Full Papers
Analysis of patient-physician discrepancy in global assessment of systemic autoimmune myopathy disease activity
R.A. Cordeiro1, F.M. Fischer2, S.K. Shinjo3
- Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, SP, Brazil. rafael19abc@hotmail.com
- Department of Environmental Health, Faculdade de Saude Publica, Universidade de Sao Paulo, SP, Brazil.
- Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, SP, Brazil.
CER15231
2022 Vol.40, N°2
PI 0339, PF 0345
Full Papers
Free to view
(click on article PDF icon to read the article)
PMID: 35200134 [PubMed]
Received: 12/10/2021
Accepted : 05/01/2022
In Press: 14/02/2022
Published: 25/02/2022
Abstract
OBJECTIVES:
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).
CONCLUSIONS:
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.
