Reliability of the next of kins' estimates of critically ill patients' quality of life

Rogers, James P.; Ridley, S.; Chrispin, Pamela; Scotton, H.; Lloyd, David G.

doi:10.1111/j.1365-2044.1997.240-az0374.x

Cited by 91 publications

(82 citation statements)

References 8 publications

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“…This study detected a trend towards negative proxy bias, but numbers were small (only 41 patient/lay proxy pairs were used), and the authors concluded that 'these preliminary findings need replication'. Finally, an inspection of the data published by Rogers et al [34] on patient/next-of-kin agreement in intensive care survivors appears to show a statistically significant negative proxy bias for 5 of the 8 SF-36 dimensions, although for the Mental Health dimension, a positive bias appears to be present.…”

Section: Discussionmentioning

confidence: 99%

Problems in Using Health Survey Questionnaires in Older Patients with Physical Disabilities

Ball¹,

Russell²,

Seymour

et al. 2001

Gerontology

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Background: The SF-36 Health Survey questionnaire has been proposed as a generic measure of health outcome. However, poor rates of return and high levels of missing data have been found in elderly subjects and, even with face-to-face interview, reliability and validity may still be disappointing, particularly in cognitively impaired patients. These patients may be the very patients whose quality of life is most affected by their illness and their exclusion will lead to biased evaluation of health status. A possible alternative to total exclusion is the use of a proxy to answer on the patient’s behalf, but few studies of older people have systematically studied patient-proxy agreement. Objective: To compare the agreement between patients, lay and professional proxies when assessing the health status of patients with the SF-36. Methods: The SF-36 was administered by interview to 164 cognitively normal, elderly patients (Mini-mental State Examination 24 or more) referred for physical rehabilitation. The SF-36 was also completed by a patient-designated lay proxy (by post) and a professional proxy. Agreement between proxies and patients was measured by intraclass correlation coefficients (ICCs), and a bias index. Results: Professional proxies were better able to predict the patients’ responses than were the lay proxies. Criterion levels of agreement (ICC 0.4 or over) were attained for four of the eight dimensions of the SF-36 by professional proxies, but for only one dimension by lay proxies. In professional proxies, the magnitude of the bias was absent or slight (<0.2) for six of the eight dimensions of the SF-36 with a small (0.2–0.49) negative bias for the other two. Lay proxies showed a negative bias (i.e. they reported poorer function than did the patients themselves) for seven of the eight dimensions of the SF-36 (small in two and moderate (0.5–0.79) in five). Conclusions: For group comparisons using the SF-36, professional proxies might be considered when patients cannot answer reliably for themselves. However, in the present study, lay proxy performance on a postal questionnaire showed a strong tendency to negative bias. Further research is required to define the limitations and potentials of proxy completion of health status questionnaires.

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Section: Discussionmentioning

confidence: 99%

Problems in Using Health Survey Questionnaires in Older Patients with Physical Disabilities

Ball¹,

Russell²,

Seymour

et al. 2001

Gerontology

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“…Although the overall reliability of the score is diminished under these circumstances, the physical score has been shown to be correlated with the actual patient answers. 24 Thus, the small number of families who answered the SIP score, especially the psychological part of the SIP score, may have altered the overall score. This most likely would bias the study toward a poorer outcome, because many families overestimate the psychological distress of patients.…”

Section: Discussionmentioning

confidence: 99%

Survival and Functional Outcome After Prolonged Intensive Care Unit Stay

et al. 2000

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“…It has been claimed that a QOL questionnaire should be suitable to be completed by a close family member when the patient cannot respond [11]. Nevertheless, a QOL questionnaire should investigate the patient's personal perception of quality of life (as perceived quality of life of QOL-IT and emotional state of QOL-SP) [18], but relatives have been reported to be able to give a good assessment only of functional aspects of quality of life [19]. If we had interviewed relatives of comatose or confused patients, therefore, we could have introduced a bias.…”

Section: Discussionmentioning

confidence: 99%

Validation of two quality of life questionnaires suitable for intensive care patients

et al. 2000

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Reliability of the next of kins' estimates of critically ill patients' quality of life

Cited by 91 publications

References 8 publications

Problems in Using Health Survey Questionnaires in Older Patients with Physical Disabilities

Problems in Using Health Survey Questionnaires in Older Patients with Physical Disabilities

Survival and Functional Outcome After Prolonged Intensive Care Unit Stay

Validation of two quality of life questionnaires suitable for intensive care patients

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