Systematic symptom and problem assessment at admission to the palliative care ward – perspectives and prognostic impacts

Table 3 Characteristics of physicians’ and patients’ symptom ratings and degree of rater agreement

Symptom	No. of assessments (paired N)	Characteristics of ratings by physicians (HOPE-SP-CL) and patients (MIDOS/IPOS)		Rater agreement by symptom/problem
		Physicians n (%) present^a	Patients n (%) present^a	Percentage of actual agreement^b	Kappa (ƙ)	Strength of agreement^c
Pain	355	234 (65.9)	232 (65.4)	54.7	.438	Moderate
Nausea	348	106 (30.5)	113 (32.5)	73.9	.394	Fair
Vomiting	346	63 (18.2)	71 (20.5)	78.1	.297	Fair
Dyspnea	351	143 (40.7)	141 (40.2)	76.1	.503	Moderate
Constipation	342	152 (44.4)	151 (44.2)	62.8	.248	Fair
Weakness	351	330 (94.0)	315 (89.7)	84.3	-.009	Not significant
Appetite loss	350	269 (76.9)	236 (67.4)	72.3	.318	Fair
Tiredness	349	239 (68.5)	264 (75.6)	63.1	.088	Not significant
Anxiety^d	348	179 (51.4)	142 (40.8)	56.0	.125	Poor
Tension^e	338	231 (68.3)	166 (49.1)	54.7	.101	Poor
Sleeping problems^f	346	132 (38.2)	194 (56.1)	59.0	.202	Poor

HOPE-SP-CL, Symptom and Problem Checklist of the German Hospice and Palliative Care Evaluation
MIDOS, New version of the minimal documentation system for patients in palliative care
IPOS, Integrated Palliative Care Outcome Scale
^adichotomized symptoms: “not present”= no/mild (HOPE-SP-CL) or none/little (MIDOS/IPOS); “present”= moderate/severe (HOPE-SP-CL) or moderate/severe/overwhelming (MIDOS/IPOS)
^bPercentage of ratings matched (both ratings either yes or no)
^cAs per Landis and Koch 1977
^dstudy-specific item added to IPOS
^estudy-specific item added to MIDOS and IPOS
^fstudy-specific item added to MIDOS, IPOS and HOPE-SP-CL

ISSN: 1472-684X