PubMed · 8312628
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1993. Four simple rules.. https://pubmed.ncbi.nlm.nih.gov/8312628/
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A 57-year-old man presented on multiple occasions to various hospitals with thrombocytopenia and complaints of easy bleeding. Despite his repeated denials of quinine use, laboratory investigations confirmed a diagnosis of quinine-induced thrombocytopenia. He appeared to have factitious disorder and to have discovered a novel means of precipitating symptoms.
Data on patients' experiences are usually collected by questionnaires with fixed response categories. An analysis of 3,600 questionnaires showed that almost every fifth responder elaborated on his/her multiple choice answers by writing additional comments. Nearly all the comments were related to topics in the questionnaire. However, the number of comments relating to each of the questions varied. The patients' additional comments may give a clearer indication of what experiences they were anxious to provide feedback on than their multiple choice answers. Additional comments to the questionnaires provide the health service with supplementary information on which its quality assurance efforts can be based.