An at-home online survey was found to be a reasonably accurate way to collect patient comorbidities prior to a physician visit in patients with prostate cancer, according to a new study. There were some differences between patient-reported and physician-reported comorbidities, but the self-reported method may be a reliable starting point for collection of medical history.
Traditionally, patients’ medical histories are collected through interviews, often repeated multiple times. “Repeated questioning may be viewed negatively by patients,” wrote study authors led by Andrew J. Vickers, PhD, of Memorial Sloan Kettering Cancer Center in New York. “Moreover, the form used to record a patient’s medical history typically includes a limited section on comorbidities in which important conditions are at risk of being missed. A brief and rushed visit may also lead to reporting errors.”
The researchers compared the use of an online tool known as the Baseline Medical History (BMH) with traditional physician-reported comorbidities. The BMH was used to collect comorbidities for 213 new prostate cancer patients with upcoming visits to the urology clinic at Memorial Sloan Kettering, and this was compared with traditional collection of 298 consecutive patients to the same clinic before the BMH was launched. The results were published in JCO: Clinical Cancer Informatics.
The overall frequency distribution of all comorbidities was similar between the two groups of prostate cancer patients. However, the patient-reported group had a higher rate of neurologic comorbidities, at 7.5% compared with 1.7% in the physician-reported group (P = .001). The same trend was seen for vascular conditions, though this was not significant (difference of 4.1%; P = .062).
Back pain was reported more in the BMH cohort, at 24% compared with 13% (P = .001), but other musculoskeletal comorbidities were reported more frequently in the physician-reported group, at 8.7% compared with 1.9% (P = .001). The largest difference in any type of comorbidity seen was for genitourinary conditions, reported in 68% of the physician-reported group and in 53% of the patient-reported group (P = .001). Smoking status was captured at a similar rate between the groups.
An analysis of how these comorbidity-reporting methods might change risk predictions in these patients showed little difference. The median risk of death at 10 years, adjusted for age and comorbidity, was 0.23 in the BMH group and 0.21 in the physician-reported group; at 15 years, these rates were 0.40 and 0.37.
“This validates the use of a patient-reported medical history as a complementary and efficient method of obtaining comorbidities before the clinic visit and suggests that patient-reported medical history is, indeed, a reliable first pass and could be considered for implementation to facilitate clinic efficiency without significantly compromising the quality of comorbidity reporting,” the authors concluded.