title: Congruence of primary brain tumor patient and caregiver symptom report.
abstract: BACKGROUND
  Evaluating the severity of symptoms in patients with primary brain tumors (PBTs) is important in clinical care and research but may be difficult due to patient neurocognitive (NC) impairment. This study was conducted to evaluate the congruence of symptom reporting in patient and caregiver dyads, examining potential impact of NC impairment and Karnofsky performance status (KPS).
  
  
  METHODS
  PBT patients undergoing NC testing and their caregivers were included in this study. These dyads (paired patient and caregiver group) completed the MD Anderson Symptom Inventory-Brain Tumor Module prior to testing, and impairment was categorized based on NC test scores. Concordance and equivalency was then assessed using Bland-Altman analysis and 2 one-sided techniques.
  
  
  RESULTS
  A total of 115 dyads participated. Median patient and caregiver age was 49 and 51 years, respectively, and 63% of patients were male (73% female caregivers). Most patients had a good KPS (≥90, 66%) but were classified as NC impaired (58%). Caregiver's report of patient symptoms are congruent to the self-report of the patient. Equivalency between patient and caregiver report were found using prespecified confidence intervals. KPS group (good, ≥90; poor, ≤80) comparisons of equivalency indicated no significant differences in symptoms and interference reporting between dyads (good = 0.49, P > .05; and poor = 0.3, P > .05) overall, but there was a tendency for higher report by caregivers if the patients had a poor KPS.
  
  
  CONCLUSIONS
  Caregivers of PBT patients have similar assessments of symptom severity (highly congruent) with patient self-report regardless of NC function or KPS. These findings suggest that caregivers may serve as proxy report of symptoms for primary brain tumor patients.
authors.affiliation: Department of Family Health, University of Texas Health Science Center-School of Nursing, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. Terri.S.Armstrong@uth.tmc.edu
authors.forename: Terri S
authors.initials: TS
authors.lastname: Armstrong
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Wefel
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Gning
authors.forename: Alvina
authors.initials: A
authors.lastname: Acquaye
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Vera-Bolanos
authors.forename: Mark R
authors.initials: MR
authors.lastname: Gilbert
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
authors.forename: Tito
authors.initials: T
authors.lastname: Mendoza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000523:psychology; D017028:Caregivers / Q000523:psychology; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D055815:Young Adult