Women less likely than men to fake injuries

NewsBot · Jul 7, 2011

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Press Release:
Women Less Likely Than Men To Fake Soccer Injuries

With the Women's World Cup in full swing in Germany, soccer fans can now rest assured that women are less likely than men to fake on-field injuries, according to a new study by researchers at Wake Forest Baptist Medical Center published in the July issue of the journal Research in Sports Medicine.

"Injuries are common in women's soccer and seem to be on the rise at the international level," said Daryl Rosenbaum, M.D., an assistant professor of Family and Community Medicine at Wake Forest Baptist. "The goals of our study were to determine the frequency of apparent injury incidents in women's international soccer and estimate what proportion of these incidents is authentic. It is clear from this study that female players don't fake injuries at the same rate as their male counterparts."

Rosenbaum said that in 2008, the International Federation of Association Football (FIFA), the international governing body of soccer, issued a directive calling for "the football family to unite in denouncing injury simulation and working to eradicate this scourge from the game." Results of a study conducted in 2010 by Rosenbaum show that the faking or exaggerating of injuries at the men's international level may be a valid concern. He hopes his research will help determine if injury simulation in soccer is due to the nature of the sport or is specific to certain types of participants.

For the latest study, video recordings of 47 televised games from two international women's tournaments were reviewed to identify incidents in which a player behaved as if injured. Apparent injuries were considered "definite" if a player withdrew from participation within five minutes or if bleeding was visible; the remaining incidents were considered "questionable." A total of 270 apparent injuries were observed, a rate of 5.74 per game. The "definite" injury rate was only 0.78 per match compared to 4.96 for "questionable" injuries.

"While it was difficult to know for certain if a player had a true injury or was faking or embellishing, we found that only 13.7 percent of apparent injuries met our definition for a 'definite' injury," Rosenbaum said. "Also consider that we saw six apparent injuries per match in the 2007 Women's World Cup but team physicians from the tournament reported only 2.3 injuries per match, so it looks like there may be some simulation in the women's game."

Rosenbaum's research indicates that apparent injury incidents for women are much less frequent than for men, however, occurring at a rate of 5.74 per match as compared to 11.26 per men's match. The proportion of apparent injuries that were classified as "definite" was nearly twice as high for women, 13.7 percent, as compared to 7.2 percent for men.

Rosenbaum said "questionable" injuries are more likely to be associated with contact and referee sanctions than "definite" injuries, which may indicate that players may use these situations to try to deceive referees. There was no evidence that teams that did this frequently won more often, nor was there any evidence that players used injury simulation as a way to try and rest or kill time.

"In the end, I think this study shows that women are less likely than men to fake soccer injuries," Rosenbaum said. "What isn't clear is if injury simulation is used to gain a tactical advantage. Only the players themselves know the answer to that question."
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NewsBot · Jul 7, 2011

Estimation of Injury Simulation in International Women's Football
Daryl A. Rosenbauma, Ravi R. Sanghani, Travis Woolen & Stephen W. Davis
Research in Sports MedicineVolume 19, Issue 3, July 2011, pages 162-169

This study attempted to determine the frequency of apparent injury incidents in women's international football and estimate what proportion was authentic. Broadcast recordings of 47 games from 2 tournaments were reviewed to identify incidents in which a player behaved as if injured. Apparent injuries were considered definite if a player withdrew from participation within 5 minutes or if bleeding was visible. Remaining incidents were considered questionable. A total of 270 apparent injuries were observed at a rate of 5.74/game compared with 11.26/game previously reported in men's football. The definite injury rate was only 0.78/game vs. 4.96/game for questionable injuries. Definite injuries were associated with on-field treatment (P < 0.010), stretcher (P < 0.010), and second half (P = 0.022), while questionable injuries were associated with fouls (P = 0.036), contact (P < 0.010), and being tackled (P = 0.025). Questionable injuries were not associated with the final third of a half or with team success.
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NewsBot · Oct 3, 2018

Can Women Live with More Symptoms than Men?: Defining Gender Differences in the Patient
Acceptable Symptom State (PASS) in Orthopaedic Foot and Ankle Surgery
Judith Baumhauer, MD, MS, MPH, Adolph Flemister, MD, Irvin Oh, MD, Benedict DiGiovanni, MD, Jeff Houck, PhD
AOFAS Annual Meeting 2018 1

Introduction/Purpose: Over the last few years an increasing focus has been directed to define cut-off points for important
health improvement. Minimal clinically important difference (MCID) values have traditionally been used to determine if a statistical
change translates to a clinical improvement to the patient. Although MCID is helpful, it may be even more important to identify if
the current treatment is adequate or that the patient has achieved an acceptable symptom state (symptoms minimal enough to live
with). The purpose of this study was to determine if gender influenced patient reported outcomes (patient acceptable symptom
state (PASS) and PROMIS Physical Function, Pain Interference and Depression) in patients with foot and ankle problems.
Methods: Prospectively collected PROMIS and PASS were identified for 450 surgical patients (Males=126, Females=324). The
CPT codes, gender %, age and follow up were recorded (Table 1). To assure the overall recovery experienced by females and
males was similar, aggregate PROMIS scores were compared using ANOVA analysis. The average PROMIS t-scores were
comparable and without clinically meaningful differences between gender groups. The ability of each PROMIS scale to predict
PASS status was determined using receiver operator curves (ROC). The area under the curve (AUC) and thresholds
approximating 95% sensitivity/specificity for males and females were assessed for each PROMIS domain. AUC values below 0.7
are not considered clinically useful. Differences AUC or approximating 95% sensitivity/specificity thresholds by gender would
support the hypothesis that PASS status is influenced by gender.
Results: There were significant differences in the AUC for gender suggesting PROMIS scores are better predictors of PASS for
females than males however there were only minor differences in near 95% sensitivity/specificity PROMIS threshold values by
gender. The AUC values for females were higher than for males for each PROMIS scale (Figure 1). The thresholds PROMIS PF, PI
and Dep for males and females are in Table 1. The thresholds for PROMIS PF to determine PASS yes was lower for females
compared to males; while the thresholds for PROMIS PI to determine PASS yes were similar between males and females. This
suggests that women accept lower function as an acceptable status than men. Men and women accept similar pain thresholds as
PASS yes.
Conclusion: PROMIS domains more accurately predict PASS status in females based on the AUC. Females are more likely to
judge their physical abilities as acceptable at a lower PROMIS PF threshold value compared to males. Despite these gender
differences, males and females both identify a PROMIS threshold (PF and PI) that was near the average of the US population (tscore
50). The lower AUC for males may indicate that males judge any symptoms as unacceptable and use a broader frame of
reference than isolatedly perceived physical function and pain interference when judging whether their physical abilities and
symptoms are acceptable.
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