Patients and Clinicians Have Different Perspectives on Outcomes in Arthritis

SARAH A. HEWLETT

ABSTRACT.

Outcome measurement in arthritis has undergone a major shift during the past 2 decades, moving from process measures (e.g., plasma viscosity) to patient-centered outcome measures (e.g., pain, function). However, while patients self-report many of these outcomes, it is clinicians who judge those reports to guide clinical decisions and define the efficacy of treatments in clinical trials. It is important to ascertain whether patient or professional views converge or diverge and also whether the outcomes being measured are those of importance to patients. This article reviews some of the available evidence on the congruence (or otherwise) of patient and professional views of outcome, and reports considerable variation between the 2 views. Reasons why views might differ are discussed (for example, disease activity might be assessed using different variables by patients and clinicians), and the possibility of the effect of the personal meaning or impact of an outcome for a patient is raised. Finally the significance of these discrepant views is addressed, posing the challenge of how we might incorporate a measure of the personal meaning of an outcome to a patient into our outcome measures. (J Rheumatol 2003;30:877-9)

Key Indexing Terms:

RHEUMATOID ARTHRITIS
PATIENTS
OUTCOME ASSESSMENT

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From the ARC Senior Lecturer in Rheumatology (Health Professions), Academic Rheumatology, University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK. E-mail: Sarah.Hewlett@bristol.ac.uk

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