Concordance Between Patient-Reported and Clinically Documented Symptoms in Acute Myeloid Leukemia

Area of Science:

• Oncology
• Health Informatics
• Patient Care

Background:

• Symptom documentation is crucial for acute myeloid leukemia (AML) patient management.
• Electronic health records (EHRs) are primary tools for clinical documentation.
• Discrepancies between patient-reported and EHR-documented symptoms can impact care.

Purpose of the Study:

• To assess the frequency and documentation patterns of patient-reported and clinician-documented symptoms in AML patients.
• To determine the concordance and discordance between patient-reported symptoms and EHR documentation.
• To identify potential gaps in capturing the full spectrum of patient experiences.

Main Methods:

• A modified Memorial Symptom Assessment Scale was used for patient-reported symptoms.
• Clinician-documented symptoms were extracted from clinical notes and nursing flow sheets in the EHR.
• Cohen's kappa and McNemar's tests were employed to evaluate concordance and discordance.

Main Results:

• Lack of energy and appetite were frequently reported by both patients and clinicians.
• Significant discordance was observed for psychosocial symptoms like sadness and irritability, which were underdocumented in the EHR.
• Patient-reported subjective experiences may be overlooked in routine clinical documentation.

Conclusions:

• Accurate and comprehensive symptom documentation is vital for effective symptom management and clinical decision-making in AML.
• Integrating structured symptom assessment tools or patient-reported outcomes into EHRs can enhance documentation accuracy.
• Improved documentation can lead to better quality of care for AML patients.