Abstract 188: Comparison of Physician- and Patient-Assessed Impressions of Treatment Efficacy: Insights from the TERISA Clinical Trial
Notice bibliographique
Résumé
BACKGROUND: Physicians typically rely on their qualitative interpretation of patients’ symptoms to evaluate the efficacy of antianginal therapy. However, the accuracy of this approach has not been examined. METHODS: Using data from the international multicenter TERISA clinical trial of patients with type 2 diabetes, CAD, and stable angina, we compared the physician’s assessment of change with patient-reported changes in angina. Physicians were asked to complete a well-validated visual analog scale (PGAVAS) at baseline and after 8 weeks of treatment. The PGAVAS asks the physician to rate the disease activity of their patient on a scale of 0 (“very good”) to 100 (“very bad”). A clinically important change in PGAVAS was defined as 8.5 points (i.e., half the baseline SD; a moderate change by Cohen’s effect size). Change from baseline in PGAVAS was compared with change from baseline in angina frequency (AF) as measured by an electronic daily diary. Among patients with an improvement in AF of ≥ 1 weekly episode, multivariable logistic regression examined predictors of physician recognition of change. RESULTS: Among 927 patients in TERISA, 892 (96%) had PGAVAS scores at baseline and at 8 weeks. Of the 605 patients with improvement in AF of ≥ 1 episode, 291 (48%) were recognized by the physician as improved (per the PGAVAS). Comparatively, of the 287 patients with unchanged or worsened AF, 197 (69%) were believed to be unchanged or worse by the physician. Overall, 45% of physicians’ assessments were discordant with their patients’ symptoms. There was a significant but poor correlation between the change in PGAVAS and change in patient-reported AF (Figure; r = 0.15). In multivariable regression, the degree of change in AF was significantly associated with physician recognition of change, with each 1 episode reduction in weekly AF associated with a 12% increased odds of physician recognition (95% CI 1.05-1.20). Age, sex, geography, and baseline AF were not associated with recognition. CONCLUSION: In TERISA, physicians were limited in their ability to recognize significant improvement in patients’ angina, although greater patient change was associated with greater physician recognition. These data suggest that patient-reported outcomes may provide added value to physicians in monitoring their patients’ angina and health status.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».