Journal of General Internal Medicine

, Volume 20, Issue 10, pp 935–937 | Cite as

Brief report: Patient-physician agreement as a predictor of outcomes

In patients with back pain
  • Thomas O. Staiger
  • Jeffrey G. Jarvik
  • Richard A. Deyo
  • Brook Martin
  • Clarence H. BraddockIII
Original Articles


OBJECTIVE: To determine whether a patient-physician agreement instrument predicts important health outcomes.

DESIGN: Three hundred eighty patients with back pain were enrolled in a comparison of rapid magnetic resonance imaging with standard x-rays. One month later, patients rated agreement with their physician in the following areas: diagnosis, diagnostic plan, and treatment plan. Outcomes included patient satisfaction with care at 1 and 12 months and functional and health status at 12 months.

SETTING: Urban academic and community primary care and specialty clinics.

MEASUREMENTS AND MAIN RESULTS: Higher agreement at 1 month (using a composite sum of scores on the 3 agreement questions) was correlated in univariate analysis with higher patient satisfaction at 1 month (R=.637, P<.001). In multivariate analysis, controlling for 1-month satisfaction and other potential confounders, higher agreement independently predicted better 12-month patient satisfaction (β=0.188, P=.003), mental health (β=1.080, P<.001), social function (β=1.124, P=.001), and vitality (β=1.190, P<.001).

CONCLUSION: Agreement between physicians and patients regarding diagnosis, diagnostic plan, and treatment plan is associated with higher patient satisfaction and better health status outcomes in patients with back pain. Additional research is required to clarify the relationship between physician communication skills, agreement, and patient outcomes.

Key Words

physician-patient communication agreement back pain satisfaction 


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Copyright information

© Society of General Internal Medicine 2005

Authors and Affiliations

  • Thomas O. Staiger
    • 1
  • Jeffrey G. Jarvik
    • 2
    • 3
    • 4
  • Richard A. Deyo
    • 1
    • 2
    • 4
  • Brook Martin
    • 4
  • Clarence H. BraddockIII
    • 5
  1. 1.Department of MedicineUniversity of WashingtonSeattleUSA
  2. 2.Department of Health ServicesUniversity of WashingtonSeattleUSA
  3. 3.Departments of Radiology and NeurosurgeryUniversity of WashingtonSeattleUSA
  4. 4.Center for Cost and Outcomes ResearchStanford UniversityStandfordUSA
  5. 5.Department of Medicine and Center for Biomedical EthicsStanford UniversityStanfordUSA

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