Patient Symptoms and Clinician Toxicity Ratings: Both Have a Role in Cancer Care

Extract

Basch et al. ( 1 ) contribute to a growing literature on the concordance—or lack thereof—between ratings made by cancer patients and proxies. This question is not new: A classic 1992 review by Sprangers and Aaronson ( 2 ) included 35 articles that explored the relationship between clinician and cancer patient assessments of quality of life (including symptoms). Interestingly, one of the summary conclusions of this review was that health-care providers underestimate the pain intensity reported by patients, a conclusion that is echoed in the study by Basch et al.

However, much has changed in this field since 1992, and the study by Basch et al. reflects these clinical and methodological advances, including the increasing acceptance of obtaining patient ratings in the therapeutic environment, and the use of standardized and previously validated questionnaires. This study is particularly noteworthy for its collection of comparable data from providers and patients at the same time points, the impressive response rates for both patients and providers, and the access to full information about specific outcomes: patient use of cancer care services (ie, emergency room [ER] visits) and vital status. Furthermore, the setting of primarily advanced small cell lung cancer with a 41% mortality rate during the study period provided an opportunity to examine these outcomes.