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Does Empathy Affect the Concordance of Self versus Non-self Patient Reported Outcomes? (Preliminary Data)
James Calvin Montgomery, B.S.1, Elizabeth A. Washnock-Schmid, B.S.1, Jacob R. Kalkman, B.S.2, Benjamin M. Sims, B.S.1, Alaa Hazime, B.S.3, Amy Tang, PhD3 and Charles S Day, MD, MBA3, (1)Wayne State University, Detroit, MI, (2)Wayne State University School of Medicine, Detroit, MI, (3)Henry Ford Health System, Detroit, MI

Introduction: As physical, social, and psychological factors can affect patient reported outcomes¹, input from objective third parties with knowledge of patient condition may have clinical benefit. We hypothesized patients who report an empathetic support system will have family and friends that better understand their pain and functionality.

Materials & Methods: Patients presenting to a tertiary care clinic at an academic medical center with non-traumatic pathologies were recruited to participate, and asked to identify a representative (family, friend, etc.) to report on their symptoms. Using tablets in clinic or links sent via email, patients and their designated representative were administered three Patient Reported Outcome Measurement Information System (PROMIS) surveys: PROMIS-Upper Extremity (UE), PROMIS-Pain Interference (PI), PROMIS-Depression (Dep); as well as QuickDASH (shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire). PROMIS questions are based on a 5-point Likert scale (1=never, 2=rarely, 3=sometimes, 4=often, 5=always). Patients and representatives were also administered part II of the West Haven-Yale Multidimensional Pain Inventory (WHYMPI) survey, an empathy measure. WHYMPI questions (14) are based on a 7-point Likert scale (0=never to 6=very often) and subdivided into negative(4), solicitous(6), and distracting(4) responses, where higher scores indicate greater empathy. Data was analyzed via paired t-test, Wilcoxon Signed Rank Test, and Spearman correlation. All analyses were performed using SAS 9.4.


  • From March 2021-June 2021 a total of 39 patients and 39 representatives, ages 24-90 (56.09±13.29), were recruited for this study; patients identified as 52.9% female, 47.1% male
  • Complete data collection has been achieved for 31 (77.5%) of the patients and 9 (22.5%) of the representatives, yielding 9 total patient-representative pairs
  • Significantly positive correlation was found between patient WHYMPI Distracting Response scores and representative/patient PROMIS-UE score concordance (rs=0.943, p=0.005)
  • Significant differences were found in mean PROMIS-Dep scores reported by the patient and representative (patient=48, representative=53.6, p= 0.0313), but were not correlated with WHYMPI scores (p>.05)

Conclusion: Preliminary data suggest that patient-representative pairs have a similar understanding of patient upper extremity function/disability when the patient reports greater representative empathy. However, patients and their representative did not have a similar understanding of patient depression, no matter the level of empathy reported.

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