Discrepancies between proxy estimates and patient reported, health related, quality of life: minding the gap between patient and clinician perceptions in heart failure

• Published in: Quality of life research 2021-04, Vol.30 (4), p.1049-1059
• Main Authors: Prichard, Roslyn A., Zhao, Fei-Li, Mcdonagh, Julee, Goodall, Stephen, Davidson, Patricia M., Newton, Phillip J., Farr-Wharton, Ben, Hayward, Christopher S.
• Format: Article
• Language: English
• Subjects: Female; Heart failure; Heart Failure - epidemiology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Patient Reported Outcome Measures; Proxy - psychology; Public Health; Quality of life; Quality of Life - psychology; Quality of Life Research; Sociology; Surveys and Questionnaires
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1007/s11136-020-02722-z

Purpose Health related quality of life (HRQoL) is rarely routinely measured in the clinical setting. In the absence of patient reported data, clinicians rely on proxy and informal estimates to support clinical decisions. This study compares clinician estimates (proxy) with patient reported HRQoL in patients with advanced heart failure and examines factors influencing discrepancies. Methods Seventy-five patients with heart failure, (22 females, 53 males) completed the EQ-5D-5L questionnaire. Thirty-nine clinicians (11 medical, 23 nursing, 5 allied health) completed the proxy version (V1) producing 194 dyads. Correlation was assessed using Spearman’s rank tests, systematic bias was examined with Bland–Altman analyses. Inter-rater agreement at the domain level, was investigated using linear weighted Kappa statistics while factors influencing the IRG were explored using independent student t -tests, analysis of variance and regression. Results There was a moderate positive correlation between clinician HRQoL estimates and patient reported utility ( r  = 0.38;  p