The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.
Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Spine (Phila Pa 1976). 2020 Jul 1;45(13):E799-E807. doi: 10.1097/BRS.0000000000003431.
Prospective cohort study.
To compare feasibility of self-reported and proxy-reported youth version of EuroQoL Five-Dimension Three-Level Questionnaire (EQ-5D-3L-Y), to estimate the agreement of health outcome between patients with adolescent idiopathic scoliosis (AIS) and their proxies, and to examine factors that may affect patient-proxy agreement.
The EQ-5D-3L-Y questionnaire has both self-reported and proxy-reported versions. Despite previous studies have indicated that proxies tended to respond with higher or lower levels of severity in specific dimensions than patients report, the level of agreement between children with AIS and their proxies remained unknown.
A consecutive sample of patients with AIS and their caregivers were recruited. Feasibility was tested according to the proportion of missing responses. Agreements between self-report and proxy EQ-5D-3L-Y were evaluated using percentage agreement, Gwet agreement coefficients and the intraclass correlation coefficients. Linear regressions and logistic regressions were conducted to assess the factors associated with the agreement in health outcome between self-reported and proxy-reported EQ-5D-3L-Y.
A total of 130 patient-proxy pairs were involved in the study. Agreement of EQ-5D-3L-Y responses between the self-report and proxy version was good for "Feeling worried/sad/unhappy" dimension, and very good for other dimensions. Poor agreement in visual analog scale score was observed between patient and proxy versions. Proxy's education level, patient's curvature type, and treatment modality were the significant determinants of the agreement in "Mobility," "usual activities," and "pain/discomfort" dimension, respectively.
Proxy-reported EQ-5D-3L-Y demonstrates good feasibility and satisfactory agreement with patient version. Proxy's education appears to have positive influence in agreement between patient-proxy dyads.
前瞻性队列研究。
比较青少年版欧洲五维健康量表（EQ-5D-3L-Y）自报和代理报告的可行性，估计青少年特发性脊柱侧凸（AIS）患者与其代理人之间健康结果的一致性，并探讨可能影响患者-代理人一致性的因素。
EQ-5D-3L-Y 问卷有自报和代理报告两种版本。尽管之前的研究表明，在特定维度上，代理人的反应往往比患者报告的严重程度更高或更低，但 AIS 患儿与其代理人之间的一致性程度仍不清楚。
连续招募 AIS 患者及其照顾者作为研究对象。根据缺失反应的比例来测试可行性。使用百分比一致性、Gwet 一致性系数和组内相关系数来评估自报和代理 EQ-5D-3L-Y 之间的一致性。采用线性回归和逻辑回归来评估与自报和代理报告 EQ-5D-3L-Y 健康结果一致性相关的因素。
共有 130 对患者-代理参与了研究。自报和代理版本的 EQ-5D-3L-Y 反应一致性在“感觉忧虑/悲伤/不开心”维度上很好，在其他维度上则非常好。在视觉模拟量表评分方面，患者和代理版本之间存在较差的一致性。代理人的教育水平、患者的弯曲类型和治疗方式是“移动性”、“日常活动”和“疼痛/不适”维度一致性的显著决定因素。
代理报告的 EQ-5D-3L-Y 具有良好的可行性和与患者版本相当的一致性。代理人的教育水平似乎对患者-代理人对之间的一致性有积极影响。
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