The preparticipation physical examination history: Who has the correct answers?

Objective: To examine whether discrepancies exist between information given by parents and student athletes during the annual preparticipation physical examination (PPE) for athletics, and if present, whether the discrepancies occurred in areas of clinical significance to sports medicine and clearance for participation. Design: Survey. Setting: Station-based PPEs for area high school student athletes were performed using the form developed by the Preparticipation Physical Evaluation Task Force (PPETF). Participants: High school student athletes and their parents or guardians. Main Outcome Measures: The discrepancy rate (and associated clinical areas of those discrepancies) for information given by parent-student pairs completing a standard historical section of a PPE. Results: Of the high school student athletes who participated in the station-based PPE, 111 (34%) participated in this study. These student athletes completed the PPE form (14 sections with a total of 38 specific questions) independently during an initial session, and then were given an identical PPE form that was completed with the assistance of a parent or legal guardian. Of the 111 parent-student pairs, only 22 (19.8%) histories were in complete agreement. Several questions had very poor agreement, as indicated by a kappa value less than or equal to 0.4. Taken together, 4 of the 14 historical information sections found on the PPE (cardiovascular, neurologic, musculoskeletal, and questions pertaining to weight) accounted for 59% of all discrepancies. Answers to individual questions did not differ significantly between parents and students when analyzed together and then by gender and age. Interestingly, students answered significantly more questions in an affirmative manner than did their parents. Conclusion: Using the form developed by the PPETF, parents and student athletes may not provide reliable historical information on which to base participation decisions. In particular, unreliable information may be obtained regarding cardiovascular and musculoskeletal issues, areas that are related to the mortality and morbidity associated with athletic activity.