Patient-Proxy Agreement Regarding Health-Related Quality of Life in Survivors with Lymphoma: A Propensity-Score Matching Analysis.

Richard Huan Xu,Dong Dong

doi:10.3390/cancers14030607

Abstract

Objective: To assess the difference between lymphoma survivors' self- and proxy-reported health-related quality of life (HRQoL) and its association with socioeconomic and health statuses. Methods: The data used in this study were obtained from a nationwide cross-sectional online survey in 2019. Information about participants' demographics, health status and HRQoL were collected. The propensity-score matching (PSM) method was used to control the effect of potential confounders on selection bias. A chi-squared test, one-way analysis of variance, and multiple linear regression models were used to assess the relationship between HRQoL and response type adjusted to respondents' background characteristics. Results: Out of the total 4400 participants, data of 2350 ones were elicited for analysis after PSM process. Patients' self-reported outcomes indicated a slightly better physical, role and emotional functioning than proxy-reported outcomes. Regression analysis showed that patients, who were older, unemployed, and who received surgery, were more likely to report a lower HRQoL. Further analysis demonstrated that proxy-reported patients who had completed treatment were more likely to report a higher HRQoL than those who were being treated. Conclusions: Our study demonstrates that the agreement between self- and proxy-reported HRQoL is low in patients with lymphoma and the heterogeneities of HRQoL among patients with different types of aggressive NHL (Non-Hodgkin's lymphoma) is large. Differences in self- and proxy-reported HRQoL should be considered by oncologists when selecting and deciding the optimal care plan for lymphoma survivors.

Highlights

Health-related quality of life (HRQoL), which reflects patients’ physical, mental, emotional, and social functioning over time, is increasingly identified as an important outcome for assessing the effectiveness of health and social care interventions [1,2]
Our study demonstrates that the agreement between self- and proxy-reported HRQoL is low in patients with lymphoma and the heterogeneities of HRQoL among patients with different types of aggressive
No evidence was provided about the effect of responses from different types of respondents on HRQoL and whether different responses were reshaped by the socioeconomic status (SES) of lymphoma survivors

Summary

Introduction

Health-related quality of life (HRQoL), which reflects patients’ physical, mental, emotional, and social functioning over time, is increasingly identified as an important outcome for assessing the effectiveness of health and social care interventions [1,2]. Studies on the relationship between SES and HRQoL among lymphoma survivors have slowly increased in recent years [10,11,12], most investigations on this relationship were collected solely through patients’ self-reported data. In clinical practice, when cancer patients are in poor physical or mental health and are unable to respond, proxies are asked to report on the patient’s behalf [13]; the impact of proxy reports on HRQoL in surveys has rarely been assessed. No evidence was provided about the effect of responses from different types of respondents on HRQoL and whether different responses were reshaped by the SES of lymphoma survivors

Methods

Results

Discussion

Conclusion