Communication in Oncology Outpatient Clinic Settings: Congruence of Quality of Life Assessment between Patient-Physician and Patient-Caregiver Dyads
Table 2
Underestimation and overestimation of symptoms, functioning, and health-related quality of life by physicians and caregivers as compared to patients.
Physician ratings compared to patient ratings (n = 45–52 pairs1)
Symptoms, functioning impairment, and health related quality of life
Caregiver ratings compared to patient ratings (n = 25–27 pairs1)
Physician underestimation
Complete agreement
Physician overestimation
Caregiver underestimation
Complete agreement
Caregiver overestimation2
−4
−3
−2
−1
(%)
0
(%)
+1
+2
+3
+4
(%)
−4
−3
−2
−1
(%)
0
(%)
+1
+2
+3
+4
(%)
6
5
4
9
46.2
8
15.4
4
11
2
3
39.5
Health related quality of life
2
2
5
3
44.4
7
25.9
4
3
1
0
29.6
4
2
11
5
45.8
11
22.9
5
4
2
4
31.3
Social functioning
1
1
5
4
40.7
7
25.9
2
3
1
3
33.3
6
5
5
7
44.2
8
15.4
9
7
1
4
40.4
Fatigue
0
0
3
7
37
4
14.8
7
2
2
2
48.1
0
1
1
18
40.8
11
22.4
14
3
1
0
36.7
Insomnia
0
0
0
6
22.2
9
33.3
9
2
1
0
44.4
1
2
6
11
38.5
17
32.7
10
1
3
1
28.8
Pain
0
1
0
3
14.8
7
25.9
8
5
1
2
59.2
0
1
5
12
34.6
18
34.6
12
3
1
0
30.8
Appetite loss
0
0
1
7
29.6
14
51.9
1
3
1
0
18.5
0
0
1
11
23.1
37
71.1
3
0
0
0
5.8
Diarrhea
0
0
0
5
18.5
16
59.2
6
0
0
0
22.2
0
0
3
6
17.3
29
55.8
7
7
0
0
26.9
Constipation
0
0
0
5
18.5
19
70.4
3
0
0
0
11.1
0
1
4
11
33.3
25
52
6
1
0
0
14.6
Financial difficulties
0
0
2
2
14.8
14
51.9
8
1
0
0
33.3
0
0
2
45
26.9
24
46.1
10
3
1
0
26.9
Dyspnea
0
0
1
2
11.1
15
55.6
5
3
1
0
33.3
1
2
3
10
34
21
44.7
7
3
0
0
21.3
Cognitive functioning
0
0
2
2
14.8
13
48.1
6
1
3
0
37
1
0
4
8
25
20
38.5
7
7
2
3
36.5
Nausea and vomiting
0
0
4
3
25.9
12
44.4
5
1
1
1
29.6
0
3
8
3
28
12
24
5
11
2
6
48
Role functioning
0
0
2
3
19.2
10
38.5
3
5
0
3
42.3
4
3
5
6
40
8
17.8
6
1
4
8
42.2
Physical functioning
2
0
1
2
20
5
20
6
5
0
4
60
4
3
7
4
37.5
10
20.8
7
2
3
8
41.7
Emotional functioning
1
1
2
2
23.1
5
19.2
3
5
3
4
57.7
Note. The comparison of the dyad’s rating was counted by sum score differences (caregiver score minus patient score) on functional impairment/symptoms/health-related quality of life. The grey area indicates where the majority of proxies underestimate, overestimate, or agree with the patients. 1The pairs were eliminated if either patient, physician, or caregiver in that pair has an incomplete data. The original eligible pairs were 52 pairs for patient-physician dyads and 27 pairs for patient-caregiver dyads. 2Overestimated for all items suggest that the proxy rated the problem severer than the patient, except for health-related quality of life ratings (overestimated for health related quality of life means that proxy perceived a better condition than patient’s perception).
