Prostate cancer patient reports are a reliable strategy for assessing the presence of certain comorbidities, according to a study by the University of North Carolina (UNC).
The study, “Comparison of Patient Report and Medical Records of Comorbidities,” appeared in the journal JAMA Oncology and supports the use of patient reports, which are less expensive than medical records in helping to choose appropriate treatments and monitor patient outcomes.
Men with prostate cancer are burdened with disease comorbidities, or the presence of additional diseases that affect treatment decisions. For example, doctors often suggest radical prostatectomy — or surgically removing the prostate — to younger patients with fewer comorbidities. On the other hand, older patients with more frequent comorbidities often receive radiotherapy and conservative management such as hormone therapy or active surveillance.
In their study, UNC researchers compared patient reports and medical records to assess the level of agreement between both methods in patients with newly diagnosed prostate cancer. They analyzed data from 881 men enrolled in the North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCESS) — a prospective, population-based cohort of patients diagnosed between January 2011 and June 2013.
Researchers looked at the 20 most common comorbidities usually present in cancer patients: cardiovascular diseases (myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease and coronary artery disease); chronic obstructive pulmonary disease; peptic ulcer disease; liver disease; diabetes; kidney disease and other cancers; AIDS; arrhythmia; clotting disorders; hypertension, hyperlipidemia; inflammatory bowel disease; asthma; anemia and other blood disorders, and arthritis.
Out of the 20 conditions analyzed, 16 were present in both patient reports and medical records in more than 90 percent of patients. That association was less so with hyperlipidemia and arthritis, and overall agreement was significanlty lower in older men with regard to multiple cardiovascular conditions and kidney disease.
Overall, “patient reporting provides information similar to medical record abstraction without significant differences by patient race or educational level,” researchers concluded. “Use of patient reports, which are less costly than medical record audits, is a reasonable approach for observational comparative effectiveness research.”