Background: Previous studies have demonstrated that the public maintains unrealistic expectations of the potential for successful recovery following major trauma. To assess the possible effect of televised (TV) medical dramas on the perceptions of the general public, we compared trauma outcomes depicted on television versus statistics from the National Trauma Data Bank (NTDB).
Methods: A systematic content analysis was conducted of consecutive episodes of 7 prime-time TV programs using a structured abstract. The most recent, complete season of each TV program was analyzed to document demographics, injury mechanisms, and outcome data. Coders also documented lapses of professionalism that occurred during trauma resuscitations. Actual health care data were obtained from the United States NTDB from the same time period. Chi-squared and unpaired t-tests were used to compare televised versus NTDB distribution across key demographic, injury and trauma outcome variables. The interrater agreement for coding TV episodes was determined using kappa statistics.
Results: A total of 114 episodes were analyzed; 173 fictional trauma cases were portrayed (1.5 incidents/episode). Interrater reliability was excellent, with a median kappa statistic of 0.81. Trauma patients on TV were younger compared with the NTDB (average age 26 vs 40, p < 0.001), and ages at the extremes were less commonly represented. Compared with reality, characters on television were less commonly women (21% vs. 29%, p=0.02), African American (10% vs. 19%, p=0.003) or Hispanic (7.1% vs. 14%, p < 0.001). Although TV patients had much higher injury severity (mean ISS 20 vs 12, p < 0.001), the overall mortality rate was less (2% vs 7%, p=0.01). Among TV trauma survivors, very few spent more than 1 week in the hospital (8%) or required long-term rehabilitation (3%). Not surprisingly, 73 instances of unprofessional conduct were associated with the trauma resuscitations portrayed on TV.
Conclusions: These findings indicate that sociodemographic and medical outcomes of trauma patients portrayed in televised medical dramas differs significantly from reality. These differences may lead the viewing public to have an unrealistic impression of trauma resuscitation, particularly with respect to recovery after injury.