Clinician versus nurse symptom reporting using the National Cancer Institute—Common Terminology Criteria for Adverse Events during chemotherapy: results of a comparison based on patient's self-reported questionnaire

Cirillo, Massimo; Venturini, M.; Ciccarelli, Lucia; Coati, Francesca; Bortolami, Oscar; Verlato, Giuseppe

doi:10.1093/annonc/mdp287

Cited by 114 publications

(87 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several other authors have reported a similar phenomenon [5][6][7][8][9][10][11] . For example, Di Maio and colleagues recently studied patients enrolled in three prospective clinical trials: one studying elderly patients with breast cancer receiving adjuvant chemotherapy and two studying patients with advanced non-small cell lung carcinoma receiving first-line treatment 9 .…”

Section: Discussionsupporting

confidence: 59%

“…Furthermore, the patient experience may not be fully captured by the physicians or nurses documenting clinical findings. Several papers from clinical trials have highlighted discrepancies in the side effects reported by medical staff and patients, with doctors frequently underestimating the incidence and severity of side effects [5][6][7][8][9][10][11] . Since underreporting of chemotherapy-related side effects is a problem even in the highly controlled clinical trial environment, it is likely to be even more pronounced in routine clinical practice, where reporting does not follow strict standards.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Self-evaluation of Adjuvant Chemotherapy-Related Adverse Effects by Patients With Breast Cancer

et al. 2016

View full text Add to dashboard Cite

Importance: The patient's perspective on chemotherapy-related side effects is becoming increasingly acknowledged both in experimental clinical trials and in the clinical practice.Objective: To evaluate how breast cancer patients receiving standard adjuvant chemotherapy report and grade side effects using a ten-item, paper questionnaire derived from the US National Cancer Institute's (NCIs) Common Terminology Criteria for Adverse Events (CTCAE) v4.0 and to compare patient with doctor reports.Design, setting and participants: The questionnaire was administered to 604 patients at 11 sites after the first and third cycle of adjuvant chemotherapy between January 2011 and October 2013. CTCAE v4.0 definitions of grade of severity for nausea, vomiting, constipation, anorexia, dysgeusia, diarrhea, fatigue, pain, paresthesia, and dyspnea were translated into Italian and rephrased. Side effect information was also extracted from the medical charts to compare to patient-reported data. Main outcomes and measures:Differences in side effects reporting between paired questionnaires were studied by the McNemar Test and the Wilcoxon signed rank test.Agreement between patient and doctor side effect reporting (grade 0 vs. grade ≥1) was studied using Cohen's kappa statistic. The effect of the number of patients enrolled at each Institution on the magnitude of discrepancy in side effect reporting between patients and doctors was studied by linear regression.Results: 596 and 581 questionnaires were collected after cycles 1 and 3, respectively. A median of 82% of fields were filled in. A corresponding doctor questionnaire completed from chart data was available for 594 and 573 patient questionnaires. The frequency and severity of chemotherapy-related side effects were consistently greater in patient-reported than doctor-reported data. As a result, inter-rater agreement was low for most side effects, 3 ranging from 0.10 for anorexia to 0.51 for vomiting (Cohen's kappa statistic). There was a strong and significant positive correlation between the magnitude of the discrepancy in the frequency of reporting side effects and the number of patients enrolled at each site. Conclusions and relevance:Adherence to reporting adjuvant chemotherapy-related side effects using the CTCAE system is high in women undergoing adjuvant chemotherapy for breast cancer. Workload may contribute to agreement discrepancies by limiting the doctorpatient relationship.

show abstract

Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Self-evaluation of Adjuvant Chemotherapy-Related Adverse Effects by Patients With Breast Cancer

et al. 2016

View full text Add to dashboard Cite

show abstract

“…However, agreement was low for subjective symptoms such as fatigue and dyspnoea. In a similar study performed in Italy among outpatients undergoing chemotherapy [20], agreement between patients and nurses was generally stronger than those between patients and physicians. Based on these results, the authors suggested that the nurses could be successfully employed in collecting treatment toxicity, because they showed a better performance than doctors in reporting information from the patients.…”

Section: Agreement Between Patients and Physiciansmentioning

confidence: 80%

“…Published studies have consistently demonstrated that health professionals underestimate the incidence and severity of symptoms, when compared with the report by patients [14][15][16][17]. More specifically, a number of publications have been focused on the comparison between patients' and physicians' reporting of treatment adverse events experienced by cancer patients, allowing the description of under-reporting by physicians [18][19][20][21].…”

Section: Agreement Between Patients and Physiciansmentioning

confidence: 99%

Patient-reported outcomes in the evaluation of toxicity of anticancer treatments

et al. 2016

View full text Add to dashboard Cite

Several studies have shown that symptomatic toxicities associated with anti-cancer treatments, such as nausea and vomiting, are frequently under-reported by health care providers, even when prospectively collected within clinical trials. Such under-reporting can produce underestimation of the absolute rate of toxicity, which is highly relevant information for patients and their physicians in clinical practice, as well as for regulatory authorities. Systematic collection of patient-reported outcomes (PROs) has been demonstrated to be a valid, reliable, feasible, and more precise approach to tabulating symptomatic toxicities, compared to health care provider reporting. The U.S. NationalCancer Institute has developed a PRO version of the Common Terminology Criteria for Adverse Events (the "PRO-CTCAE") to improve toxicity measurement in clinical trials. The PRO-CTCAE is an item bank with 124 individually validated toxicity questions for patients, with an accompanying software system for directly collecting information about symptomatic adverse events from patients. The barriers and challenges that need to be addressed when considering broad integration of PRO toxicity monitoring in cancer clinical trials are discussed, including challenges related to data collection logistics, analytic approaches, and resource utilization. The advent of instruments like the PRO-CTCAE, conceived to describe therapy side effects from the patient perspective, brings the potential both to improve the quality of data for risk-benefit evaluation in clinical research, and to provide future patients facing treatment decisions with information about prior experiences of their peers.3

show abstract

“…[17][18][19][20][21][22] Symptom research has looked at patient-clinician agreement of symptoms related to angina pectoris, 23 myocardial infarction, 24,25 psychological and somatic disorders, 8,[26][27][28][29] HIV infection, 30 and cancer. 31,32 One study found fair to substantial agreement between adult selfassessment and clinician assessment on the symptoms related to 'strep throat'. 33 However, there is a relative paucity of primary care reports for infectious diseases, particularly for respiratory infection.…”

Section: Introductionmentioning

confidence: 99%

Agreement between self-report and medical records on signs and symptoms of respiratory illness

Barbara

Loeb

Dolovich

et al. 2012

Primary Care Respiratory Journal

View full text Add to dashboard Cite

show abstract

Clinician versus nurse symptom reporting using the National Cancer Institute—Common Terminology Criteria for Adverse Events during chemotherapy: results of a comparison based on patient's self-reported questionnaire

Abstract: Our results support the validity of nurse toxicity reporting and that the nurse staff could be successfully employed in collecting toxicity data because of a greater ability to elicit information from patients than the medical staff.

Cited by 114 publications

References 18 publications

Self-evaluation of Adjuvant Chemotherapy-Related Adverse Effects by Patients With Breast Cancer

Self-evaluation of Adjuvant Chemotherapy-Related Adverse Effects by Patients With Breast Cancer

Patient-reported outcomes in the evaluation of toxicity of anticancer treatments

Agreement between self-report and medical records on signs and symptoms of respiratory illness

Contact Info

Product

Resources

About