Evidence map›Paper›PMID 34228242›Full record

ArticleJournal of patient-reported outcomes2021

Patient-proxy agreement on change in acute stroke patient-reported outcome measures: a prospective study.

Brittany R Lapin, Nicolas R Thompson, Andrew Schuster, Irene L Katzan

Open access · goldAbstract read
In one paragraph

Article in Journal of patient-reported outcomes, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Agreement between patient- and proxy-reported outcome measures in adult musculoskeletal trauma and injury: a scoping review.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Brittany R LapinQuantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. LapinB@ccf.org.ORCID http://orcid.org/0000-0002-4314-2282
Nicolas R ThompsonQuantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Andrew SchusterCenter for Outcomes Research & Evaluation, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
Irene L KatzanCenter for Outcomes Research & Evaluation, Neurological Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
Cleveland Clinic · USOutcomes Research Consortium · US

Funding

Clinical and Translational Science Collaborative of ClevelandUL1TR002548 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI MCCOMSEY, GRACE A · 2018 to 2022
$35.5M
NCATS NIH HHS UL1 TR002548Pharmaceutical Research and Manufacturers of America Foundation RSGHO18
6 · The paper itself

Abstract

objectivesResearch has indicated proxies overestimate symptoms on patients' behalves, however it is unclear whether patients and proxies agree on meaningful change across domains over time. The objective of this study is to assess patient-proxy agreement over time, as well as agreement on identification of meaningful change, across 10 health domains in patients who underwent acute rehabilitation following stroke.

methodsStroke patients were recruited from an ambulatory clinic or inpatient rehabilitation unit, and were included in the study if they were undergoing rehabilitation. At baseline and again after 30 days, patients and their proxies completed PROMIS Global Health and eight domain-specific PROMIS short forms. Reliability of patient-proxy assessments at baseline, follow-up, and the change in T-score was evaluated for each domain using intra-class correlation coefficients (ICC(2,1)). Agreement on meaningful improvement or worsening, defined as 5+ T-score points, was compared using percent exact agreement.

resultsForty-one patient-proxy dyads were included in the study. Proxies generally reported worse symptoms and functioning compared to patients at both baseline and follow-up, and reported less change than patients. ICCs for baseline and change were primarily poor to moderate (range: 0.06 (for depression change) to 0.67 (for physical function baseline)), and were better at follow-up (range: 0.42 (for anxiety) to 0.84 (for physical function)). Percent exact agreement between indicating meaningful improvement versus no improvement ranged from 58.5-75.6%. Only a small proportion indicated meaningful worsening.

conclusionsPatient-proxy agreement across 10 domains of health was better following completion of rehabilitation compared to baseline or change. Overall change was minimal but the majority of patient-proxy dyads agreed on meaningful change. Our study provides important insight for clinicians and researchers when interpreting change scores over time for questionnaires completed by both patients and proxies.

Indexed as

AgreementPatient-reported outcome measuresPROMISProxyReliabilityStroke

Identifiers

PMID34228242
PMCPMC8260647
OpenAlexW3177561055

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.