title: Comparison of patients' and providers' severity evaluation of oral mucosal conditions.
abstract: BACKGROUND
  In dental diseases, significant discrepancies were observed in the oral health-related quality of life evaluation between patients and providers. Few studies have been performed specifically on the impact of oral mucosal diseases on patients' health.
  
  
  OBJECTIVE
  We sought to compare the evaluation of the severity of oral mucosal conditions in providers and patients.
  
  
  METHODS
  Patients with an oral mucosal condition were recruited at the oral health care unit of a dermatologic hospital. Severity was evaluated both by the physician and by the patient, using a global severity assessment score on a 5-point scale. The 14-item Oral Health Impact Profile was used to evaluate oral health-related quality of life, the 12-item General Health Questionnaire for psychologic problems, and the 20-item Toronto Alexithymia Scale for alexithymia (ie, the difficulty in identifying and expressing feelings).
  
  
  RESULTS
  Data were complete for 206 patients. The agreement between patients' and providers' evaluation was very low (Cohen κ = 0.18). Severity was particularly underestimated by the physician in patients with alexithymia (43% compared with 25% of patients with no alexithymia) and with psychologic problems (44% vs 25%).
  
  
  CONCLUSIONS
  Because of the high number of different conditions, and thus the small figures in each group, it was not possible to analyze the concordance between patient and provider in each single condition.
  
  
  CONCLUSIONS
  Even in the severity assessment of his or her own disease, it is plausible that a patient does not provide a simple clinical evaluation, but includes subjective aspects. It is important for the physician to take into account the severity the patient perceives in making treatment decisions, and in evaluating clinical improvement.
authors: Health Services Research Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IDI-IRCCS), Rome, Italy. f.sampogna@idi.it
authors: Francesca
authors: F
authors: Sampogna
authors: Björn
authors: B
authors: Söderfeldt
authors: Björn
authors: B
authors: Axtelius
authors: Fabio
authors: F
authors: Bergamo
authors: Paolo
authors: P
authors: Gisondi
authors: Cristina
authors: C
authors: Di Pietro
authors: Livia
authors: L
authors: Alessandroni
authors: Calogero
authors: C
authors: Pagliarello
authors: Grazia
authors: G
authors: Zino
authors: Paola
authors: P
authors: Pallotta
authors: Stefano
authors: S
authors: Tabolli
authors: Damiano
authors: D
authors: Abeni
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000503:physiopathology*; D009061:Mouth Mucosa / Q000503:physiopathology*; D009909:Oral Health; D010820:Physicians; D011788:Quality of Life; D012647:Self-Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D055815:Young Adult