AUA 2017: Concordance Between Physician-documented Versus Patient-reported Comorbidities In Prostate Cancer: Validation Of A Novel Informatics Tool

Boston, MA ( Katherine Fleshner, a medical student, presented her interesting study focusing on the concordance between physician documented and patient reported comorbidities in the setting of prostate cancer urology visits. She described a novel web tool utilized in the urology clinic at Memorial Sloan Kettering and called: “Baseline Medical History”. This online tool allows patients to report their own medical history from home before their doctor visit. Subsequently, the physician would review the information with the patient during the clinic visit and modify it accordingly, before being entered into the electronic medical record. This was origionally implemented in order to lower the burden of multiple interviews. The authors aimed to examine the concordance between this novel online patient filled tool and the traditional physician-documented collection of comorbidities.

Overall, comorbidities were collected for 213 new prostate cancer visits to the urology clinic through an online survey, before the clinical encounter. The frequency distributions of comorbidities as reported by patients before physician review was compared to those documented by physicians for a sample of 298 consecutive patients presenting to the same urology clinic before the survey began.

The results demonstrated that patient were extremely satisfied with the survey. Comorbidities and life expectancy estimates were highly comparable between the two groups. A few comorbidity categories were reported in higher frequency in the patient-reported group compared to the physician-documented group. These included: cardiovascular (25% vs. 20%), vascular-related (8.5% vs. 4.4%), neurologic (7.5% vs. 1.7%), gastrointestinal (30% vs. 25%), musculoskeletal comorbidities (30% vs. 21%), as well as other cancers (30% vs. 12%). In contrast, genitourinary comorbidities, including lower urinary tract symptoms and erectile dysfunction were more commonly reported in the physician group (68% vs. 53%).

In summary, in this elegant presentation it was shown that patients completing a novel online web-based tool, focusing on their medical history, provide relatively accurate and complete information, even before physician review.

Presented by: Katherine Fleshner, London, Ontario, Canada

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre

Twitter: @Goldberghanan

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA