转移性乳腺癌患者的合并症和症状影响治疗决策并影响预后和生活质量。本研究的目的是检查医生记录与患者报告的合并症和症状之间的一致性，以了解其相对有效性。患有转移性乳腺癌的新患者完成了一项电子摄入调查，评估患者的健康史和症状。涵盖 54 种合并症和 42 种症状的医生记录摘自 2016 年 11 月至 2020 年 3 月期间相应门诊就诊的记录。评估了患者报告和每种情况的医疗记录之间的一致性，以及每位患者与医生报告的合并症和症状的风险比。总共 168 名患者被纳入分析（年龄，中位数 = 56 岁，范围 = 29-86 岁；131 名白人 [78.9%]）。 54 种合并症中有 23 种在患者和医生之间具有中度至高度的一致性 (κ ≥ 0.40)。医生记录了更多数量的可客观测量的合并症，这些合并症的一致性也更高（例如，糖尿病 [κ = 0.83] 和高血压 [κ = 0.79]），而患者报告的合并症数量更多，这些主观性更强，一致性也较低（焦虑 [κ = 0.30]、GERD [κ = 0.36]）。一名医生记录的合并症和两名患者报告的合并症与生存率显着相关（p<<0.05）。 42 种症状中只有 2 种症状在患者和医生之间具有中度至高度的一致性。医生记录的 1 种症状和患者报告的 9 种症状与生存率降低显着相关 (p<0.05)。患者和医生报告的合并症的一致性差异很大，患者报告可以补充医生的记录。与患者相比，医生明显低估了症状；因此，一致性也很低。患者报告的多种症状可预测生存；因此，将它们合并起来可以提供更丰富的预测生存估计。© 2023 作者。约翰·威利出版的癌症医学

Comorbidities and symptoms in metastatic breast cancer patients impact treatment decisions and influence prognosis and quality of life. The objective of this study is to examine the concordance between physician documentation and patient reports of comorbidities and symptoms to understand their comparative effectiveness.New patients with metastatic breast cancer completed an electronic intake survey assessing patient health history and symptoms. Physician documentation across 54 comorbidities and 42 symptoms was abstracted from notes for the corresponding clinic visits between November 2016 and March 2020. Concordance between patient reports and medical records for each condition and hazards ratios for each patient versus physician reported comorbidity and symptom were assessed.A total of 168 patients were included in the analysis (age, median = 56 years, range = 29-86 years; 131 white [78.9%]). Twenty-three of 54 comorbidities had a moderate to high level of agreement between patients and physicians (κ ≥ 0.40). Physicians documented higher numbers of comorbidities that can be objectively measured which also had higher concordance (e.g., diabetes [κ = 0.83] and hypertension [κ = 0.79]) while patients reported higher numbers of comorbidities that are more subjective which also had lower concordance (anxiety [κ = 0.30], GERD [κ = 0.36]). One physician-documented and two patient-reported comorbidities were significantly associated with survival (p < 0.05). Only 2 of 42 symptoms had a moderate to high level of agreement between patients and physicians. One physician-documented and nine patient-reported symptoms were significantly associated with decreased survival (p < 0.05).Agreement between patients' and physicians' reporting of comorbidities varies substantially, and patient reports can complement physician documentation. Physicians significantly underreported symptoms versus patients; thus, concordance was also low. Multiple patient-reported symptoms were predictive of survival; thus, incorporating them can provide more informative estimates of predicted survival.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.