Quantifying the value of the patient’s perspective concerning the effects of lipodystrophy on quality of life (QoL) may be useful. To test this hypothesis, French researchers surveyed 143 patients with lipodystrophy. They used using correlations between patient-reported outcomes (PROs) and clinician-reported and biological outcomes.

““Assessment of Body Change and Distress” (ABCD) consisted of three parts: signs of lipodystrophy (6 items), global satisfaction (n=1) and 20 items evaluating QoL.

Results

• ABCD QoL score is weakly or not associated with viral load (r=0.03), CD4 count (r=0.13) and CDC classification (P=NS).
• Its correlation with the clinician’s report of number of sites of lipodystrophy is weak (r=0.17).
• Correlations between different PROs are logically higher.
• ABCD QoL score is more correlated with the patient’s report of number of sites of lipodystrophy (r=0.39) and with satisfaction (r=0.58).
• ABCD QoL score is correlated with health distress and social dimensions of the MOS-HIV and with mental component of the SF-12, but not with physical dimensions of these questionnaires.

In conclusion, the authors write, “PROs are weakly correlated with biological markers, and although overlapping, each of the PROs measures a distinct concept.”

“Clinicians cannot infer the QoL of their patients neither from a viral load nor from a clinical exam. The patient’s perspective is essential in medical decision making and so it is with lipodystrophy: that is the psychological and social distress related to the body changes must be measured in clinical trials, to make sure that life is not lengthened at the expense of its quality.”

12/09/05

Reference
M Duracinsky and others. Disagreement between clinicians’ and patients’ reported outcomes in lipodystrophy. Abstract 38. 7th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV. November 13-16, 2005. Dublin, Ireland. Antiviral Therapy 2005; 10:L25.