Is there a difference in patient and physician quality of life evaluation in pelvic organ prolapse?

Quality of life (QoL) assessment is important in the evaluation of women with urogenital prolapse. The aim of this study was to investigate the relationship between physician and patient-assessed QoL using the Prolapse Quality of Life questionnaire (PQoL). Patients with symptomatic prolapse were recruited and asked to complete a PQoL. A second PQoL was filled in by the physician blinded to the patient responses, on the basis of a detailed urogynaecological history. These data were analysed by an independent statistician assessing concordance between patient and physician assessment (weighted kappa analysis: individual questions, Wilcoxon's signed rank test: QoL scores). Weighted kappa showed poor concordance between the patient and physician responses; mean Kappa: 0.46, range 0.020-0.83. The physician underestimated QoL score in five out of nine domains (mean 8.8%) and overestimated QoL score in four out of nine domains (mean 4.3%). This study confirms that QoL outcomes based on the physicians' perspective may not be valid.