Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2005 Oct;40(5 Pt 2):1676-93.
doi: 10.1111/j.1475-6773.2005.00447.x.

Proxies and other external raters: methodological considerations

A Lynn Snow  1 , Karon F Cook, Pay-Shin Lin, Robert O Morgan, Jay Magaziner
Affiliations
Review

Proxies and other external raters: methodological considerations

A Lynn Snow et al. Health Serv Res. 2005 Oct.

Abstract

Objective: The purpose of this paper is to introduce researchers to the measurement and subsequent analysis considerations involved when using externally rated data. We will define and describe two categories of externally rated data, recommend methodological approaches for analyzing and interpreting data in these two categories, and explore factors affecting agreement between self-rated and externally rated reports. We conclude with a discussion of needs for future research.

Data sources/study setting: Data sources for this paper are previous published studies and reviews comparing self-rated with externally rated data.

Study design/data collection/extraction methods: This is a psychometric conceptual paper.

Principal findings: We define two types of externally rated data: proxy data and other-rated data. Proxy data refer to those collected from someone who speaks for a patient who cannot, will not, or is unavailable to speak for him or herself, whereas we use the term other-rater data to refer to situations in which the researcher collects ratings from a person other than the patient to gain multiple perspectives on the assessed construct. These two types of data differ in the way the measurement model is defined, the definition of the gold standard against which the measurements are validated, the analysis strategies appropriately used, and how the analyses are interpreted. There are many factors affecting the discrepancies between self- and external ratings, including characteristics of the patient, the proxy, and of the rated construct. Several psychological theories can be helpful in predicting such discrepancies.

Conclusions: Externally rated data have an important place in health services research, but use of such data requires careful consideration of the nature of the data and how it will be analyzed and interpreted.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Example of the Proxy Data Measurement Model
Figure 2
Figure 2
Example of the Other-Rated Data Measurement Model
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bassett SS, Magaziner J, Hebel JR. “Reliability of Proxy Response on Mental Health Indices for Aged, Community-Dwelling Women.”. Psychology and Aging. 1990;5:127–32. - PubMed
    1. Becchi A, Rucci P, Placentino A, Neri G, de Girolamo G. “Quality of Life in Patients with Schizophrenia—Comparison of Self-Report and Proxy Assessments.”. Social Psychiatry and Psychiatric Epidemiology. 2004;39:397–401. - PubMed
    1. Boldingh EJ, Jacobs-van der Bruggen MA, Lankhorst GJ, Bouter LM. “Assessing Pain in Patients with Severe Cerebral Palsy: Development, Reliability, and Validity of a Pain Assessment Instrument for Cerebral Palsy.”. Archives of Physical and Medical Rehabilitation. 2004;85:758–66. - PubMed
    1. Boyd JH, Weissman MM, Thompson WD, Myers JK. “Screening for Depression in a Community Sample. Understanding the Discrepancies between Depression Symptom and Diagnostic Sales.”. Archives of General Psychiatry. 1982;39:1195–200. - PubMed
    1. Bruera E, Sweeney C, Calder K, Palmer L, Benisch-Tolley S. “Patient Preferences versus Physician Perceptions of Treatment Decisions in Cancer Care.”. Journal of Clinical Oncology. 2001;19:2883–5. - PubMed

Publication types

LinkOut - more resources