Doctors should listen to patient self-rating of health, study says

A review of medical data shows patients reporting they "feel" in poor health often have higher levels of inflammation, which can indicate or increase the risk for longer-term illness.

By Stephen Feller

HOUSTON, July 15 (UPI) -- Doctors often tell patients not to worry about their health if tests and measurements show nothing wrong, but new research suggests "feeling bad" could be a more reliable indicator of future illness than medical professionals think.

Researchers at Rice University say doctors should stop ignoring patient concerns that do not match test results because many times they are voicing more than paranoia or misguided instinct, based on a recent study comparing patient opinion to medical tests.


Self-rated health -- a patient's answer when asked how they feel -- has value, the researchers say, because indicators of long-term health problems such as inflammation are not always picked up by the standard battery of tests conducted by primary care physicians.

"When a patient says, 'I don't feel like my health is very good right now,' it's meaningful thing with a biological basis, even if they don't show symptoms," Dr. Christopher Fagundes, a professor of psychology at Rice University, said in a press release. "When I go to patient-advocate conferences, people say they're grateful we're finding biological mechanisms because they feel like doctors have ignored them for years, saying, 'It's in your head.' Well, it's in your head, but there's a reason."


For the study, published in the journal Psychoneuroendocrinology, researchers reviewed data on 1,500 people gathered through self-assessments of health and blood samples, which had been analyzed for herpes viruses and biomarkers for inflammation.

The researchers say herpes is a good indicator because the virus is not always active. A latent infection can still cause inflammation and other health effects that may not pop up on standard tests -- which means doctors miss them, and don't look when ignoring seemingly unfounded patient concerns.

After analyzing the participant data, the researchers said patients who reported feeling healthy had low virus and inflammation levels, while those with concerns about how they felt had higher virus and inflammation levels.

The tests are often skipped by primary care physicians because they are time consuming and can't be done in the office, but the researchers say if a patient reports feeling in ill health, running more tests is worth it because there may be something there.

"That was an odd finding," Fagundes said. "You would think that objective markers like blood pressure would be more accurate. The way people generally report how they feel is more often linked to a future disease or mortality than what the doctor accesses. As psychologists, we think, 'They're sensing something. There's something going on here.' That's what took us to this paper."


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