Petersen Morten Aa, Larsen Henrik, Pedersen Lise, Sonne Nan, Groenvold Mogens
The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Bispebjerg bakke 23, Opgang 20d, DK-2400 Copenhagen NV, Denmark.
Eur J Cancer. 2006 May;42(8):1159-66. doi: 10.1016/j.ejca.2006.01.032. Epub 2006 Apr 18.
It is often difficult to recruit patients for palliative care studies and severe attrition must be expected resulting in biased findings. This may be avoided if equivalent information could be obtained from sources other than the patients. Therefore, we investigated whether physician assessments can be used to evaluate the patients' health-related quality of life (HRQOL). Patient and physician assessments of the patients' HRQOL were obtained once a week for up to 13 weeks using EORTC QLQ-C30 items. The agreement between patients and physicians at first contact (N=115) and for the following 13 weeks combined (total N=263) was investigated. Significant differences between patient and physician assessments were observed for all HRQOL domains assessed. Physicians reported patients to have fewer problems/symptoms than patients did for all HRQOL domains except for physical and social functioning. The agreement between patients and physicians was poor. Using physician assessments may bias findings and cannot be recommended as a substitute for patient self-assessment in palliative care.
招募患者参与姑息治疗研究往往困难重重，而且预计会出现严重的失访情况，从而导致研究结果产生偏差。如果能够从患者以外的其他来源获取等效信息，这种情况或许可以避免。因此，我们调查了医生评估是否可用于评估患者的健康相关生活质量（HRQOL）。使用欧洲癌症研究与治疗组织（EORTC）QLQ-C30条目，每周对患者的HRQOL进行一次患者和医生评估，持续长达13周。我们调查了初次接触时（N = 115）以及接下来13周综合起来（总N = 263）患者与医生评估之间的一致性。在所评估的所有HRQOL领域中，均观察到患者与医生评估之间存在显著差异。除了身体和社会功能领域外，在所有HRQOL领域中，医生报告的患者问题/症状比患者自己报告的要少。患者与医生之间的一致性较差。使用医生评估可能会使研究结果产生偏差，因此不建议在姑息治疗中用其替代患者自我评估。
