Scholarlink

Background <p>Clinician-assessed symptoms are expected to agree with patient-perceived symptoms. However, patients may value the impact of symptoms on their health-related quality of life (HRQoL) differently from clinicians. This study aimed to evaluate the relationship between patient-perceived HRQoL and clinician-assessed symptom severity in patients with Heart Failure (HF) and Atrial Fibrillation (AF).</p> Methods <p>Newly diagnosed HF and AF patients were prospectively included. Information on symptoms and HRQoL was collected at diagnosis and after 12&#xa0;months during routine HF- and AF-outpatient clinic visits. Symptom severity was assessed by clinicians using the NYHA classification for HF and EHRA score for AF. HRQoL was assessed using the CaReQol-CHF (HF) and AFEQT (AF).</p> Results <p>Complete baseline and 12-month follow-up information was available for 254 HF patients and 765 AF patients. Moderate correlations were observed between NYHA classification and CaReQoL-CHF at diagnosis and follow-up (Spearman’s ρ: HF<sub>social</sub>: 0.202 and 0.426, HF<sub>physical</sub>: 0.317 and 0.421, respectively), and between EHRA score and AFEQT (Spearman’s ρ: −0.363 and −0.305). Clinician-assessed improvement in HF or AF symptoms from diagnosis to 12&#xa0;months was associated with patient-reported improvement in HRQoL (HF<sub>social</sub>: F(250.2) = 3.11, <i>p</i> &lt; 0.046; HF<sub>physical</sub>: F(251.2) = 11.19, <i>p</i> &lt; 0.001; and AF: F(762.2) = 25.86, <i>p</i> &lt; 0.001). When clinicians reported unchanged or worsening symptoms, no significant HRQoL changes were reported by patients.</p> Conclusion <p>Clinician-assessed symptoms correlate moderately with patient-reported HRQoL, with large inter-individual variation in HRQoL. NYHA and EHRA classifications may not accurately reflect patient-perceived burden of disease over time. Incorporating patient-reported outcomes into routine care may better guide treatment, improve the identification of patients’ needs, and support informed clinical and shared decision-making.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Clinician-assessed NYHA and EHRA symptom classifications only moderately reflect patient-reported quality of life in heart failure and atrial fibrillation

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月6日

查看全文
  • Jeroen A. A. van de Pol,
  • Frederique J. Hafkamp,
  • Pepijn H. van der Voort,
  • Johannes C. Post,
  • Sylvie F. A. M. S. de Jong,
  • Monica Monroy,
  • Sabine C. M. Eijsbouts,
  • Ruud F. Spee,
  • Arjen R. T. van de Ven,
  • Boudewijn Klop

摘要

Background

Clinician-assessed symptoms are expected to agree with patient-perceived symptoms. However, patients may value the impact of symptoms on their health-related quality of life (HRQoL) differently from clinicians. This study aimed to evaluate the relationship between patient-perceived HRQoL and clinician-assessed symptom severity in patients with Heart Failure (HF) and Atrial Fibrillation (AF).

Methods

Newly diagnosed HF and AF patients were prospectively included. Information on symptoms and HRQoL was collected at diagnosis and after 12 months during routine HF- and AF-outpatient clinic visits. Symptom severity was assessed by clinicians using the NYHA classification for HF and EHRA score for AF. HRQoL was assessed using the CaReQol-CHF (HF) and AFEQT (AF).

Results

Complete baseline and 12-month follow-up information was available for 254 HF patients and 765 AF patients. Moderate correlations were observed between NYHA classification and CaReQoL-CHF at diagnosis and follow-up (Spearman’s ρ: HFsocial: 0.202 and 0.426, HFphysical: 0.317 and 0.421, respectively), and between EHRA score and AFEQT (Spearman’s ρ: −0.363 and −0.305). Clinician-assessed improvement in HF or AF symptoms from diagnosis to 12 months was associated with patient-reported improvement in HRQoL (HFsocial: F(250.2) = 3.11, p < 0.046; HFphysical: F(251.2) = 11.19, p < 0.001; and AF: F(762.2) = 25.86, p < 0.001). When clinicians reported unchanged or worsening symptoms, no significant HRQoL changes were reported by patients.

Conclusion

Clinician-assessed symptoms correlate moderately with patient-reported HRQoL, with large inter-individual variation in HRQoL. NYHA and EHRA classifications may not accurately reflect patient-perceived burden of disease over time. Incorporating patient-reported outcomes into routine care may better guide treatment, improve the identification of patients’ needs, and support informed clinical and shared decision-making.