Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK.
Academic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Temple Bank House, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK; Caudwell Children, Minton Hollins Building, Shelton Old Road, Stoke-On-Trent ST4 7RY, UK.
J Clin Epidemiol. 2015 May;68(5):584-95. doi: 10.1016/j.jclinepi.2014.12.007. Epub 2014 Dec 31.
To examine how accurately proxies evaluate quality of life (QoL) in people they know, using cross-cultural data from the multidimensional, multilingual World Health Organization Quality of Life assessment short-form (the WHOQOL-BREF) and whether accuracy varies by health condition or proxy type (eg, family/professional).
Systematic review with meta-analysis: We searched five databases for reports of proxy-completed WHOQOL-BREF scores and aggregated results using a random-effects model. Minimal clinically important difference values were calculated.
Analyses included nine studies (1980 dyads) of physical (n = 762) or mental (n = 604) health conditions, or intellectual disability (n = 614), in 10 countries. Mean person-proxy correlations ranged from 0.28 (social QoL) to 0.44 (physical QoL). Proxy measures were underestimates (ie, significantly lower than persons reported for themselves) for social [mean difference (MD) = 4.7, 95% confidence interval (CI): 1.8, 7.6], psychological (MD = 3.7, 95% CI: 0.6, 6.8), and physical (MD = 3.1, 95% CI: 0.6, 5.6) QoL. Underestimates varied significantly between health conditions for social (P < 0.001), psychological (P = 0.009), and physical (P = 0.02) QoL. Family members assessed psychological and environmental QoL better than professionals.
Proxies tend to be imprecise, underestimating QoL, and should be aware of this tendency. Where health care is decided for others, family members' views about QoL should be prioritized.
使用来自多维度、多语言世界卫生组织生活质量评估简表（WHOQOL-BREF）的跨文化数据，考察代理人在评价其认识的人的生活质量（QoL）时的准确性如何，以及准确性是否因健康状况或代理类型（如家庭/专业）而异。
系统评价和荟萃分析：我们在五个数据库中搜索了报告代理完成的 WHOQOL-BREF 评分的报告，并使用随机效应模型汇总结果。计算了最小临床重要差异值。
分析包括来自 10 个国家的 9 项研究（1980 对），涉及身体（n = 762）或精神（n = 604）健康状况或智力残疾（n = 614）。人与人之间的相关性平均范围从 0.28（社会 QoL）到 0.44（身体 QoL）。对于社会（平均差异（MD）= 4.7，95%置信区间（CI）：1.8，7.6）、心理（MD = 3.7，95% CI：0.6，6.8）和身体（MD = 3.1，95% CI：0.6，5.6）QoL，代理测量值被低估（即，显著低于个人自我报告的水平）。社会（P < 0.001）、心理（P = 0.009）和身体（P = 0.02）QoL 的健康状况之间存在显著差异。家庭成员对心理和环境 QoL 的评估优于专业人员。
代理人往往不准确，低估了 QoL，并且应该意识到这种倾向。在为他人决定医疗保健时，应优先考虑家庭成员对 QoL 的看法。
