The agreement between proxy and self-completed EQ-5D for care home residents was better for index scores than individual domains

Abstract

ObjectiveProxy measures are an alternative source of data for care home residents who are unable to complete the health utility measure, but the agreement levels between residents and care home staff for the EQ-5D have not been investigated previously. The objective of the present study was to examine the inter-rater agreement levels for the reporting of EQ-5D by care home residents and staff, adjusting for the impact of clustering.Study Design and SettingThe data consist of EQ-5D scores for 565 pairs of care home residents and proxies and quality-adjusted life-years (QALYs) for 248 pairs. Cluster-adjusted agreement was compared for the domains, index scores, and QALYs from the EQ-5D. Factors influencing index score agreement are also described.ResultsThe results show poor to fair agreement at the domain level (cluster-adjusted Kappa −0.03 to 0.26) and moderate agreement at the score level (cluster-adjusted intra-class correlation coefficient [ICC] 0.44–0.50) and for QALYs (cluster-adjusted ICC 0.59). A higher likelihood of depression and lower cognitive impairment were both associated with smaller discrepancy between proxy and self-completed scores.ConclusionProxies appear to be an acceptable source of data for index scores and QALYs but may be less reliable if individual domains are considered.

“A game of two halves?” Understanding the process and outcomes of English care home closures: Qualitative and quantitative perspectives

“…It is not surprising that participants in our study reported lower levels of quality of life (compared to population norms), as individuals who are in contact with health and social care services are likely to have some form of long‐term or chronic illness (Windle et al, ). The quality of life scores in our study are similar to those presented in other studies set in residential care (Devine et al, ; Gordon et al, ).…”

“…It also enabled consultees to take part in situations where the older person lacked capacity to consent. As a result, our sample is comparable to other studies of older people's social care (Devine et al, ), and we have no evidence of systematic bias. Despite the scale of these closures, our quantitative sample remains limited and can only provide descriptive statistics. Given this may have been one of the most significant closure processes in the UK to date, it seems unlikely that this is a topic that could ever generate a sufficient sample size for data to be statistically generalizable to the whole population of older people in care.…”

Clinical characteristics of hospitalized heart failure patients with preserved, mid‐range, and reduced ejection fractions in Japan

“…19 The proxy EQ-5D measured by physicians or home care staff is likely to be an acceptable alternative to the self-reported EQ-5D for estimating the summary scores of the EQ index and quality-adjusted life year, although it does not have sufficient agreement at the domain level. 20,21 For acutely ill patients, retrospective proxy estimation patient QOL using the EQ-5D is also acceptable at a level that does not pose clinical problems. 22 In this study, physicians, nurses, and research associates retrospectively completed (as proxies) the EQ-5D according to each patient's physical and psychological status when the patient was discharged.…”

“…Platelet count (×10 4 /μL) 19 [15][16][17][18][19][20][21][22][23][24] 18 [15][16][17][18][19][20][21][22][23] 19 [15][16][17][18][19][20][21][22][23][24] 19 [15][16][17][18][19][20][21][22][23][24][25] 24 26 [18][19][20][21][22][23][24][25][26][27][28][29][30]…”

An Empirical Comparison of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U in a Post-Hospitalisation Population of Frail Older People Living in Residential Aged Care

“…The acceptability and feasibility of the EQ-5D for administration with individuals exhibiting mild to moderate cognitive impairment and living in residential aged care and has been demonstrated in a number of published studies internationally [12][13][14][15]. For individuals who are unable to selfcomplete the EQ-5D due to more severe levels of cognitive impairment a proxy version is available (CEQ-5D).…”