title: Level of patient-physician agreement in assessment of change following conservative rehabilitation for shoulder pain.
abstract: BACKGROUND
  Assessment of health-related status has been shown to vary between patients and physicians, although the degree of patient-physician discordance in the assessment of the change in status is unknown.
  
  
  METHODS
  Ninety-nine patients with shoulder dysfunction underwent a standardized physician examination and completed several self-reported questionnaires. All patients were prescribed the same physical therapy intervention. Six weeks later, the patients returned to the physician, when self-report questionnaires were re-assessed and the Global Rating of Change (GROC) was completed by the patient. The physician completed the GROC retrospectively. To determine agreement between patient and physician, intra-class correlation (ICC) coefficient and Pearson'srusing the 15-point GROC and weighted kappa using a consolidated three-point GROC were calculated.
  
  
  RESULTS
  Utilizing the 15-point GROC, complete agreement was observed in 37 of 99 patients (37%). ICC and Pearson'srbetween patient and physician were 0.62 and 0.63, respectively. Utilizing a consolidated three-point GROC, complete agreement was observed in 76 of 99 patients (77%). Weighted kappa was 0.62.
  
  
  CONCLUSIONS
  Assessment of change reported by the patient demonstrates moderate to good agreement with physician assessment. These findings indicate that the GROC does reflect and represent similar assessment of change in health status by patients and physicians. This can aid discussion of both past treatment results and future treatment plans.
authors.affiliation: Department of Kinesiology, California State University, Fresno, CA, USA.
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Moore-Reed
authors.affiliation: Shoulder Center of Kentucky, Lexington, KY, USA.
authors.forename: W Ben
authors.initials: WB
authors.lastname: Kibler
authors.affiliation: Department of Biostatistics, University of Kentucky, Lexington, KY, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Bush
authors.affiliation: Division of Athletic Training, University of Kentucky, Lexington, KY, USA.
authors.forename: Tim L
authors.initials: TL
authors.lastname: Uhl
keywords: conservative treatment; orthopaedics; rehabilitation; self-report questionnaires; shoulder pain