title: Evaluation of agreement between physicians' notation of 'no evidence of disease' (NED) and patients' report of cancer status.
abstract: This study examines extent of agreement between oncologists' and cancer patients' reports of current cancer status. Participants with history of cancer were given a comprehensive geriatric assessment in which they were asked whether they had cancer at the present time. This was compared to cancer status concurrently recorded by their physicians in the chart. 75.5% of patients whose physicians reported 'no evidence of disease' (NED) reported that they currently had cancer. 30% of them were anxious and 27% were depressed. Among patients for whom both the patient and physician reported no cancer, only 12.5% were anxious and 7% depressed. Compared to patients with concordant responses, those who discrepantly reported they had cancer had significantly more comorbid illnesses, medications, and pain, and lower levels of social, emotional, and physical functioning. Moreover, equal levels of distress and dysfunction were found between those who reported cancer but had NED and those who reported cancer and did have active disease by physician notation. Although conclusions about cause and effect are limited due to study design, findings suggest that some patients might suffer unnecessarily from lack of understanding about current disease status. These findings also suggest the need for improved physician-patient communication and symptom recognition/management.
authors.affiliation: Department of Psychiatry, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA. oates006@mc.duke.edu
authors.forename: Carolyn T
authors.initials: CT
authors.lastname: Oates
authors.forename: Richard
authors.initials: R
authors.lastname: Sloane
authors.forename: Sally S
authors.initials: SS
authors.lastname: Ingram
authors.forename: Pearl H
authors.initials: PH
authors.lastname: Seo
authors.forename: Harvey J
authors.initials: HJ
authors.lastname: Cohen
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Clipp
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D003142:Communication; D015897:Comorbidity; D003469:Culture; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005240:Feasibility Studies; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D009657:North Carolina; D010555:Personality Inventory; D010817:Physician-Patient Relations; D011788:Quality of Life / Q000523:psychology; D012650:Self Disclosure; D012803:Sick Role; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*