title: Level of agreement between patient self-report and observer ratings of health-related quality of life communication in oncology.
abstract: OBJECTIVE
  To determine the level of agreement between patients and observers regarding the frequency with which health-related quality of life topics are discussed during outpatient clinical oncology visits.
  
  
  METHODS
  The sample (n=50) consisted of a consecutive series of cancer patients undergoing chemotherapy. Both the patients and observers used a checklist to report which HRQL topics had been discussed during the consultation. Percentage of agreement, kappa and adjust-kappa statistics were calculated.
  
  
  RESULTS
  The percentage agreement between patients' and observers' ratings was generally high, ranging from 74% for fatigue to 96% for sleep problems and cognitive functioning. The average percentage of agreement over the 13 HRQL topics rated was 86%. Cohen's kappa varied between 0.41 (for pain) and 0.78 (for sleep problems). Prevalence-adjusted kappa's were generally higher, ranging from 0.48 (for fatigue) to 0.92 (for sleep problems and social functioning). The average Cohen's kappa and prevalence-adjusted kappa over the 13 HRQL topics were 0.56 and 0.71, respectively. Level of agreement was not found to vary significantly as a function of patients' background characteristics.
  
  
  CONCLUSIONS
  Oncology patients' self-reports of the HRQL-related topics discussed during outpatient chemotherapy visits are in reasonably close agreement with those provided by observers.
  
  
  CONCLUSIONS
  Our results indicate that the patient is a legitimate source of information about the HRQL-related content of medical encounters, and thus can be used in communication studies where the collection of observational data (e.g., via audio- or videotaping) is either too costly or logistically impractical.
authors.affiliation: Department of Pharmacy, Medical Center Alkmaar, Alkmaar, The Netherlands.
authors.forename: Doranne L
authors.initials: DL
authors.lastname: Hilarius
authors.forename: Paul H A M
authors.initials: PH
authors.lastname: Kloeg
authors.forename: Symone B
authors.initials: SB
authors.lastname: Detmar
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Muller
authors.forename: Neil K
authors.initials: NK
authors.lastname: Aaronson
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000523:psychology; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003142:Communication; D003625:Data Collection; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000523:psychology*; D009426:Netherlands; D009723:Nurse-Patient Relations; D009730:Nursing Assessment / Q000592:standards*; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000523:psychology; D009859:Oncology Nursing; D011788:Quality of Life / Q000523:psychology*
chemical_list: D000970:Antineoplastic Agents