Department of Healthcare Economics and Health Policy, The University of Tokyo Graduate School of Medicine Faculty of Medicine, Bunkyo-ku, Tokyo, Japan.
Keio University Faculty of Nursing And Medical Care Graduate School of Health Management, Fujisawa, Kanagawa, Japan.
BMJ Open. 2022 Feb 24;12(2):e048232. doi: 10.1136/bmjopen-2020-048232.
This prospective study used the EQ-5D utility and Visual Analogue Scale (VAS) scores to analyse the potential usefulness of proxy responses in quality of life assessments of Japanese patients with terminal lung cancer sufficiently healthy to communicate and reply by themselves. We did not investigate the potential usefulness of using proxy responses for patients who could not respond by themselves.
A prospective observational study.
Single centre.
The EQ-5D and VAS responses were gathered from 30 in-hospital patients with lung cancer for a total of three observation points. At nearly the same time, two nurses responded by providing proxy responses.
EQ-5D and VAS responses.
There were no significant differences between the patients' and nurses' responses for EQ-5D utility and VAS scores. For the five dimensions of the EQ-5D, significant differences were found between the patients' and nurses' responses for usual activities (patients' response 1.64±0.07, nurses' response 1.41±0.05, p=0.03) and anxiety/depression (patients' response: 1.40±0.05, nurses' response: 1.19±0.03, p=0.02). There was a significant weak positive correlation between patients' and nurses' responses regarding changes in responses from the first to the third observation point (Spearman's rank correlation coefficient ρ=0.228; p<0.01).
The results suggest that proxy responses are useful because there were no significant differences between the patients' and nurses' responses for EQ-5D utility and VAS scores at the three observation points. These findings should, however, be verified in future large-scale trials.
本前瞻性研究使用 EQ-5D 效用和视觉模拟量表(VAS)评分,分析在自身交流和回复能力充分的日本终末期肺癌患者的生活质量评估中,使用代理回复的潜在作用。我们并未调查对于自身无法回复的患者使用代理回复的潜在作用。
前瞻性观察性研究。
单中心。
EQ-5D 和 VAS 回复由 30 名住院肺癌患者收集,共进行了三个观察点。几乎同时,两名护士提供了代理回复。
EQ-5D 和 VAS 回复。
在 EQ-5D 效用和 VAS 评分方面,患者和护士的回复之间没有显著差异。对于 EQ-5D 的五个维度,患者和护士的回复在日常活动方面存在显著差异(患者的回复为 1.64±0.07,护士的回复为 1.41±0.05,p=0.03)和焦虑/抑郁(患者的回复:1.40±0.05,护士的回复:1.19±0.03,p=0.02)。患者和护士在从第一个观察点到第三个观察点的回复变化方面存在显著的弱正相关(Spearman 等级相关系数 ρ=0.228;p<0.01)。
结果表明,代理回复是有用的,因为在三个观察点上,患者和护士的 EQ-5D 效用和 VAS 评分的回复之间没有显著差异。然而,这些发现应在未来的大规模试验中得到验证。