Fischer Jakob L, Tolisano Anthony M, Navarro Alvaro I, Abuzeid Waleed M, Humphreys Ian M, Akbar Nadeem A, Shah Sharan, Schneider John S, Riley Charles A, McCoul Edward D
Department of Otolaryngology - Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, MD.
Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD.
Ochsner J. 2024 Winter;24(4):262-272. doi: 10.31486/toj.24.0071.
Patients and providers vary in how they describe common otolaryngology-related complaints. These differences can lead to miscommunication and frustration that may affect patient outcomes and satisfaction. The aim of this cross-sectional survey-based study was to explore the differences in migraine symptom selection by otolaryngology patients and clinicians. Between June 2020 and October 2022, patients and otolaryngology providers at 5 academic medical centers were asked to select as many symptoms as they felt were related to migraine from a list of 28 common symptom terms in 6 domains: headache-related, eye-related, systemic, sinonasal, facial, and ear-related. The primary study outcome was to assess the differences in patient and clinician perceptions of migraine-related symptoms. A secondary outcome was to assess differences by geographic location. A total of 381 patients and 31 otolaryngology clinicians participated. Patients and providers selected a similar number of symptom terms to define migraine, selecting a median of 10 and 11 symptoms, respectively. Otolaryngology clinicians were more likely than patients to define migraine using eye-related symptoms (difference 10.5%; 95% CI 7.4%, 13.6%) and ear-related symptoms (difference 17.2%; 95% CI 3.4%, 31.0%). Patients were more likely to define migraine using facial symptoms (difference -17.3%; 95% CI -34.1%, -0.5%). Otolaryngologists and patients were equally likely to select headache-related, sinonasal, and systemic symptoms when defining migraine. Minor differences were identified based on geographic location. We found differences between otolaryngologists and their patients in the interpretation of the symptoms of migraine. Clinicians were more likely than patients to describe migraine using eye-related and ear-related symptoms, whereas patients were more likely to describe migraine using facial symptoms. These findings have important counseling and communication implications for clinicians.
患者和医疗服务提供者在描述常见的耳鼻喉科相关症状时存在差异。这些差异可能导致沟通不畅和沮丧情绪，进而可能影响患者的治疗效果和满意度。这项基于横断面调查的研究旨在探讨耳鼻喉科患者和临床医生在偏头痛症状选择上的差异。在2020年6月至2022年10月期间，5家学术医疗中心的患者和耳鼻喉科医疗服务提供者被要求从6个领域的28个常见症状术语列表中选择他们认为与偏头痛相关的尽可能多的症状：头痛相关、眼部相关、全身症状、鼻窦相关、面部相关和耳部相关。主要研究结果是评估患者和临床医生对偏头痛相关症状认知的差异。次要结果是评估地理位置的差异。共有381名患者和31名耳鼻喉科临床医生参与。患者和医疗服务提供者选择用于定义偏头痛的症状术语数量相似，分别选择了中位数为10个和11个症状。耳鼻喉科临床医生比患者更有可能使用眼部相关症状（差异10.5%；95%置信区间7.4%，13.6%）和耳部相关症状（差异17.2%；95%置信区间3.4%，31.0%）来定义偏头痛。患者更有可能使用面部症状来定义偏头痛（差异 - -17.3%；95%置信区间34.1%，0.5%）。耳鼻喉科医生和患者在定义偏头痛时选择头痛相关、鼻窦相关和全身症状的可能性相同。根据地理位置发现了微小差异。我们发现耳鼻喉科医生和他们的患者在偏头痛症状的解释上存在差异。临床医生比患者更有可能使用眼部相关和耳部相关症状来描述偏头痛，而患者更有可能使用面部症状来描述偏头痛。这些发现对临床医生的咨询和沟通具有重要意义。
