Analysis of patient-physician discrepancy in global assessment of systemic autoimmune myopathy disease activity

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art_CORDEIRO_Analysis_of_patientphysician_discrepancy_in_global_assessment_of_2022.PDF (269.83 KB)
Citações na Scopus
4
Tipo de produção
article
Data de publicação
2022
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
CLINICAL & EXPER RHEUMATOLOGY
Autores
FISCHER, F. M.
Citação
CLINICAL AND EXPERIMENTAL RHEUMATOLOGY, v.40, n.2, p.339-345, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective To compare the perception of disease activity (DA) between adult patients with systemic autoimmune myopathies (SAMs) and their physicians, and analyse possible sources of discordance. Methods This cross-sectional study included 75 patients with SAMs. Patients and physicians rated the global DA on a 0-10 cm visual analogue scale. A discrepancy score was calculated by subtracting physician assessment from patient assessment. Three groups were defined: (I) no discrepancy: difference within-2.0 to +2.0; (II) negative discrepancy (ND): difference <-2.0 (patient underrated DA in relation to physcian); (III) positive discrepancy (PD): difference >+2.0 (patient overrated DA in relation to physician). Logistic regression was used to identify predictors of discordance. Results Discordance in patient-physician assessment of DA was found in 21 (28%) cases. ND was observed in 3 (4%), PD in 18 (24%), and no discrepancy in 54 (72%) assessments. Due to the small number, ND cases were excluded from the analysis. PD was associated with older age, personal history of depression, past joint involvement, higher MMT-8 and lower extramuscular DA. In the regression model, for each additional year of age, the chance of PD increases, on average, by 9% (OR 1.09; 95%CI 1.01-1.17, p=0.034). Personal history of depression increases the chance of PD by 829% (OR 9.29; 95%CI 1.52-56.89, p=0.016). Conclusion Almost 30% of patients had discordance in DA assessment from their physicians. The majority of them overrated their DA. These patients tend to be older and are more likely to have personal history of depression, past joint involvement, and milder disease.
Palavras-chave
dermatomyositis, polymyositis, myositis, self-assessment, visual analogue scale, patient-reported outcome measures, health status
URI
https://observatorio.fm.usp.br/handle/OPI/45826
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - LIM/17