Košir Urška, van de Wal Deborah, Husson Olga, Zablith Nadine, Turcotte Robert E
Division of Orthopedic Surgery, McGill University Health Centre (MUHC), Montreal, QC, Canada.
Department of Experimental Psychology, University of Oxford, Oxford, UK.
J Cancer Surviv. 2025 Feb;19(1):376-385. doi: 10.1007/s11764-023-01473-3. Epub 2023 Oct 17.
We aimed to describe the level of agreement between patients and physicians on the ratings of daily functioning and pain in a cohort of sarcoma patients and assess how (dis)agreement and its change over time predicted patient-reported outcomes in survivorship.
We performed secondary analysis of longitudinal data from a sarcoma-specialty clinic in Montreal, Canada. Demographics, clinical characteristics and patient-physician agreement were summarized descriptively. Linear mixed models were used to assess the effects of time, baseline agreement, change in agreement over time, interaction of time and change in agreement and 12-month daily functioning, quality of life, and fatigue.
Data were available for 806 patients (57.7% male, x̄ = 53.3 years) who completed at least one questionnaire. Patient-physician disagreement was common on the level of function (43.4%) and pain (45.7%). Baseline physician-patient agreement was associated with better 12-month outcomes. Improvement in agreement on function over time was significantly associated with daily functioning (F(2, 212) = 3.18, p = 0.043) and quality of life (F(2, 212) = 3.17, p < 0.044). The pattern was similar though less pronounced for the agreement on pain.
Our study offers novel insights into the importance of patient-physician agreement and communication's role in long-term patient-reported outcomes in sarcoma.
The results emphasize the importance of mutual understanding of symptoms and patients' needs and suggest that further consultation in cases of discordance of ratings and opinions might be beneficial for optimal survivorship.
我们旨在描述肉瘤患者队列中患者与医生在日常功能和疼痛评分上的一致程度，并评估（不）一致及其随时间的变化如何预测生存期间患者报告的结局。
我们对来自加拿大蒙特利尔一家肉瘤专科诊所的纵向数据进行了二次分析。对人口统计学、临床特征和患者-医生一致性进行了描述性总结。使用线性混合模型评估时间、基线一致性、一致性随时间的变化、时间与一致性变化的相互作用以及12个月的日常功能、生活质量和疲劳的影响。
共有806名患者（57.7%为男性，平均年龄53.3岁）的数据可用，这些患者至少完成了一份问卷。患者与医生在功能水平（43.4%）和疼痛（45.7%）方面的不一致很常见。基线医患一致性与更好的12个月结局相关。功能方面一致性随时间的改善与日常功能（F(2, 212) = 3.18，p = 0.043）和生活质量（F(2, 212) = 3.17，p < 0.044）显著相关。疼痛方面的一致性模式相似，但不太明显。
我们的研究为医患一致性的重要性以及沟通在肉瘤患者长期报告结局中的作用提供了新的见解。
结果强调了对症状和患者需求相互理解的重要性，并表明在评分和意见不一致的情况下进一步咨询可能有助于实现最佳生存。
