Discrepancies between patient-reported outcomes and clinician-reported outcomes in chronic venous disease, irritable bowel syndrome, and peripheral arterial occlusive disease.
OBJECTIVE
To explore the degree of agreement between patient- and clinician-reported outcomes (PROs and CROs, respectively) in three chronic diseases.


METHODS
Respectively, 120, 131, and 61 French general practitioners (GPs) included 291, 307, and 90 patients with chronic venous disease (CVD), irritable bowel syndrome (IBS), and peripheral arterial occlusive disease (PAOD), in a cross-sectional survey. Patients completed a specific Health-Related Quality of Life (QoL) questionnaire (Chronic Venous Insufficiency Questionnaire [CIVIQ], Functional Digestive Disorders Quality of Life [FDDQL], and Claudication Scale [CLAU-S], respectively) and scored their pain (visual analog scale, pain-free walking distance). GPs were concomitantly asked to estimate patients' pain and QoL.


RESULTS
Although correlated (CVD and IBS: Kw = 0.27 and Kw = 0.31, respectively; PAOD: r = 0.64, P < 0.01), pain intensity estimated by GPs was lower than as estimated by patients with CVD and IBS (e.g., 39.0 +/- 24.9 vs. 30.4 +/- 21.0 for IBS), and pain-free walking distance was greater as estimated by GPs than by patients with PAOD. Pain estimated by patients only partially reflected their QoL (r between 0.30 and 0.78; P between 0.02 and <0.01). Global QoL scores estimated by patients and GPs were moderately correlated (Kw between 0.17 and 0.28). GPs underestimated QoL impairment in CVD (global score: 72 +/- 19 vs. 61 +/- 20) and in most dimensions of the IBS questionnaire (in six of eight dimensions), and overestimated QoL impairment in PAOD (54 +/- 21 vs. 66 +/- 23).


CONCLUSIONS
Although correlated, PROs and CROs differed. In addition, their relationship was not consistent across diseases. PROs are therefore essential to take account of all the aspects of diseases.
Chassany
Olivier
O
Clinical Research Delegation, AP-HP, Hôpital Saint Louis, Paris, France. olivier.chassany@sls.ap-hop-paris.fr
Le-Jeunne
Philippe
P
Duracinsky
Martin
M
Schwalm
Marie-Sophie
MS
Mathieu
Marc
M
D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D006304:Health Status; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology; D043183:Irritable Bowel Syndrome / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D010465:Perception; D016491:Peripheral Vascular Diseases / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014689:Venous Insufficiency / Q000503:physiopathology / Q000628:therapy*