Comparison of recognition of symptom burden in MPN between patient- and physician-reported assessment – an intraindividual analysis by the German Study Group for MPN (GSG-MPN)

IF 12.8 1区 医学 Q1 HEMATOLOGY
Kirsi Manz, Florian H. Heidel, Steffen Koschmieder, Rudolf Schlag, Jörg Lipke, Frank Stegelmann, Martin Griesshammer, Martine Klausmann, Carl Crodel, Andreas Hochhaus, Holger Schulz, Joachim R. Göthert, Haifa Al-Ali, Heiko Becker, Andreas Reiter, Gernot Beutel, Kim Kricheldorf, Tim H. Brümmendorf, Wolfgang Hoffmann, Konstanze Döhner, Susanne Isfort, On behalf of the German Study Group for Myeloproliferative Neoplasms (GSG-MPN)
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Abstract

Myeloproliferative neoplasms (MPN) are associated with a variety of symptoms that severely impact patients’ quality of life and ability to perform daily activities. Recent studies showed differences in the perception of physician- versus patient-reported symptom burden. However, studies directly comparing patient- and physician-reported ratings are lacking. Here, a retrospective analysis on symptom burden of 3979 MPN patients of the Bioregistry of the German Study Group for MPN was conducted to intra-individually compare physician and patient reports collected at the same time. Cohen’s kappa was calculated to assess the degree of agreement between patient and physician reports. Factors influencing baseline symptom severity were identified using linear regression and adjusted Cox models were calculated to investigate the effect of symptom burden on survival. MPN patients had a high symptom burden, which neither decreased over time nor upon cytoreductive therapy. All symptoms were more frequently reported by patients compared to physicians. Agreement remained low and only slightly improved when considering a higher threshold for patient symptom severity. Patients with severe symptom burden had inferior survival compared to patients with less severe symptoms. Assessment of symptom burden in MPN is therefore insufficient and patient-reported outcome tools need to be implemented into clinical routine.

Abstract Image

Abstract Image

比较患者和医生报告的评估对MPN症状负担的认识——德国MPN研究组(GSG-MPN)的个体分析
骨髓增生性肿瘤(MPN)与多种症状相关,严重影响患者的生活质量和日常活动能力。最近的研究表明,在医生和患者报告的症状负担的感知差异。然而,直接比较病人和医生报告的评分的研究是缺乏的。本研究回顾性分析德国MPN研究组Bioregistry的3979例MPN患者的症状负担,对同时收集的医生和患者报告进行个体内比较。计算Cohen的kappa来评估病人和医生报告之间的一致程度。采用线性回归确定影响基线症状严重程度的因素,并计算调整后的Cox模型,探讨症状负担对生存的影响。MPN患者有很高的症状负担,这种负担既没有随着时间的推移而减少,也没有通过细胞减少治疗。与医生相比,患者报告所有症状的频率更高。一致性仍然很低,当考虑到患者症状严重程度的更高阈值时,一致性仅略有改善。重度症状负担患者的生存期低于轻度症状负担患者。因此,对MPN症状负担的评估是不够的,需要将患者报告的结果工具纳入临床常规。
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来源期刊
Leukemia
Leukemia 医学-血液学
CiteScore
18.10
自引率
3.50%
发文量
270
审稿时长
3-6 weeks
期刊介绍: Title: Leukemia Journal Overview: Publishes high-quality, peer-reviewed research Covers all aspects of research and treatment of leukemia and allied diseases Includes studies of normal hemopoiesis due to comparative relevance Topics of Interest: Oncogenes Growth factors Stem cells Leukemia genomics Cell cycle Signal transduction Molecular targets for therapy And more Content Types: Original research articles Reviews Letters Correspondence Comments elaborating on significant advances and covering topical issues
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