Measurement of agreement on health-related quality of life changes in response to respiratory rehabilitation by patients and physicians - A prospective study

Milo A. Puhan, Michaela Behnke, P. J. Devereaux, Victor M. Montori, Otto Braendli, Martin Frey, Holger J. Schünemann

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Introduction: To provide optimal care for patients with chronic obstructive pulmonary disease physicians need to understand if their patients benefit from an intervention. The objective of this study was to assess agreement between patients and physicians on health-related quality of life (HRQL) changes in response to respiratory rehabilitation and to explore sources for disagreement. Methods: Sixty-one patients rated their health states on a validated preference-based instrument, the feeling thermometer (FT). In an analogous manner, the eight treating physicians rated the patients' health states on the FT. Patients and physicians were blinded to each other's ratings. We calculated intraclass correlation coefficients (ICC) to assess agreement between patients and physicians and used HRQL instruments and the 6-min walking test to assess the evaluative properties of the FT. Results: We found moderate agreement at baseline (ICC 0.40, P=0.018) and follow-up (ICC 0.49, P=0.008) but large disagreement about change scores (ICC 0.02, P=0.46). Patients' FT change scores correlated well with change scores of the Chronic Respiratory Questionnaire, SF-36 and the Borg scale for dyspnoea whereas physicians' FT change scores correlated significantly with the change score of the 6-min walking test (r=0.33). Physicians' ratings showed an inconsistent pattern for correlations with HRQL measures. Conclusions: There is large disagreement between patients and physicians on HRQL changes in response to respiratory rehabilitation. Investigators should assess whether the introduction of HRQL instruments into clinical practice raises the awareness of physicians towards HRQL and improves agreement with their patients.

Original languageEnglish (US)
Pages (from-to)1195-1202
Number of pages8
JournalRespiratory Medicine
Volume98
Issue number12
DOIs
StatePublished - Dec 1 2004

Keywords

  • COPD
  • Physician-patient relations
  • Quality of life
  • Respiratory rehabilitation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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