Do Interviewer and Physician Health Ratings Predict Mortality?

Todd, Megan; Goldman, Noreen

doi:10.1097/ede.0b013e3182a713a8

Cited by 17 publications

(17 citation statements)

References 22 publications

(27 reference statements)

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“…Results from Taiwan suggest that the interviewer’s rating is a better mortality predictor than the rating of overall health provided by the respondent. Interviewers may base their evaluations not only on information directly obtained in the survey, but also on their observations of the respondent’s appearance, responsiveness, cognition, and disposition [ 18 ]. Although the physicians’ ratings are weak predictors, these physicians were seeing respondents for the first time and basing their judgments on only a routine physical examination and a medical history completed by the respondent.…”

Section: Discussionmentioning

confidence: 99%

What Matters Most for Predicting Survival? A Multinational Population-Based Cohort Study

2016

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Despite myriad efforts among social scientists, epidemiologists, and clinicians to identify variables with strong linkages to mortality, few researchers have evaluated statistically the relative strength of a comprehensive set of predictors of survival. Here, we determine the strongest predictors of five-year mortality in four national, prospective studies of older adults. We analyze nationally representative surveys of older adults in four countries with similar levels of life expectancy: England (n = 6113, ages 52+), the US (n = 2023, ages 50+), Costa Rica (n = 2694, ages 60+), and Taiwan (n = 1032, ages 53+). Each survey includes a broad set of demographic, social, health, and biological variables that have been shown previously to predict mortality. We rank 57 predictors, 25 of which are available in all four countries, net of age and sex. We use the area under the receiver operating characteristic curve and assess robustness with additional discrimination measures. We demonstrate consistent findings across four countries with different cultural traditions, levels of economic development, and epidemiological transitions. Self-reported measures of instrumental activities of daily living limitations, mobility limitations, and overall self-assessed health are among the top predictors in all four samples. C-reactive protein, additional inflammatory markers, homocysteine, serum albumin, three performance assessments (gait speed, grip strength, and chair stands), and exercise frequency also discriminate well between decedents and survivors when these measures are available. We identify several promising candidates that could improve mortality prediction for both population-based and clinical populations. Better prognostic tools are likely to provide researchers with new insights into the behavioral and biological pathways that underlie social stratification in health and may allow physicians to have more informed discussions with patients about end-of-life treatment and priorities.

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Section: Discussionmentioning

confidence: 99%

What Matters Most for Predicting Survival? A Multinational Population-Based Cohort Study

2016

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“…This finding on spouse's health report gained confirmation from some subsequent studies (Daugherty, 2009;Peek, Stimpson, Townsend et al, 2006). Meanwhile, a new line of research started to emerge with a focus on health evaluation by survey interviewers (Chen and Wu, 2008;Feng, Zhu, Zhen et al, 2016;Smith and Goldman, 2011;Todd and Goldman, 2013). According to these studies, the use of interviewer-rated health (IRH) may have some advantages over SRH in capturing health situations and may complement the routine use of SRH.…”

Section: Introductionmentioning

confidence: 75%

“…This is not a surprise. Compared to SRH, evaluation by interviewer could be less affected by subjective factors (Todd and Goldman, 2013) and thus may have some advantages over SRH (Brissette, Leventhal, and Leventhal, 2003). Because interviewers usually rate respondents' health at the end of the interview, which is the practice in the CLHLS, interviewers can incorporate information on a respondent's reported health and health-related conditions and information from their own observations while communicating with respondents.…”

Section: Discussionmentioning

confidence: 99%

Self-rated health and interviewer-rated health: differentials in predictive power for mortality among subgroups of Chinese elders

Zhu¹,

Feng²,

Gu³

2017

IJPS

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Abstract:Interviewer-rated health (IRH) and self-rated health (SRH) have strong and independent predictive power for mortality, but their relative predictive power has not been examined among subpopulations. Because individuals from different subpopulations have distinct views, understandings, and judgments about health that influence their criteria and referents for SRH, we examine whether IRH is a valid predictor of mortality within subpopulations, which may provide added value for understanding its association with mortality. Using data from the 2005 and 2008 waves of the Chinese Longitudinal Healthy Longevity Survey, this study modeled associations of SRH and IRH with mortality in various subgroups among 12,583 older adults in China. We found that IRH is a robust predictor of mortality, independent of SRH, across major demographic and socioeconomic subpopulations after adjusting for a wide range of covariates. The predictive power of IRH for mortality was generally more robust than that of SRH in most subpopulations. Our findings suggest that IRH could be a good complement to SRH among subgroups of the Chinese older population.

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“…It should perhaps be recalled here that the latter category included “poor” and “very poor”. Other studies have focused on the predictive ability of physician ratings: Giltay et al reported a better prognostic value for self-rated health than for physician-rated health when it came to predicting cancer mortality, while the opposite was true when it came to predicting cardiovascular deaths [ 5 ]; and a study on community-dwelling Taiwanese elders by Todd and Goldman yielded unexpected findings, in that physician ratings were observed to have a weak predictive power, and a clear, weaker predictive capacity as compared to both self-rated and interviewer-rated health [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…, while poor self-rated health was associated with cancer mortality, poor physician-rated health was associated with cardiovascular mortality [ 5 ]. In terms of mortality, Todd and Goldman reported that interviewer ratings displayed a better predictive behavior than did physician ratings in the case of older adults in Taiwan [ 6 ]. Physician-rated health has also been used in a number of studies as an adjustment variable, in an attempt to control for “objective” health status: for instance, Wilper et al observed a higher mortality risk associated with lack of health insurance, controlling for physician-rated health, among other variables [ 7 ]; and Moor et al used physician-rated health as an adjustment variable in a study on the association of neuroticism and subjective health [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Discordance between physician-rated health and an objective health measure among institutionalized older people

et al. 2015

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BackgroundAlthough physician-rated health is emerging as a potentially useful variable in research, with implications in practice, it has not been analyzed. Moreover, one of its most important aspects, namely, concordance with patients’ objective health state, has not been investigated. This study sought to measure concordance between physician-rated health and an objective health measure, and assess both measures’ validity in predicting death.MethodsThe data for the study were drawn from a 1998–1999 survey and subsequent mortality follow-up of residential and nursing homes in Madrid (Spain). Study subjects were 630 residents aged ≥65 years, and their respective facility physicians. Measures included agreement between physicians’ rating of residents’ overall health (good, intermediate or poor) and an objective measure of residents’ health (good, intermediate or poor), based on functional capacity, cognitive status, and number of chronic conditions. Overrating was defined as any case where health, rated as good by a physician, was objectively rated as poor.ResultsWhereas 45 % of physicians and 55 % of residents rated their health as good, only 4 % of such residents had good objective health. Of those who received a physician rating of good/very good health, 39.0 % had poor objective health. There was evidence of clear overrating in 18 % of the population, and clear to moderate overrating in 73 % of the population. In terms of power to predict mortality, the pattern of behavior shown by the objective health measure was good, graded and congruent, and better than that shown by physician-rated health.ConclusionPhysician overrating of the overall health of older persons in residential and nursing homes, would appear to be very high. Although some degree of contextualization by physicians in this setting might be considered reasonable, the degree of overrating in our population seems nevertheless excessive.

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Do Interviewer and Physician Health Ratings Predict Mortality?

Cited by 17 publications

References 22 publications

What Matters Most for Predicting Survival? A Multinational Population-Based Cohort Study

What Matters Most for Predicting Survival? A Multinational Population-Based Cohort Study

Self-rated health and interviewer-rated health: differentials in predictive power for mortality among subgroups of Chinese elders

Discordance between physician-rated health and an objective health measure among institutionalized older people

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