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

Cecilie Lindström Egholm; Niels Steen Krogh; Theodore Pincus; Lene Dreyer; Torkell Ellingsen; Bente Glintborg; Marcin Ryszard Kowalski; Tove Lorenzen; Ole Rintek Madsen; Henrik Nordin; Claus Rasmussen; Merete Lund Hetland

doi:10.3899/jrheum.150007

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

Cecilie Lindström Egholm, Niels Steen Krogh, Theodore Pincus, Lene Dreyer, Torkell Ellingsen, Bente Glintborg, Marcin Ryszard Kowalski, Tove Lorenzen, Ole Rintek Madsen, Henrik Nordin, Claus Rasmussen, Merete Lund Hetland

Department of Clinical Medicine

38 Citations (Scopus)

Abstract

Objective. To assess the frequency of discordance in patient's (PtGA) and physician's (PGA) global assessment, and to investigate whether higher discordance in female patients compared with male patients is associated with the physician's sex in patients with rheumatoid arthritis (RA), axial spondy-loarthritis (axSpA), and psoriatic arthritis (PsA). Methods. PtGA, PGA, and other patient-related variables were retrieved from the Danish DANBIO registry, used nationwide to monitor patients with RA, axSpA, and PsA. A questionnaire was sent to all physicians registering in DANBIO (n = 265) regarding individual physician characteristics including sex and age. Discordance was defined as PtGA > 20 mm higher (or lower) than PGA. First encounters between patients and physicians were analyzed using descriptive statistics and mixed model regression analysis. Results. Ninety physicians (34%) returned the questionnaire and were pairwise matched with 10,282 first patient encounters (8300 patients with RA, 524 axSpA, and 1458 PsA). The frequency of discordant (PtGA > PGA) encounters (not including PGA > PtGA seen in < 2%) in RA, axSpA, and PsA was 49.0%, 48.3%, and 56.5%, respectively. Discordance was more common in female patients with high scores on functional disability, pain, and fatigue across the 3 diseases, whereas it was independent of the physician's sex. Conclusion. 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.

Original language	English
Journal	Journal of Rheumatology
Volume	42
Issue number	10
Pages (from-to)	1781-5
Number of pages	5
ISSN	0315-162X
DOIs	https://doi.org/10.3899/jrheum.150007
Publication status	Published - 1 Oct 2015

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Lindström Egholm, C., Krogh, N. S., Pincus, T., Dreyer, L., Ellingsen, T., Glintborg, B., Kowalski, M. R., Lorenzen, T., Madsen, O. R., Nordin, H., Rasmussen, C., & Hetland, M. L. (2015). 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. Journal of Rheumatology, 42(10), 1781-5. https://doi.org/10.3899/jrheum.150007

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. / Lindström Egholm, Cecilie; Krogh, Niels Steen; Pincus, Theodore et al.

In: Journal of Rheumatology, Vol. 42, No. 10, 01.10.2015, p. 1781-5.

Research output: Contribution to journal › Journal article › Research › peer-review

Lindström Egholm, C, Krogh, NS, Pincus, T, Dreyer, L, Ellingsen, T, Glintborg, B, Kowalski, MR, Lorenzen, T, Madsen, OR, Nordin, H, Rasmussen, C & Hetland, ML 2015, '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', Journal of Rheumatology, vol. 42, no. 10, pp. 1781-5. https://doi.org/10.3899/jrheum.150007

Lindström Egholm C, Krogh NS, Pincus T, Dreyer L, Ellingsen T, Glintborg B et al. 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. Journal of Rheumatology. 2015 Oct 1;42(10):1781-5. doi: 10.3899/jrheum.150007

Lindström Egholm, Cecilie ; Krogh, Niels Steen ; Pincus, Theodore et al. / 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. In: Journal of Rheumatology. 2015 ; Vol. 42, No. 10. pp. 1781-5.

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title = "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 = "Objective. To assess the frequency of discordance in patient's (PtGA) and physician's (PGA) global assessment, and to investigate whether higher discordance in female patients compared with male patients is associated with the physician's sex in patients with rheumatoid arthritis (RA), axial spondy-loarthritis (axSpA), and psoriatic arthritis (PsA). Methods. PtGA, PGA, and other patient-related variables were retrieved from the Danish DANBIO registry, used nationwide to monitor patients with RA, axSpA, and PsA. A questionnaire was sent to all physicians registering in DANBIO (n = 265) regarding individual physician characteristics including sex and age. Discordance was defined as PtGA > 20 mm higher (or lower) than PGA. First encounters between patients and physicians were analyzed using descriptive statistics and mixed model regression analysis. Results. Ninety physicians (34%) returned the questionnaire and were pairwise matched with 10,282 first patient encounters (8300 patients with RA, 524 axSpA, and 1458 PsA). The frequency of discordant (PtGA > PGA) encounters (not including PGA > PtGA seen in < 2%) in RA, axSpA, and PsA was 49.0%, 48.3%, and 56.5%, respectively. Discordance was more common in female patients with high scores on functional disability, pain, and fatigue across the 3 diseases, whereas it was independent of the physician's sex. Conclusion. 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.",

author = "{Lindstr{\"o}m Egholm}, Cecilie and Krogh, {Niels Steen} and Theodore Pincus and Lene Dreyer and Torkell Ellingsen and Bente Glintborg and Kowalski, {Marcin Ryszard} and Tove Lorenzen and Madsen, {Ole Rintek} and Henrik Nordin and Claus Rasmussen and Hetland, {Merete Lund}",

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doi = "10.3899/jrheum.150007",

language = "English",

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pages = "1781--5",

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TY - JOUR

T1 - Discordance of Global Assessments by Patient and Physician Is Higher in Female than in Male Patients Regardless of the Physician's Sex

T2 - Data on Patients with Rheumatoid Arthritis, Axial Spondyloarthritis, and Psoriatic Arthritis from the DANBIO Registry

AU - Lindström Egholm, Cecilie

AU - Krogh, Niels Steen

AU - Pincus, Theodore

AU - Dreyer, Lene

AU - Ellingsen, Torkell

AU - Glintborg, Bente

AU - Kowalski, Marcin Ryszard

AU - Lorenzen, Tove

AU - Madsen, Ole Rintek

AU - Nordin, Henrik

AU - Rasmussen, Claus

AU - Hetland, Merete Lund

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Objective. To assess the frequency of discordance in patient's (PtGA) and physician's (PGA) global assessment, and to investigate whether higher discordance in female patients compared with male patients is associated with the physician's sex in patients with rheumatoid arthritis (RA), axial spondy-loarthritis (axSpA), and psoriatic arthritis (PsA). Methods. PtGA, PGA, and other patient-related variables were retrieved from the Danish DANBIO registry, used nationwide to monitor patients with RA, axSpA, and PsA. A questionnaire was sent to all physicians registering in DANBIO (n = 265) regarding individual physician characteristics including sex and age. Discordance was defined as PtGA > 20 mm higher (or lower) than PGA. First encounters between patients and physicians were analyzed using descriptive statistics and mixed model regression analysis. Results. Ninety physicians (34%) returned the questionnaire and were pairwise matched with 10,282 first patient encounters (8300 patients with RA, 524 axSpA, and 1458 PsA). The frequency of discordant (PtGA > PGA) encounters (not including PGA > PtGA seen in < 2%) in RA, axSpA, and PsA was 49.0%, 48.3%, and 56.5%, respectively. Discordance was more common in female patients with high scores on functional disability, pain, and fatigue across the 3 diseases, whereas it was independent of the physician's sex. Conclusion. 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.

AB - Objective. To assess the frequency of discordance in patient's (PtGA) and physician's (PGA) global assessment, and to investigate whether higher discordance in female patients compared with male patients is associated with the physician's sex in patients with rheumatoid arthritis (RA), axial spondy-loarthritis (axSpA), and psoriatic arthritis (PsA). Methods. PtGA, PGA, and other patient-related variables were retrieved from the Danish DANBIO registry, used nationwide to monitor patients with RA, axSpA, and PsA. A questionnaire was sent to all physicians registering in DANBIO (n = 265) regarding individual physician characteristics including sex and age. Discordance was defined as PtGA > 20 mm higher (or lower) than PGA. First encounters between patients and physicians were analyzed using descriptive statistics and mixed model regression analysis. Results. Ninety physicians (34%) returned the questionnaire and were pairwise matched with 10,282 first patient encounters (8300 patients with RA, 524 axSpA, and 1458 PsA). The frequency of discordant (PtGA > PGA) encounters (not including PGA > PtGA seen in < 2%) in RA, axSpA, and PsA was 49.0%, 48.3%, and 56.5%, respectively. Discordance was more common in female patients with high scores on functional disability, pain, and fatigue across the 3 diseases, whereas it was independent of the physician's sex. Conclusion. 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.

U2 - 10.3899/jrheum.150007

DO - 10.3899/jrheum.150007

M3 - Journal article

C2 - 26233511

SN - 0315-162X

VL - 42

SP - 1781

EP - 1785

JO - Journal of Rheumatology

JF - Journal of Rheumatology

IS - 10

ER -