Aa Petersen Morten, Pedersen Lise, Groenvold Mogens
The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen NV, Denmark.
Palliat Med. 2007 Jun;21(4):289-94. doi: 10.1177/0269216307077694.
Using physician assessments of patients' health related quality of life may improve the feasibility of studies in palliative care. However, poor agreement between patients and physicians has been found. We investigated whether subgroups of patients with good agreement existed.
Patient and physician assessments of twelve European Organisation for Research and Treatment of Cancer Quality of Life Care Questionnaire 30 domains were obtained once a week for up to 13 weeks. The association between agreement and patient characteristics at the first assessment (n = 115) was investigated using multivariate logistic regression. Significant associations were verified using the follow-up time-points combined (total n = 263).
Significant associations between patient characteristics and agreement were found for most domains. However, few subgroups had good agreement. The evaluations on follow-up data did not confirm the findings of subgroups with good agreement.
Based on our findings physician assessments cannot be recommended as a substitute for patient self-assessment for any subgroups of palliative care patients.
采用医生对患者健康相关生活质量的评估可能会提高姑息治疗研究的可行性。然而，已发现患者与医生之间的一致性较差。我们调查了是否存在一致性良好的患者亚组。
针对12个欧洲癌症研究与治疗组织生活质量护理问卷的30个领域，每周获取一次患者和医生的评估结果，持续长达13周。使用多变量逻辑回归研究首次评估时（n = 115）一致性与患者特征之间的关联。使用合并的随访时间点（总计n = 263）验证显著关联。
在大多数领域发现患者特征与一致性之间存在显著关联。然而，几乎没有亚组具有良好的一致性。对随访数据的评估未证实存在一致性良好的亚组这一发现。
基于我们的研究结果，对于任何姑息治疗患者亚组，不建议将医生评估作为患者自我评估的替代方法。
