Doctors and patients don't agree: cross sectional study of patients' and doctors' perceptions and assessments of disability in multiple sclerosis

• Published in: BMJ 1997-05, Vol.314 (7094), p.1580-1583
• Main Authors: Rothwell, P M, McDowell, Z, Wong, C K, Dorman, P J
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Disabilities; Disability; Disability Evaluation; Disabled Persons; Female; Humans; Judgment; Male; Medical research; Medical sciences; Mental health; Middle Aged; Multiple sclerosis; Multiple Sclerosis - physiopathology; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Nervous system diseases; Neurology; Patients; Physical disabilities; Physician-Patient Relations; Quality of Life; Questionnaires; Scotland; Severity of Illness Index; Side effects; Vitality
• ISSN: 0959-8138; 0959-8146; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.314.7094.1580

Abstract Objectives: To compare the judgments of clinicians on which domains of health in the short form questionnaire (SF-36) would be most important to patients with multiple sclerosis with the opinions of patients themselves; to compare assessment of physical disability in multiple sclerosis by a clinician using Kurtzke's expanded disability status scale and a non-clinically qualified assistant using the Office of Population Census and Surveys' (OPCS) disability scale with self assessment of disability and other domains of health related quality of life by patients using the SF-36 and the EuroQol questionnaire; and to compare the scores of patients for each domain of the SF-36 with control data matched for age and sex. Design: Cross sectional study. Setting: Clinical department of neurology, Edinburgh. Subjects: 42 consecutive patients with multiple sclerosis attending a neurology outpatient clinic for review or a neurology ward for rehabilitation. Main outcome measures: Scores on the SF-36; EuroQol; Kurtzke's expanded disability status scale; the OPCS disability scale. Results: Patients and clinicians disagreed on which domains of health status were most important (χ2=21, df=7, P=0.003). Patients' assessment of their physical disability using the physical functioning domain of the SF-36 was highly correlated with the clinicians' assessment (r=-0.87, P