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The Discrepancy between Patient and Clinician Reported Function in Extremity Bone Metastases
Stein J Janssen1, Eva A J van Rein1, Nuno Rui Paulino Pereira1
1Department of Orthopaedic Surgery, Orthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Sarcoma
|October 12, 2016
Summary
Clinician assessments using the Musculoskeletal Tumor Society (MSTS) scoring system overestimate patient function. Patient-reported MSTS scores were significantly lower than clinician-reported scores, highlighting a discrepancy in perceived functional outcomes.
Area of Science:
- Orthopedics
- Oncology
- Rehabilitation Medicine
Background:
- The Musculoskeletal Tumor Society (MSTS) scoring system is widely used to assess functional outcomes in patients with musculoskeletal tumors.
- The MSTS score's development by clinicians, rather than patients, raises questions about its accuracy in reflecting patient-perceived function.
- Discrepancies between clinician and patient perspectives can impact treatment expectations and patient satisfaction.
Purpose of the Study:
- To investigate the differences between patient-reported and clinician-reported Musculoskeletal Tumor Society (MSTS) scores.
- To determine if clinician assessments of function align with patient self-assessments.
- To evaluate the reliability of the MSTS score when completed by patients versus clinicians.
Main Methods:
- 128 patients with bone metastases in the extremities completed the MSTS score.
- MSTS scores were also extracted from clinician reports in medical records.
- A comparative analysis was performed to identify differences between patient and clinician-reported scores.
Main Results:
- Clinician-reported MSTS scores (median: 65) were significantly higher than patient-reported scores (median: 57).
- The median difference indicated an overestimation of function by clinicians by 8 points (p < 0.001).
- This overestimation was observed in patients with bone metastases in both lower and upper extremities.
Conclusions:
- Clinician-reported MSTS scores tend to overestimate functional outcomes compared to patient self-assessments.
- Acknowledging this discrepancy is crucial for realistic patient counseling regarding treatment outcomes.
- Understanding patient perceptions of function is vital for comprehensive care and managing expectations.
