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Pollack IF, Jakacki RI, Butterfield L, Okada H, Chiba Y, Hashimoto N, Kagawa N, Kinoshita M, Kijima N, Hirayama R, Oji Y, Tsuboi A, Oka Y, Sugiyama H, Yoshimine T, Valle RD, Tejada S, Inoges S, Idoate MA, de Cerio ALD, Espinos J, Aristu J, Gallego J, Calvo JP, Bendandi M, Zhu J, Chen C, Ravelo A, Yu E, Dhanda R, Schnadig ID, Zhang L, Fan H, Zhang I, Chen X, Wang H, Da Fonseca A, Badie B, Okada H, Butterfield LH, Hamilton RL, Mintz AH, Engh JA, Drappatz J, Lively MO, Chan MD, Salazar AM, Potter DM, Shaw EG, Lieberman FS, Wei J, Kong LY, Wang F, Xu S, Doucette TA, Ferguson SD, Yang Y, McEnery K, Jethwa K, Gjyshi O, Qiao W, Lang FF, Rao G, Fuller GN, Calin GA, Heimberger AB, Yang S, Archer GE, Miao H, Cui X, Xie W, Snyder D, Pretorian AJ, Dechkovskaia A, Reap E, Perez LAS, Norberg P, Schmittling R, Mitchell DA, Sampson JH, Wang F, Wei J, Gjyshi O, Kong LY, Xu S, Lang F, Calin G, Heimberger AB, Xu S, Wei J, Kong LY, Wang F, Calin G, Heimberger AB, Walker DG, Crough T, Beagley L, Smith C, Jones L, Khanna R, Hashimoto N, Tsuboi A, Chiba Y, Kijima N, Oka Y, Oji Y, Kinoshita M, Kagawa N, Yoshimine T, Sugiyama H, Kanemura Y, Sumida M, Yoshioka E, Yamamoto A, Kanematsu D, Matsumoto Y, Fukusumi H, Takada A, Nonaka M, Nakajima S, Mori K, Goto S, Kamigaki T, Maekawa R, Shofuda T, Moriuchi S, Yamasaki M, Yeung JT, Hamilton R, Jakacki R, Okada H, Pollack I, Pellegatta S, Eoli M, Antozzi C, Frigerio S, Bruzzone MG, Cuppini L, Nava S, Anghileri E, Cantini G, Prodi E, Ciusani E, Ferroli P, Saini M, Broggi G, Mantegazza R, Parati EA, Finocchiaro G, Hegde M, Corder A, Chow KK, Mukherjee M, Brawley VS, Heslop HE, Gottschalk S, Yvon E, Ahmed N, Gibo DM, Debinski W, Bonomo J, Rossmeisl J, Robertson J, Dickinson P, Salacz ME, Camarata PJ, Ots M, McIntire J, Lovick D, Mitchell DA, Archer G, Bigner D, Friedman H, Lally-Goss D, Perry B, Herndon J, McGehee S, McLendon R, Coleman RE, Sampson J, Hegde M, Grada Z, Byrd T, Shaffer DR, Ghazi A, Brawley VS, Corder A, Schonfeld K, Dotti G, Heslop H, Gottschalk S, Wels W, Baker ML, Ahmed N, Robbins JM, Dickinson PJ, York D, Sturges BK, Martin B, Higgins RJ, Bringas J, Bankiewicz K, Gruber HE, Jolly DJ, Narayana A, Mathew M, Kannan R, Madden K, Golfinos J, Parker E, Ott P, Pavlick A, Bota DA, Pretto C, Hantos P, Hofman FM, Chen TC, Carrillo JA, Schijns VE, Stathopoulos AA, Prins RM, Everson R, Soto H, Lisiero DN, Young E, Liau LM, Archer GE, Xie W, Norberg P, Dechkovskaia A, Friedman A, Bigner DD, Mitchell DA, Sampson JH, Boczkowski D, Mitchell DA, Gururangan SG, Grant G, Driscoll T, Archer G, King J, Boczkowski D, Xie W, Nair S, Perry B, Fuchs H, Kurtzberg J, Friedman H, Bigner D, Sampson J, Shevtsov MA, Pozdnyakov AV, Kim AV, Samochernych KA, Guzhova IV, Romanova IV, Margulis BA, Khachatryan WA. CLIN-IMMUNOTHERAPY/BIOLOGIC THERAPIES. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Schnadig ID, Fromme EK, Loprinzi CL, Sloan JA, Mori M, Li H, Beer TM, Perrin N. Prognostic significance of patient-physician disagreement about performance status in patients with advanced cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.9021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9021 Background: Physician-reported performance status (PS) is an important prognostic factor in advanced malignancies and is a commonly used stratification variable in cancer clinical trials. However, the extent, predictors, and prognostic importance of disagreement in PS assessment between physicians and patients have not been examined. Methods: Using NCCTG clinical trials from 1987–1990 (J Clin Oncol 19(15):3539–3546, 2001), we analyzed the difference and agreement of PS (ECOG and Karnofsky [KPS]) and nutritional status assessments reported by physicians and patients individually. The degree of disagreement was analyzed using paired t-test. Overall mortality was estimated by Kaplan-Meier method. The effect of disagreement on overall survival was analyzed by Cox regression. Independent predictors of disagreement were identified by logistic regression. Results: 1,636 patients with advanced lung and colorectal cancer had a median survival of 9.8 months (95% CI, 9.4 to 10.4). Percent agreement between patients and physicians about KPS, ECOG PS, and appetite/nutritional status was 32.9%, 43.4% and 42.0% respectively. Physicians were more likely to rate patients better than individual patients were to rate themselves: ECOG (Mean 0.91 vs 1.30, p<.0001), KPS (Mean 83.3 vs. 81.7, p<0.0001), appetite/nutritional status (Mean 1.6 vs. 2.1, p<0.0001). Inability to work, depression and less than a high school education were independently associated with disagreement. An increased risk of death was observed for patient and physician disagreement on KPS (HR=1.15, 95% CI, 1.03 to 1.27 p=0.01) and appetite/nutritional status (HR=1.39, 95% CI, 1.26 to 1.54 p<0.0001). Conclusions: Patients and physicians frequently disagree about patient PS, with physicians tending to rate patients higher than patients do themselves. Baseline patient demographic factors that independently predict disagreement have been identified. Disagreement confers an increased risk of death in the setting of advanced malignancies. These findings illustrate limitations of physician-only assessed PS. No significant financial relationships to disclose.
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Affiliation(s)
- I. D. Schnadig
- Oregon Health & Science University, Portland, OR; Mayo Clinic, Rochester, MN
| | - E. K. Fromme
- Oregon Health & Science University, Portland, OR; Mayo Clinic, Rochester, MN
| | - C. L. Loprinzi
- Oregon Health & Science University, Portland, OR; Mayo Clinic, Rochester, MN
| | - J. A. Sloan
- Oregon Health & Science University, Portland, OR; Mayo Clinic, Rochester, MN
| | - M. Mori
- Oregon Health & Science University, Portland, OR; Mayo Clinic, Rochester, MN
| | - H. Li
- Oregon Health & Science University, Portland, OR; Mayo Clinic, Rochester, MN
| | - T. M. Beer
- Oregon Health & Science University, Portland, OR; Mayo Clinic, Rochester, MN
| | - N. Perrin
- Oregon Health & Science University, Portland, OR; Mayo Clinic, Rochester, MN
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