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Patients’ Self-Rated Health Might Be As Accurate As Some Testing

HOUSTON – If you are having trouble predicting how patients will fare in terms of illness and death, you might simply ask them what they think.

A study published recently in the journal Psychoneuroendocrinology suggests that self-rated health (SRH) is a reliable predictor of health outcomes, including morbidity and mortality.

In fact, according to the Rice University-led research, it could be as reliable as blood tests, blood pressure measurements, or other symptomatic evidence a physician might gather.

"A couple of years ago there was a boom of work in psychology and medicine about what we call patient-reported outcomes, the idea that what patients actually feel like and say they feel like seems to be more prognostic of morbidity and mortality than all the cholesterol ratings and blood tests we get from doctors' offices," explained co-author Christopher Fagundes, PhD.

"That was an odd finding," Fagundes added. "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."

The researchers found evidence of links between self-rated health and rising levels of herpesvirus activity, an important marker of poor cellular immunity that promotes high levels of inflammation. The study examined associations between SRH, inflammation — i.e., peripheral cytokines in the blood — and reactivation of latent herpesviruses among a sample of 1,208 individuals participating in the Texas City Stress and Health Study.

For the research, participants completed a self-report measure of SRH and a blood draw. Results indicated that higher SRH was associated with lower reactivation of latent herpesviruses and inflammation. In addition, study authors pointed out, “reactivation of latent herpesviruses partially mediated the association between SRH and inflammation. Accordingly, findings add to our growing understanding of the association between SRH and immune dysfunction.”

"We found that self-rated health was associated with reactivation of herpesviruses," said lead author Kyle W. Murdock, PhD, in a Rice press release. "We're not talking about the sexually transmitted disease, but viruses that are associated with things like cold sores that are ubiquitous among adults."

Fagundes suggested that physicians should pay close attention to what patients report, noting, "When a patient says, 'I don't feel like my health is very good right now,' it's a meaningful thing with a biological basis, even if they don't show symptoms.”

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