Magaziner J, Bassett S S, Hebel J R, Gruber-Baldini A
Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore 21201, USA.
Am J Epidemiol. 1996 Feb 1;143(3):283-92. doi: 10.1093/oxfordjournals.aje.a008740.
Proxy and subject responses to survey questions about chronic conditions, health symptoms, and physical and instrumental functioning were compared to determine the extent of disagreement, the direction of nonrandom discrepancies (i.e., bias), and how disagreement and bias vary by proxy and subject characteristics. Subjects included 538 community-dwelling women aged 65 years and older who participated in the third home interview of a health survey in Baltimore, Maryland, 1986, and a self-designated proxy for each. The authors observed kappa values of > 0.6 (i.e., substantial to almost perfect agreement) for five of nine chronic conditions, no health symptoms, six of seven physical tasks of daily living, and seven of seven instrumental tasks of daily living. With few exceptions, proxies were more likely than subjects to report the presence of a condition, symptom, or functional problem. Variations in agreement and bias were noted by subject and proxy characteristics, with different patterns observed for different measurement areas. When using proxy reports in place of self-reports, it is important to evaluate the impact that using proxies has on study results.
比较了代理人和受试者对有关慢性病、健康症状以及身体和工具性日常活动功能的调查问题的回答，以确定不一致的程度、非随机差异（即偏差）的方向，以及不一致和偏差如何因代理人和受试者的特征而异。受试者包括538名年龄在65岁及以上的社区居住女性，她们参与了1986年在马里兰州巴尔的摩进行的一项健康调查的第三次家庭访谈，以及为每位女性指定的一名代理人。作者观察到，在九种慢性病中的五种、无健康症状、七种日常生活身体任务中的六种以及七种日常生活工具性任务中的七种上，kappa值大于0.6（即实质性到几乎完美的一致性）。除了少数例外情况，代理人比受试者更有可能报告存在某种疾病、症状或功能问题。根据受试者和代理人的特征注意到了一致性和偏差的差异，不同测量领域观察到了不同的模式。当使用代理人报告代替自我报告时，评估使用代理人对研究结果的影响非常重要。
