Self-reported quality of life of individual cancer patients: Concordance of results with disease course and medical records

Purpose: To investigate the applicability of a standard quality of life (QL ) questionnaire to individual cancer patients and to explore the potential for impact of QL information on the process of care by comparing at group l evel the QL results with the medical records. Patients and Methods: One hundred fourteen consecutive patients at the onco logy clinics at St James's Hospital, Leeds, United Kingdom, completed the E uropean: Organisation for the Research and Treatment of Cancer (EORTC) Qual ity of Life Questionnaire (QLQ)-C30 on a touch-screen computer over a 6-mon th period. The QL results were compared with the corresponding medical reco rds at individual and group level. Results: For individual patients, the serial measurement of QL allowed reco gnition of patterns over time corresponding to disease course. At group lev el, a higher proportion of patients reported problems on EORTC QLQ-C30 than were mentioned in the medical records (McNemar paired test, P < .01), Most often clinicians mentioned pain (22% to 39%), and at the initial visit rol e (66%), and social issues (77%). For the rest of the symptoms and function s, the problems were recorded in between 1% and 25% of the notes, but 20% t o 76% of the patients reported QL impairment. Problems that were not record ed in the medical notes tended to be of low severity, with ct significant t rend observed for pain, fatigue, nausea/vomiting, dyspnea, loss of appetite , and physical function scale (<chi>(2) test, 11.55 to 34.42, df = 1, P < . 001). Conclusion: The QL data on individual patients was consistent with the clin ical records, thus providing evidence for the validity of these measures in assessment of the individual. The QL profiles had more information on symp toms and particularly on functional issues, such as emotional distress and physical performance. <(c)> 2001 by American Society of Clinical Oncology.