PMID- 15761453
OWN - NLM
STAT- MEDLINE
DCOM- 20050624
LR  - 20151119
IS  - 0147-9563 (Print)
IS  - 0147-9563 (Linking)
VI  - 34
IP  - 2
DP  - 2005 Mar-Apr
TI  - Patient perception and provider assessment of severity of heart failure as 
      predictors of hospitalization.
PG  - 89-98
AB  - OBJECTIVE: To assess the agreement between 2 methods of assigning New York Heart 
      Association (NYHA) functional class to patients with chronic heart failure (CHF): 
      deriving NYHA class from self-report interview data versus clinician assignment. 
      To then determine the ability of each method to predict all-cause 
      hospitalization. METHODS: Adults with CHF > or = 50 years old from an urban 
      health system in Indianapolis, Indiana, were administered the Kansas City 
      Cardiomyopathy Questionnaire (a validated CHF symptom questionnaire) at baseline. 
      Patient self-reported functional data were then used to derive NYHA class. 
      Clinical providers who were blinded to patients' questionnaire data independently 
      assessed NYHA functional class. We used a weighted kappa statistic to evaluate 
      the agreement between the NYHA class from patient-derived and that from 
      provider-assigned methods. We then assessed the ability of patient and provider 
      NYHA to predict time to hospitalization using Cox proportional hazards models. 
      RESULTS: Of 156 patients with complete 6-month follow-up (mean age 63 years +/- 9 
      SD, 53% African American, and 68% women), the correlation coefficient was 0.43 
      between the patient-derived and provider-assigned NYHA methods. The weighted 
      kappa statistic was 0.278, and the 95% confidence interval was 0.18 to 0.37, 
      indicating only slight agreement. Patients classified themselves in worse 
      categories than did their providers. Provider-assigned NYHA was a better 
      predictor of hospitalization (P = .06). CONCLUSIONS: There is only slight 
      agreement between patient-derived and clinician-assigned NYHA functional class. A 
      different approach with patients may be needed if providers hope to use patients' 
      reports to identify those at risk for hospitalization.
FAU - Subramanian, Usha
AU  - Subramanian U
AD  - Roudebush Veterans Administration Medical Center, Indianapolis, Indiana 46202, 
      USA.
FAU - Weiner, Michael
AU  - Weiner M
FAU - Gradus-Pizlo, Irmina
AU  - Gradus-Pizlo I
FAU - Wu, Jingwei
AU  - Wu J
FAU - Tu, Wanzhu
AU  - Tu W
FAU - Murray, Michael D
AU  - Murray MD
LA  - eng
GR  - AG07631/AG/NIA NIH HHS/United States
GR  - R01 AG19105/AG/NIA NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Heart Lung
JT  - Heart & lung : the journal of critical care
JID - 0330057
SB  - IM
MH  - Aged
MH  - Attitude to Health
MH  - Confidence Intervals
MH  - Female
MH  - Follow-Up Studies
MH  - Health Personnel
MH  - Heart Failure/*diagnosis/mortality/therapy
MH  - *Hospitalization
MH  - Humans
MH  - Interviews as Topic
MH  - Male
MH  - Middle Aged
MH  - Patients
MH  - Perception
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Risk Assessment
MH  - Risk Factors
MH  - *Severity of Illness Index
MH  - Surveys and Questionnaires
MH  - Survival Analysis
MH  - Time Factors
MH  - Urban Population
EDAT- 2005/03/12 09:00
MHDA- 2005/06/25 09:00
CRDT- 2005/03/12 09:00
PHST- 2005/03/12 09:00 [pubmed]
PHST- 2005/06/25 09:00 [medline]
PHST- 2005/03/12 09:00 [entrez]
AID - S0147956304001050 [pii]
AID - 10.1016/j.hrtlng.2004.05.002 [doi]
PST - ppublish
SO  - Heart Lung. 2005 Mar-Apr;34(2):89-98. doi: 10.1016/j.hrtlng.2004.05.002.