Students and physicians differ in perception of quality of life in patients with tumors of the upper gastrointestinal tract

TL;DR

This study shows that medical students and physicians differ in how they assess patients' quality of life for upper GI tumors, with students closer to patient reports.

Contribution

The study reveals that students' assessments align better with patients' self-reported symptoms than physicians' estimates.

Findings

Students' symptom scores correlated with patients' for two-thirds of the measures, while physicians' did so for a third.

Physicians tended to overestimate symptoms, while students underestimated them.

Patient-reported outcomes are shown to be more reliable than physician estimates for HRQoL.

Abstract

Health-related quality of life (HRQoL) has recently gained importance as treatment options for tumors of the upper GI tract lead to improved long-term survival. HRQoL is often estimated by physicians even though their reliability and the impact of outside factors such as contact time and level of medical education is unclear. Therefore, in this study we investigated the correlation between physicians’, students’, and patients’ assessment of HRQoL. 54 patients presenting with tumors of the upper GI tract were included and asked to fill out the standardized HRQoL questionnaires EORTC QLQ-C30 and QLQ-OG25. Attending physicians and medical students filled out the same questionnaires through estimation of patients’ HRQoL. Correlation was assessed through Pearson’s and Kendall’s τb coefficients. Physicians’ and patients’ assessments correlated for one out of six of the functional and a third of the symptom scores. Students’ and patients’ assessments correlated for one third of the functional and two thirds of the symptom scores. Students tended to underestimate patients’ symptom burden while physicians tended to overestimate it. Physicians failed to correctly assess several pathognomonic symptoms in this study. Students showed higher correlation with patients’ symptoms than physicians. Even so, this adds to mounting evidence that shows the benefit of using patient-reported outcomes as a gold standard regarding HRQoL.

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