digit preference and age heaping in age data. Result Whipple's index shows a calculated score of 148.94 for the ages ending in 0 or 5. Myer's Blended index recorded the deviation score of 9.89, based on the moderate age heaping, while the UN Age-Sex Accuracy score of 21.90 scored the data a moderate level of accuracy. These results indicate there are continuing structural errors in self-reported or proxy persistent structural inconsistencies in self- or proxy-reported age data.  Conclusion Despite methodological and technological advancements in the 2021 census, there is the presence of persistent structural, educational, and cultural forces. Improvements in enumerator training, verification of documentation and the civil registration system are critical for improving the reliability of data and enhancing demographic and policy-oriented analysis in Nepal. Novelty This paper provides a national-level assessment of age data quality using the 2021 census, providing information for future assessments beyond Nepal's demographic data.

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Cancer treatment relies on accurate staging, an essential aspect of which is determination of the size of a tumour. Measuring the size of a tumour in daily practice often proves problematic and results in rounding of values to approximate values. It has been shown that size values are most frequently reported with end digits of 0 or 5.

BACKGROUND: Data on age in developing countries are subject to errors, particularly in circumstanceswhere literacy levels are not high. A common error in age reporting is the tendency of rounding the agesto the nearest figure ending in ‘0’ or ‘5’ or to a lesser extent, to the nearest even number. Because of thistendency, commonly known as “digital preference”, age heaping occurs at certain ages.The aim of this study was to study this phenomenon and both Myers’ and Whipple’s Indexes wereemployed to identify the digit preference in Iranian national census, 2005.METHODS: Myers’ and Whipple’s Indexes were employed to study the pattern of digit preference. TheMyers' Blended Index shows heaping at ages ending in 0 and 5 years, and the pattern of heaping is pro-nounced for both urban and rural populations.RESULTS: The quality of age reporting for the 2005 census data was poor if compared to the 1995 censusdata. Digit preference occurred most often in the female population compared to male one, and in ruralareas compared to urban ones.CONCLUSIONS: It can be concluded that both males and females tend to misreport their ages before age60 especially in rural areas. So, whenever any data gathering regarding age information occurs, the IDcard should be used regardless of person's self report.

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