Discordance of Global Assessments by Patient and Physician Is Higher in Female than in Male Patients Regardless of the Physician’s Sex: Data on Patients with Rheumatoid Arthritis, Axial Spondyloarthritis, and Psoriatic Arthritis from the DANBIO Registry

Abstract

In this study on Danish patients with RA, axSpA, and PsA, the PtGA was > 20 mm higher than the PGA in about half of the encounters, and more common in female patients of both female and male physicians. This finding highlights one of the challenges in shared decision making.

A cross‐sectional study on factors associated with patient–physician discordance in global assessment of patients with axial spondyloarthritis: an Asian perspective

“…Higher global pain score was related to higher PGA, hence resulting in greater discordance between PGA and PhGA. This is similar to a Danish study on patients with spondyloarthropathy including axSpA in which pain was associated with higher discordance in PGA–PhGA …”

“…Physician variables such as gender and age of the physician which may influence PhGA results were not included in the study. A Danish study showed that discordance was independent of physician's gender . Comorbidities such as chronic pain syndromes and mood disorders, which include fibromyalgia and depression, respectively, have been known to coexist with axSpA and may contribute to overestimation of patient‐reported symptoms such as pain scores, hence influencing discordance .…”

“…Factors were deemed to be associated with patient–physician discordance if the ρ‐value was lower than the significance level of 0.05. We did a sensitivity analysis with multivariate logistics regression by categorizing patient–physician discordance into greater and equal to 20 and less than 20 . Data was analyzed using Stata SE 14.0 (StataCorp., College Station, TX, USA).…”

“…Singapore is a multiethnic Asian country with the majority being Chinese (74.1%), followed by Malay (13.4%), Indian (9.2%) and others (3.3%) . Previous studies based on Western populations have identified factors such as functional disability, global pain score, fatigue and spine pain to be determinants of discordance between patient global assessment (PGA) and physician global assessment (PhGA) …”

Incorporating the patient's perspective in outcomes research

“…Discrepancies between physicians’ and patients’ assessments of their disease activity [1–3], treatment preferences [4,5], factors utilized in decision-making [6–8], and thresholds to change treatment plans [9], underscore the importance of including the patients’ perspective in outcomes research.…”