Agreement of patient and physician ratings on mobility and self-care in neurological diseases

Abstract

With a newly developed questionnaire, which integrates the patient and provider ratings on mobility and self-care on an IRT scale (MOSES-Combi) and thus ensures the same measurement scale for patients and providers, we examined the level of agreement between neurology patients and the physicians treating them, how agreement changes after rehabilitation, and what factors affect the extent of agreement. A total of 258 neurology patients from nine inpatient rehabilitation centers and the physicians treating them filled out the MOSES-Combi at the beginning and end of rehabilitation. Multilevel analyses were conducted. While the average value of the person parameters for patients and physicians is quite similar at the beginning of rehabilitation, there are highly significant differences after rehabilitation. The patient generally describes himself as more limited. Agreement at the individual level at the start of rehabilitation is moderate to substantial, with ICCs between .552 and .750. At the end of rehabilitation, agreement reduces. Factors that predict agreement are site and setting rehabilitation goals in the respective areas of mobility and self-care being observed. Our study indicates that general organizational conditions can have an influence on the extent of agreement.