Abstract
BackgroundProxy respondent-someone who assists the intended respondent or responds on their behalf-are widely applied in the measurement of health-related quality of life (HRQL). However, proxies may not provide the same responses as the intended respondents, which may bias the findings.ObjectivesTo determine whether the use of proxies is related to socio-demographic characteristics of the intended respondent, and to assess the possible proxy response bias of Chinese version of EQ-5D-3 L in general population.MethodsA cross-sectional study based on a provincially representative sample from 2013 National Health Service Survey (NHSS) in Shaanxi, China was performed. HRQL was measured by Chinese version of EQ-5D-3 L. Propensity score matching (PSM) was used to get matched pairs of self-reports and proxy-reports. Before and after PSM, univariate logistic and linear models including the indicator of proxy response as the only independent variable, were employed to assess the possible proxy response bias of the dimensional and overall health status of EQ-5D-3 L respectively.Results19.9% of the responses involved a proxy. Before PSM, the proxy-report group was younger in age and reported less unhealthy lifestyle, lower prevalence of disease, and less hospitalization than the self-report group. After PSM, it showed that the proxy-report group was statistically more likely to report health problem on each dimension of EQ-5D-3 L, with odds ratios larger than one comparing with self-report group. The means of EQ-5D-3 L index and EQ VAS of proxy-report group were 0.022 and 0.834 lower than self-report group.ConclusionsSignificantly negative proxy response bias was found in Chinese EQ-5D-3 L in general population, and the magnitude of the bias was larger in physical dimensions than psychological dimensions after using PSM to control confounders.
Highlights
Health-Related Quality of Life (HRQL) is known as an important component of health evaluation in addition to conventional objective indicators, such as morbidity, mortality and clinical measurements [1,2,3,4]
Significantly negative proxy response bias was found in Chinese EQ-5D-3 L in general population, and the magnitude of the bias was larger in physical dimensions than psychological dimensions after using Propensity score matching (PSM) to control confounders
EQ-5D is a generic instrument widely applied for measuring health-related quality of life (HRQL) and health technology assessment (HTA) in many countries [10,11,12,13,14]
Summary
Health-Related Quality of Life (HRQL) is known as an important component of health evaluation in addition to conventional objective indicators, such as morbidity, mortality and clinical measurements [1,2,3,4]. In order to ensure adequate sample size and reduce the selection bias for the survey, proxies (e.g., family, professional caregiver, friend, relative) are usually allowed to substitute for the intended respondents who are unavailable (e.g., institutionalized or hospitalized) or unable (e.g., physical or cognitive impairments) to complete the questionnaire on their own behalf [5]. This may bring significant proxy response bias into HRQL measurement [5,6,7,8,9]. Proxies may not provide the same responses as the intended respondents, which may bias the findings
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
