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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2006

Open Access 01-12-2006 | Research

Physician-estimated disease severity in patients with chronic heart or lung disease: a cross-sectional analysis

Authors: Kurt Kroenke, Kathleen W Wyrwich, William M Tierney, Ajit N Babu, Fredric D Wolinsky

Published in: Health and Quality of Life Outcomes | Issue 1/2006

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Abstract

Background

We evaluated how well physicians' global estimates of disease severity correspond to more specific physician-rated disease variables as well as patients' self-rated health and other patient variables.

Methods

We analyzed baseline data from 1662 primary care patients with chronic cardiac or pulmonary disease who were enrolled in a longitudinal study of health-related quality of life (HRQoL). Each patient's primary physician rated overall disease severity, estimated the two-year risk of hospitalization and mortality, and reported the use of disease-specific medications, tests, and subspecialty referrals. Patient variables included sociodemographic characteristics, psychosocial factors, self-rated health, and both generic and disease-specific HRQoL.

Results

Physicians rated 40% of their patients "about average", 30% "worse", and 30% "better" than the typical patient seen with the specific target disorder. The physician's global estimate of disease severity was strongly associated (P < 0.001) with each of the five more specific elements of physician-rated disease severity, but only marginally associated with patient self-rated health. Multivariable regression identified a set of patient variables that explained 16.4% of the variance in physician-rated disease severity.

Conclusion

Physicians' global ratings may provide disease severity and prognostic information unique from and complementary to patient self-rated health and HRQoL measures. The elements influencing physician-rated disease severity and its predictive validity for clinical outcomes warrant prospective investigation.
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Metadata
Title
Physician-estimated disease severity in patients with chronic heart or lung disease: a cross-sectional analysis
Authors
Kurt Kroenke
Kathleen W Wyrwich
William M Tierney
Ajit N Babu
Fredric D Wolinsky
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2006
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-4-60

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