This article is more than 5 years old. Information may no longer be current.
Patients with cancer often accurately report comorbidities
Click Here to Manage Email Alerts
Patient reporting of comorbid conditions may be as effective as, but less costly than, medical record auditing for observational comparative effectiveness research, according to results of a prospective study.
“This is the first large-scale study, to our knowledge, to specifically examine information source in comorbidity reporting, a central issue in observational comparative effectiveness research,” Ronald C. Chen, MD, MPH, associate professor in the department of radiation oncology at University of North Carolina at Chapel Hill, and colleagues wrote.
Chen and colleagues prospectively collected and compared patient-reported information and medical records of 881 patients (median age, 65 years; range, 41-80) newly diagnosed with localized prostate cancer, enrolled in the North Carolina Central Cancer Registry from January 2011 to June 2013.
Researchers collected data on the following comorbidities: myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, chronic obstructive pulmonary disease, peptic ulcer disease, liver disease, diabetes, kidney disease, other cancers, HIV or AIDS, coronary artery disease, arrhythmia, clotting disorders, hypertension, hyperlipidemia, inflammatory bowel disease, asthma, anemia and other blood conditions and arthritis.
The researchers used the statistic to measure agreement between patient reports and medical records for each comorbid condition. Subgroup analyses examined differences in statistics based on age, race, marital status, educational level and income.
“The comorbid conditions of patients with cancer affect treatment decisions which, in turn, affect survival and health-related quality of life outcomes,” the researchers wrote. “Comparative effectiveness research studies must account for these conditions via medical record abstraction or patient report.”
In 16 of 20 conditions, patient reports and medical records agreed among more than 90% of patients. Agreement was lowest for hyperlipidemia (68%; =0.36) and arthritis (66%; =0.14).
Multivariate analysis showed patients aged older than 70 years had lower agreement for MI (OR = 0.31; 95% CI, 0.12-0.8), cerebrovascular disease (OR = 0.1; 95% CI, 0.01-0.78), coronary artery disease (OR = 0.37; 95% CI, 0.2-0.67), arrhythmia (OR = 0.44; 95% CI, 0.25-0.79) and kidney disease (OR = 0.18; 95% CI, 0.06-0.52). Race and educational level were not significantly associated with results in 18 of 19 conditions.
“Patient reporting provides information similar to medical record abstraction and may be a less costly method for assessing comorbid conditions for observational comparative effectiveness research,” the researchers wrote.
Chen and colleagues provide a more “economical strategy” for the identification of comorbidities, according to Zaina P. Qureshi, PhD, assistant professor in the department of health services policy and management at Arnold School of Public Health at University of South Carolina, and colleagues.
“The study ... provides a potentially more economical strategy for identifying comorbid illness by obtaining information from patients on their comorbid conditions,” Qureshi and colleagues wrote in an accompanying editorial. “The presence or absence of comorbid conditions plays a central role in determining patient fitness for the wide range of currently available localized prostate cancer therapies.”
Although more studies are needed, this should not “prevent adoption of the findings in research and clinical settings,” they added. – by Melinda Stevens
Disclosures: The researchers and editorial authors report no relevant financial disclosures.
Click Here to Manage Email Alerts