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Comparison of Clinician Assessment of World Health Organization Functional Class with Patient Self-Assessment

Tonya Zeiger


E. Viray

Charles Burger


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Conference: 2010 International PHA Conference and Scientific Sessions

Release Date: 06.24.2010

Presentation Type: Abstracts

Zeiger T, Viray E, Burger C. 
Mayo Clinic, Jacksonville, FL, USA

BACKGROUNDIt is standard of care is to assess a Pulmonary Hypertension (PH) patient’s World Health Organization (WHO) functional class (FC) with each clinic visit. We hypothesized that the patient would rate their WHO FC in agreement with the assessment made by the PH clinician.

METHODSA total of 210 Mayo Clinic PH clinic patients were given a self-assessment form during consultation to assess WHO FC according to symptoms (Figure 1). The assessment by the PH physician occurred at the same visit. The number of physician-patient agreements and intraclass correlation were estimated with a 95% confidence interval.

RESULTSMean age was 70 years (25 to 93). 62 of 210 patients (30%) were male. WHO diagnostic group: 1 (41%), 2 (33%), 3 (21%), 4 (5%). Mean six-minute walk: 305 m. Mean systolic pulmonary artery pressure: 57 mmHg. The intraclass correlation coefficient was 0.83. Furthermore, there was exact agreement for 158 out of 210 patients (75%). The majority of disagreements in the remaining 52 patient-physician comparisons (N=34, 16%) were when the patient-assessed WHO FC was 4 and physician-assessment was FC 3 (Figure 2).

CONCLUSIONSThere was strong agreement between patient-physician WHO FC assessments; however, the primary challenge occurred in those patients who self-assessed as WHO FC 4 but whom the physician considered to be WHO FC 3. The current self-assessment tool may not permit the patient to appropriately discriminate between those 2 classes in all cases.

Comparison of Clinician Assessment of World Health Organization Functional Class with Patient Self-A

Comparison of Clinician Assessment of World Health Organization Functional Class with Patient Self-A