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Comparative Study
. 2021 Jan 27;19(1):35.
doi: 10.1186/s12955-021-01679-y.

How are you doing in the eyes of your spouse? Level of agreement between the self-completed EQ-5D-5L and two proxy perspectives in an orthopaedic population: a randomized agreement study

Maria C J M Tol  1 , Jurrian P Kuipers  2 , Nienke W Willigenburg  2 , Hanna C Willems  3 , Rudolf W Poolman  4
Affiliations
Comparative Study

How are you doing in the eyes of your spouse? Level of agreement between the self-completed EQ-5D-5L and two proxy perspectives in an orthopaedic population: a randomized agreement study

Maria C J M Tol et al. Health Qual Life Outcomes. .

Abstract

Objectives: To determine the level of agreement between both proxy versions and the self-completed EQ-5D-5L.

Design: A randomized agreement study.

Setting and participants: We recruited 120 patients (compos mentis) and their proxies at the orthopaedic outpatient clinic. Patients completed the regular EQ-5D-5L and their proxy completed the proxy version of the EQ-5D-5L and rated the patients' health from their own (proxy-proxy) perspective (i.e. how do you rate the health of the patient), and from the patient's (proxy-patient) perspective (i.e. how do you think the patient would rate their own health if they were able to).

Measures: The primary outcome was the agreement between patients and their proxy, quantified as the intra class correlation coefficient for the EQ-5D-5L Utility score.

Results: Average Utility scores were 0.65 with the self completed EQ-5D-5L, versus 0.60 with the proxy-patient version and 0.58 with the proxy-proxy version. The ICC was 0.66 (95% CI 0.523, 0.753) for the proxy-patient perspective and 0.58 (95% CI 0.411, 0.697) for the proxy-proxy perspective. The mean gold standard score of the VAS-Health was 69.7 whereas the proxy-proxy perspective was 66.5 and the proxy-patient perspective was 66.3.

Conclusion and implications: The proxy-patient perspective yielded substantial agreement with the self completed EQ-5D-5L, while the agreement with the proxy-proxy perspective was moderate. In this study population of patients without cognitive impairment, proxies tended to underestimate the quality of life of their relative.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study design and flowchart
Fig. 2
Fig. 2
Evaluation of effect patients’ health status on proxies ability to accurately assess patient’s health status
See this image and copyright information in PMC

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