Kwoh C K, Ibrahim S A
Department of Medicine, University Hospitals of Cleveland, Case Western Reserve University School of Medicine, Ohio 44106-6033, USA.
Arthritis Rheum. 2001 Aug;45(4):372-7. doi: 10.1002/1529-0131(200108)45:4<372::AID-ART350>3.0.CO;2-D.
In chronic diseases such as arthritis, patients' priorities and values are of prime importance in the measurement of outcome. Relatively few indices take this into account. We sought to identify individual rheumatology patients' choices for important health and symptom status outcomes and assess physicians' ability to detect them.
A cross-sectional, observational study design was used to examine rheumatology patients' choices for important health and symptom status outcomes. A descriptive summary of patients' choices of "most important" health and symptom status outcomes was compiled. The sensitivity and specificity of physicians' ability to detect their patients' choices for important health or symptom status outcomes were calculated.
The sample consisted of 79 rheumatology patients, 30 men and 49 women, with a mean age of 52.6 years. The feeling of being in control was the mental health outcome rated most important by the largest number of the patients (42%); cognitive function (making decisions, solving problems) (22%), feelings of being happy (18%), and feelings of being satisfied (16%) were also rated as being "most important" by many patients. Feelings of hope were rated "most important" by the fewest patients (2%). The physicians' sensitivity to detecting patients' choices of most important outcomes was highest for social functioning and lowest for mental functioning. The specificity to detect patients' choices of less important outcomes was highest for physical functioning and lowest for symptom status.
In this study involving 4 rheumatologists, patients were found to differ in their choices of important health and symptom status outcomes. Physicians often fail to identify these choices.
在关节炎等慢性病中，患者的优先事项和价值观在结局测量中至关重要。相对而言，很少有指标考虑到这一点。我们试图确定类风湿关节炎患者对重要健康和症状状态结局的选择，并评估医生察觉这些选择的能力。
采用横断面观察性研究设计，以检查类风湿关节炎患者对重要健康和症状状态结局的选择。汇编了患者对“最重要”健康和症状状态结局选择的描述性总结。计算了医生察觉患者对重要健康或症状状态结局选择的敏感性和特异性。
样本包括79名类风湿关节炎患者，30名男性和49名女性，平均年龄52.6岁。掌控感是被最多患者（42%）评为最重要的心理健康结局；认知功能（做决定、解决问题）（22%）、幸福感（18%）和满足感（16%）也被许多患者评为“最重要”。希望感被评为“最重要”的患者最少（2%）。医生察觉患者对最重要结局选择的敏感性在社会功能方面最高，在心理功能方面最低。察觉患者对较不重要结局选择的特异性在身体功能方面最高，在症状状态方面最低。
在这项涉及4名风湿病学家的研究中，发现患者在重要健康和症状状态结局的选择上存在差异。医生常常未能识别出这些选择。
