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The validity of proxy responses on patient-reported outcome measures: Are proxies a reliable alternative to stroke patients' self-report?
- Source :
-
Quality of Life Research . Jun2021, Vol. 30 Issue 6, p1735-1745. 11p. 7 Charts. - Publication Year :
- 2021
-
Abstract
- Purpose: Caregivers, or proxies, often complete patient-reported outcome measures (PROMs) on behalf of patients with stroke. The objective of our study was to assess the validity and responsiveness of proxy-responses compared to patient-responses across multiple domains of health. Methods: Stroke patients and their proxies were recruited to complete PROMs between 7/2018–11/2019. PROMs included Neuro-QoL cognitive function, PROMIS physical function, satisfaction with social roles, anxiety, fatigue, pain interference, sleep disturbance, Global Health, and PHQ-9. Internal consistency and convergent validity were compared between patient- and proxy-reported measures. Known-groups validity was assessed across levels of stroke disability. Internal responsiveness was evaluated using paired t-tests for a subset of patients who attended rehabilitation following stroke. Analyses were stratified by patients ≤ 3 vs > 3 months from stroke. Results: This cross-sectional study included 200 stroke patients (age 62.2 ± 13.3, 41.5% female) and their proxies (age 56.5 ± 13.9, 70% female, 72% spouses). PROMs had high internal consistency and were significantly correlated for patients and proxies. Patient- and proxy-reported measures worsened with increasing stroke disability. For 34 (17%) patients who attended rehabilitation, patients self-reported improvement on 5 domains whereas proxies reported no improvement. Compared to patient self-reports, validity was worse for proxy-reports on patients ≤ 3 months but better > 3 months from stroke. Conclusions: Both patient- and proxy-reported PROMs demonstrated strong validity. Only patient-reported PROMs were responsive to change, and proxies had worse validity for patients ≤ 3 months from stroke but better validity for patients > 3 months from stroke. These findings justify the utilization of proxy responses in stroke patients > 3 months from stroke. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09629343
- Volume :
- 30
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Quality of Life Research
- Publication Type :
- Academic Journal
- Accession number :
- 150691909
- Full Text :
- https://doi.org/10.1007/s11136-021-02758-9