Patient versus clinician symptom reporting using the National Cancer Institute Common Terminology Criteria for Adverse Events: Results of a questionnaire-based study Journal Article

  

Authors:	Basch, E.; Iasonos, A.; McDonough, T.; Barz, A.; Culkin, A.; Kris, M. G.; Scher, H. I.; Schrag, D.
Article Title:	Patient versus clinician symptom reporting using the National Cancer Institute Common Terminology Criteria for Adverse Events: Results of a questionnaire-based study
Abstract:	Background: The Common Terminology Criteria for Adverse Events (CTCAE) are used as standard practice in trials of cancer treatments by clinicians to elicit and report toxic effects. Alternatively, patients could report this information directly as patient-reported outcomes, but the accuracy of these reports compared with clinician reports remains unclear. We aimed to compare the reporting of symptom severity reported by patients and clinicians. Methods: Between March and May, 2005, a questionnaire with 11 common CTCAE symptoms was given to consecutive outpatients and their clinicians (physicians and nurses) in lung and genitourinary cancer clinics in the Memorial Sloan-Kettering Cancer Center, New York, NY, USA. Patients completed a version that used language adapted from the CTCAE for patient self-reporting. The results from the questionnaire were compared with clinician reporting of the same symptoms. Findings: Of 435 patients and their clinicians asked to take part in the study, 400 paired surveys were completed. For most symptoms, agreement between patient and clinician was high, and most discrepancies were within a grade difference of one point. Agreement was higher for symptoms that could be observable directly, such as vomiting and diarrhoea, than for more subjective symptoms, such as fatigue and dyspnoea. Differences in symptom reporting rarely would have changed treatment decisions or dosing, and patients assigned greater severity to symptoms more than did clinicians. No significant differences were recorded between the results when the questionnaire was completed by the patient before or after the clinician. Interpretation: Patient reporting of symptoms could add to the current approach to symptom monitoring in cancer treatment trials. Future research should assess the effect of self reporting on clinical outcomes and efficiency, and the use of real-time collection of patient-reported outcomes for early detection of potentially serious adverse events. © 2006 Elsevier Ltd. All rights reserved.
Keywords:	adult; aged; aged, 80 and over; middle aged; major clinical study; constipation; fatigue; cytotoxic agent; diarrhea; side effect; antineoplastic agents; research design; antineoplastic agent; anorexia; medical decision making; reproducibility of results; pain; nausea; lung neoplasms; health survey; lung cancer; patient monitoring; urogenital tract cancer; self report; questionnaires; coughing; dyspnea; urogenital neoplasms; questionnaire; chemotherapy induced emesis; symptom; disease severity; patients; physicians; mitoxantrone; urinary frequency; outpatient; hot flush; physician attitude; platinum complex; taxane derivative; hormone; clinical trials; nurse
Journal Title:	Lancet Oncology
Volume:	7
Issue:	11
ISSN:	1470-2045
Publisher:	Elsevier Science, Inc.
Date Published:	2006-11-01
Start Page:	903
End Page:	909
Language:	English
DOI:	10.1016/s1470-2045(06)70910-x
PUBMED:	17081915
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-33750305266&partnerID=40&md5=2bebaf5f08582a0df7139a4cfd25253c
Notes:	--- - "Cited By (since 1996): 57" - "Export Date: 4 June 2012" - "CODEN: LOANB" - "Source: Scopus"

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