Ratings of cancer chemotherapy toxicity by oncologists, nurses, and pharmacists

In order to examine the perceived toxicity of commonly used drug regimens for cancer chemotherapy, eight oncologists, twelve nurses, and five pharmacists rated the toxicity of 30 different drug combinations. Although the correlations revealed a high degree of agreement, the oncologists' ratings and the nurses' ratings differed systematically at the lower- and the higher-toxicity levels. This was most readily described by a "regression effect," wherein oncologists' ratings appear to regress toward the mean relative to the nurses' ratings. The perception of both toxicity and the importance of side effects such as nausea and vomiting may be substantially different between physicians and nurses, and hence, has important implications for how patients communicate these to the various health care professionals.