The agreement between proxy and self-completed EQ-5D for care home residents was better for index scores than individual domains.
Bottom Line: Cluster-adjusted agreement was compared for the domains, index scores, and QALYs from the EQ-5D.The 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).Proxies appear to be an acceptable source of data for index scores and QALYs but may be less reliable if individual domains are considered.
Affiliation: Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, United Kingdom WC1H 9SH. Electronic address: firstname.lastname@example.org.Show MeSH
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Mentions: At baseline, the mean index score and VAS given by the residents (index score = 0.56, VAS = 67.2) were higher than that given by the proxy (index score = 0.51, VAS = 64.4). Scores from 17% (96/565) of the residents and 4% (24/565) of the carers reported perfect health (11111) at baseline, and so were assigned an index score of 1. The distribution of index scores for the residents and carers is broadly similar to those reported by Brazier et al. , with few reporting values between 1 and 0.95 and few reporting values around 0.45. The worst imaginable health state (33333) at baseline was rare, with one resident and none of the carers providing this rating. For the baseline VAS, 7% (35/474) of the residents and 1% (3/474) of the proxies rated health as perfect (100). No proxies gave worst possible health for the VAS and only nine (2%) of the residents rated their health as the worst possible. Of these, only three scores were considered reliable by the trial staff. For those with index scores at all three time points, 17% of carers consistently over-rated residents' health and 26% consistently under-rated health status compared with residents' own ratings. Fig. 1 suggests that there is a greater tendency for the proxies to use the some problems category (2) compared with self-report.
Affiliation: Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, United Kingdom WC1H 9SH. Electronic address: email@example.com.