Ashanya Malalasekera , Cindy Sim Y. Tan , Viet Phan , Po Yee Yip , Janette Vardy , Stephen Clarke , Steven Kao
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Survival was calculated from date of chemotherapy using Kaplan Meier method.</p></div><div><h3>Results</h3><p>A total of 79 patients (median age 63 years, 87% stages IIIB/IV) were included. PS scores differed in 34 (43%) cases. The inter-rater reliability between patients and their oncologists was Kappa=0.35 (<em>p</em><0.001). In 31/34 (91%) of cases where the physicians and patients did not agree, physicians were more optimistic in their PS rating. If only patient PS scores were used, 11 patients (14%) would be deemed unfit for chemotherapy (ECOG≥3) and 21 patients (27%) would be excluded from most chemotherapy trials (ECOG≥2). ECOG (0 versus >0) irrespective of assessor was predictive of survival (<em>p</em>=0.017–0.023<em>)</em>.</p></div><div><h3>Conclusions</h3><p>There was only fair agreement in PS scores assessed by NSCLC patients and oncologists, with patient scores usually poorer. 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Survival was calculated from date of chemotherapy using Kaplan Meier method.</p></div><div><h3>Results</h3><p>A total of 79 patients (median age 63 years, 87% stages IIIB/IV) were included. PS scores differed in 34 (43%) cases. The inter-rater reliability between patients and their oncologists was Kappa=0.35 (<em>p</em><0.001). In 31/34 (91%) of cases where the physicians and patients did not agree, physicians were more optimistic in their PS rating. If only patient PS scores were used, 11 patients (14%) would be deemed unfit for chemotherapy (ECOG≥3) and 21 patients (27%) would be excluded from most chemotherapy trials (ECOG≥2). ECOG (0 versus >0) irrespective of assessor was predictive of survival (<em>p</em>=0.017–0.023<em>)</em>.</p></div><div><h3>Conclusions</h3><p>There was only fair agreement in PS scores assessed by NSCLC patients and oncologists, with patient scores usually poorer. 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引用次数: 13
摘要
内科医生使用东部肿瘤合作组织(ECOG)绩效评分来评估患者的绩效状态(PS)并指导治疗决策,但患者不一定同意他们的评分。我们将非小细胞肺癌(NSCLC)患者的PS评分与其内科肿瘤学家的评分进行比较,以探讨一致性,以及是否存在差异可能对治疗和生存预测有影响。方法snsclc患者在化疗前使用患者主观整体评估工具自我评估其PS评分。Kappa用于评估患者和肿瘤学家之间ECOG评分的一致性。用Kaplan Meier法从化疗日期开始计算生存期。结果共纳入79例患者(中位年龄63岁,87%为IIIB/IV期)。34例(43%)患者的PS评分存在差异。患者与其肿瘤学家之间的评分间信度Kappa=0.35 (p<0.001)。在31/34(91%)医生和患者意见不一致的病例中,医生对他们的PS评分更为乐观。如果仅使用患者PS评分,11例患者(14%)被认为不适合化疗(ECOG≥3),21例患者(27%)被排除在大多数化疗试验之外(ECOG≥2)。ECOG (0 vs >0)与评估者无关,可预测生存(p= 0.017-0.023)。结论NSCLC患者和肿瘤学家评估的PS评分只有公平一致,患者评分通常较低。许多患者会将自己排除在治疗干预之外,包括基于他们的PS评级的临床试验。
Eastern Cooperative Oncology Group score: Agreement between non-small-cell lung cancer patients and their oncologists and clinical implications
Background
Oncologists use Eastern Cooperative Oncology Group (ECOG) performance score to assess patients' performance status (PS) and guide treatment decisions, but patients may not necessarily agree on their scores. We compared PS scores assessed by patients with non-small-cell lung cancer (NSCLC) to those of their medical oncologists to explore concordance and whether any discrepancy may have implications on treatment and survival prediction.
Methods
NSCLC patients self-assessed their PS scores using the Patient-Generated Subjective Global Assessment tool prior to chemotherapy. Kappa was used to assess agreement of ECOG scores between patients and oncologists. Survival was calculated from date of chemotherapy using Kaplan Meier method.
Results
A total of 79 patients (median age 63 years, 87% stages IIIB/IV) were included. PS scores differed in 34 (43%) cases. The inter-rater reliability between patients and their oncologists was Kappa=0.35 (p<0.001). In 31/34 (91%) of cases where the physicians and patients did not agree, physicians were more optimistic in their PS rating. If only patient PS scores were used, 11 patients (14%) would be deemed unfit for chemotherapy (ECOG≥3) and 21 patients (27%) would be excluded from most chemotherapy trials (ECOG≥2). ECOG (0 versus >0) irrespective of assessor was predictive of survival (p=0.017–0.023).
Conclusions
There was only fair agreement in PS scores assessed by NSCLC patients and oncologists, with patient scores usually poorer. A number of patients would have excluded themselves from therapeutic interventions including clinical trials based on their PS rating.