Disagreement in Patient and Carer Assessment of Functional Abilities After Stroke
Abstract
Background and Purpose —The aims of this study were to describe differences between functional ability assessments made by stroke patients and their informal carers and to investigate the psychological associates of the difference in assessments. Methods —A prospective design was used, with repeated assessments of function, mood, and carer strain. Thirty hospital stroke patients and their main carer were interviewed 3 times: within 1 month of stroke, 1 month after discharge, and 6 months after discharge. Results —There were significant differences between patient and carer assessments at all 3 time points, with patient self-assessment less disabled than carer assessment (at least P <0.02). The disagreement in assessment was unrelated to patient or carer mood ( P >0.05) but greater disagreement was associated with greater carer strain ( P <0.05). The source of the disagreement in functional ability assessment remains unclear. Conclusions —The method of assessment affects the rating of functional abilities after stroke. Carer strain is potentially increased when the patient or carer makes an unrealistic assessment of the patient’s level of independence.
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Clinicians can be biased in their decision making.
“However, clinicians can be biased in their decision making and expert disagreement is prevalent in medical decision-making tasks [7, 33, 34].”
From Understanding the Effect of Counterfactual Explanations on Trust and Reliance on AI for Human-AI Collaborative Clinical Decision Making (2023) · cites this paper as [33]
The introduction (p. 1) discusses possible bias in assessments used clinically and reports that doctors and nurses gave different ratings of patients’ abilities. The study itself examines disagreement between stroke patients and carers, not bias in clinicians’ decision-making, so it supports only the narrower point about variability in assessments. (LLM, conf=0.78)
Experimental — accuracy not yet measuredExpert disagreement is prevalent in medical decision-making tasks.
“However, clinicians can be biased in their decision making and expert disagreement is prevalent in medical decision-making tasks [7, 33, 34].”
From Understanding the Effect of Counterfactual Explanations on Trust and Reliance on AI for Human-AI Collaborative Clinical Decision Making (2023) · cites this paper as [33]
The introduction (p. 1) reports that doctors and nurses have given different ratings of patients’ functional abilities, supporting an example of clinical disagreement. The study itself examines stroke patients and informal carers, not experts, and neither passage establishes that expert disagreement is prevalent across medical decision-making tasks. (LLM, conf=0.82)
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- Authors
- Knapp, P., & Hewison, J.
- Affiliations
- University of Leeds (GB)
- Venue
- Stroke
- Published
- 1999-05
- Volume
- 30
- Issue
- 5
- Pages
- 934-938
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2076574055
- Semantic Scholar
- f43d92f093fd6af0418a5d9211840eeb87f63059
- Cited by
- 59
- References
- 15
- Citations by year
- 2024: 2 · 2023: 1 · 2021: 2 · 2020: 2 · 2017: 2 · 2015: 1 · 2014: 1 · 2013: 3 · 2012: 3
- FWCI
- 1.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- functional ability assessment, patient self-assessment, informal caregivers, carer strain, mood, functional independence, stroke recovery
- MeSH terms
- Activities of Daily Living, Adult, Aged, Aged, 80 and over, Attitude to Health, Cerebrovascular Disorders, Disability Evaluation, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Prospective Studies, Severity of Illness Index, Stress, Psychological, Caregivers, Patient Satisfaction, Mood Disorders
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