1. Discussion Alan Zaslavsky Harvard Medical School

2. Fabrication as a Statistical Procedure Fabrication is like imputation – Duplication is like hot deck – Duplication with random modifications is like multiple imputation – Duplication is like weight modification Fabrication is a multilevel process – Interview, interviewer, area, … project level

3. Fabrication as a Game Payoffs/risks to fabricator – Reduce effort while receiving payment – Risks greater for higher-level organization/person Detection/deterrence Costs/risks to data purchaser – Paying more for less information – Wrong decisions – Loss of credibility (cliff loss function) Risks may change with greater expertise on either side

4. Assumptions about Fabricators Fabricators are not very sophisticated – No fancy synthesis models Fabricators are not trying to work hard – Falsifying must be easier than data collection – Will not know how to “beat” moderately sophisticated detection techniques If fabricators try harder … – Good standard synthesis methods could be hard to detect – Learning on both sides

5. Fabrication on the Continuum of Survey Management Related to other survey errors at scale – Inadequately designed survey questions and tools Not adapted to conditions under which survey fielded – Interviewer errors Misinterpretation of questions, procedures Interpersonal interview technique Training and motivation Monitoring of “honesty”, accuracy, technique

6. Detection techniques Good survey management – Timely, at all levels – Recruitment, observation – Metadata and paradata Post-survey analysis – Replication of survey: interpenetrating samples – Subject-matter expertise – Statistical outliers (single and patterns) Earlier is better

7. Regina Faranda Extensive checking – Subject-matter and survey expertise – Checklist: QC Statistical assumptions? – Can be stated and tested

8. Rita Thissen Detailed specifics of monitoring and detection systems – Technology: CARI, CAPI, … (Anecdotes rarely heard)

9. Mike Robbins Duplicate detection is like record linkage – Likelihood ratio Duplicate detection also important in other settings – US Census (2000?): match 330M

10. Robbins – Duplicate detection Duplicate detection is like record linkage – Likelihood ratio Duplicate detection also important in other settings – US Census (2000?): match 330M × 330M possible record pairs Would models be different for fabricated data, processing errors, repeated real interviews?

11. Example: Medicare CAHPS survey Pulled ~5000 responses (out of ~400K/year) Examined 27 substantive items Complex features – Substantial amount of screening/skipped items – Multiple choice items – Blocks of closely related items

12. Agreement – all pairs

13. Best agreement: duplicates?

14. Conclusions Know your data and survey methodology Thanks to speakers for sharing their experience and methods