title: Do Patients and Physicians Agree When They Assess Quality of Life?
abstract: Patient and physician agreement on the most significant symptoms is associated with treatment outcomes and satisfaction with care. Thus, we sought to assess patient and physician agreement on patient-reported quality of life (QoL), and whether patient-related variables predict disagreement. In this cross-sectional, multisite study, patients and physicians completed the FACT-BMT at day 90. Agreement was analyzed with the intraclass coefficient correlation (ICC). Rates of underestimation and overestimation were calculated. Logistic regression models identified predictors of disagreement. We analyzed 96 pairs of questionnaires completed by 96 patients and 11 physicians. The patients' median age was 54 years, 52% were men, and 52% had undergone allogeneic hematopoietic cell transplantation (HCT). The physicians' median age was 42, 64% were men, and they had worked in the HCT field for an average of 12 years. Agreement on QoL was moderate (ICC = .436). Exploratory analyses revealed poor agreement for emotional (ICC = .092) and social (ICC = .270) well-being and moderate agreement for physical (ICC = .457), functional (ICC = .451), and BMT concerns (ICC = .445). Patients' well-being was underestimated by physicians in 41% to 59% of the categories of well-being parameters, and overestimated in 10% to 24%. Patient's anxiety predicted less disagreement in all scales except in social well-being, for which nonsignificant associations were observed. Patient-related variables explained 12% to 19% of the variance in disagreement across well-being scales. Patient and physician agreement on QoL was suboptimal, particularly in emotional and social well-being. The implementation of patient-reported outcomes in the daily care of HCT recipients may contribute to improving patient-centered care.
authors.affiliation: Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; IIB-Sant Pau, Jose Carreras Leukemia Research Institute, Barcelona, Spain. Electronic address: abarata@santpau.cat.
authors.forename: Anna
authors.initials: A
authors.lastname: Barata
authors.affiliation: Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; IIB-Sant Pau, Jose Carreras Leukemia Research Institute, Barcelona, Spain.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Martino
authors.affiliation: Epidemiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Ignasi
authors.initials: I
authors.lastname: Gich
authors.affiliation: Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: García-Cadenas
authors.affiliation: Hematology Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Abella
authors.affiliation: Hematology Department, Hospital de la Vall d'Hebrón, Barcelona, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Barba
authors.affiliation: Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; IIB-Sant Pau, Jose Carreras Leukemia Research Institute, Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Briones
authors.affiliation: Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Salut
authors.initials: S
authors.lastname: Brunet
authors.affiliation: Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; IIB-Sant Pau, Jose Carreras Leukemia Research Institute, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Esquirol
authors.affiliation: Hematology Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: García-Pallarols
authors.affiliation: Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Garrido
authors.affiliation: Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Granell
authors.affiliation: Hematology Department, Hospital de la Vall d'Hebrón, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Martinez
authors.affiliation: Hematology Department, Hospital de la Vall d'Hebrón, Barcelona, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Mensa
authors.affiliation: Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Silvana
authors.initials: S
authors.lastname: Novelli
authors.affiliation: Hematology Department, Hospital del Mar, Barcelona, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Sánchez-González
authors.affiliation: Hematology Department, Hospital de la Vall d'Hebrón, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Valcárcel
authors.affiliation: Hematology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; IIB-Sant Pau, Jose Carreras Leukemia Research Institute, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Sierra
mesh_terms: D000328:Adult; D000342:Affective Symptoms; D001007:Anxiety; D003430:Cross-Sectional Studies; D034462:Dissent and Disputes; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011788:Quality of Life; D057566:Self Report; D066107:Social Skills; D011795:Surveys and Questionnaires; D014184:Transplantation, Homologous
keywords: Agreement; Cancer; Hematopoietic cell transplantation; Oncology; Quality of life