The Validity of Proxy-Generated Scores as Measures of Patient Health Status

Rothman, Margaret; Hedrick, Susan C.; Bulcroft, Kris; Hickam, David H.; Rubenstein, Laurence Z.

doi:10.1097/00005650-199102000-00004

Cited by 225 publications

(140 citation statements)

References 16 publications

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“…A previous validation study 1 of the SF-36 in stroke survivors reported that the SF-36 did not appear to characterize social functioning well. In addition, the poor agreement between proxy and self-completion responses reported by Segal and Schall 16 and Rothman et al 15 cast doubt on the validity of proxy respondents, particularly for the more subjective items. Similar to recommendations regarding the SF-36, 1 the SF-12 needs to be supplemented by other measures for a comprehensive assessment of health in stroke survivors.…”

Section: Discussionmentioning

confidence: 96%

“…Due to the inability of some stroke survivors to selfcomplete health status questionnaires, the use of proxy assessments has been studied in several generic health status instruments, including the Health Utilities Index (HUI), 13 the EuroQol, 14 the Sickness Impact Profile (SIP), 15 and the Health Status Questionnaire (formerly the SF-36 of the Medical Outcomes Study). 16 The conclusions of these investigations have been mixed.…”

Section: Discussionmentioning

confidence: 99%

“…Dorman et al 14 concluded that the HRQL information obtained by proxy on the more observable domains of the EuroQol may be sufficiently valid and unbiased to be useable in most types of trials and surveys, but found poor agreement for the domain that assessed psychological function. Rothman et al 15 studied the validity of proxy assessments using the SIP and also found that proxy responses for psychosocial attributes were less predictive of patient responses than proxy responses to observable attributes.…”

Section: Discussionmentioning

confidence: 99%

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Replicability of SF-36 Summary Scores by the SF-12 in Stroke Patients

Pickard

Johnson

Penn

et al. 1999

Stroke

104

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Background and Purpose-The replicability of the physical and mental component summary scores of the Short Form (SF)-36 has been established using the SF-12 in selected patient populations but has yet to be assessed in stroke patients.If the summary scores of the SF-12 are highly correlated with those of the SF-36, the benefits of using a shorter health-status measure may be realized without substantial loss of information or precision. Both self-reported and proxy assessments were evaluated for replicability. Methods-Intraclass correlation coefficients (ICCs) and linear regression were used to assess the ability of the SF-12 physical component summary (PCS-12) scores to predict PCS-36 scores and the SF-12 mental component summary (MCS-12) scores to predict MCS-36 scores. Multivariate regression was used to explore the relationship between SF-12 and SF-36 scores. Results-The MCS-12 and PCS-12 scores were strongly correlated with the corresponding SF-36 summary scores for surveys completed by proxy or self-report (ICCs ranged from 0.954 to 0.973). Regression analysis of the proxy assessments indicated that patient age was an important effect modifier in the relationship between MCS-12 and MCS-36 scores. Conclusions-The SF-12 reproduced SF-36 summary scores without substantial loss of information in stroke patients.Accordingly, the SF-12 can be used at the summary score level as a substitute for the SF-36 in stroke survivors capable of self-report. However, the mental health summary scores of proxy assessments are influenced by patient age, thereby limiting the replicability of the SF-36 by the SF-12 under these conditions. (Stroke. 1999;30:1213-1217.)

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Replicability of SF-36 Summary Scores by the SF-12 in Stroke Patients

Pickard

Johnson

Penn

et al. 1999

Stroke

104

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“…Burden may foster intolerance, leading to an underestimation of the patient's functional competence. Rothman et al (28) demonstrated that for severely impaired patients the significant other's score on the psychosocial dimension for a patient was found to be more closely associated with the significant other's own level of psychological distress and caregiver burden than with the patient's psychosocial health.…”

Section: Patient and Proxy Ratings Of Patient Qlmentioning

confidence: 99%

Proxy ratings of patient quality of life Factors related to patient–proxy agreement

Essén¹

2004

Acta Oncologica

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It is generally agreed that patients are the best raters of their quality of life (QL). Where it is not possible to obtain information from the patient the use of proxies can be an alternative. The proxy can be a significant other or a healthcare provider. The use of a proxy offers a solution to non-response. The accuracy of proxy reports is most typically determined by examining the extent to which patient and proxy ratings agree. A literature overview shows that agreement depends on several factors. Methodological limitations may have an impact on agreement. Agreement also varies according to the QL domains under study; the highest agreement is usually found for concrete domains. In addition, patient and proxy characteristics are related to agreement. When designing QL studies the threat of selection bias due to exclusion of patients has to be balanced against the threat of information bias due to proxy ratings.

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“…This has practical benefits but in terms of validity there is a case for obtaining the perspective of the patient, indeed research has shown poor concordance between patients" and professionals" ratings (Rothman, Hedrick, Bulcroft, Hickam, & Rubenstein, 1991). Service providers and patients may describe engagement in different ways.…”

Section: Introductionmentioning

confidence: 99%