ArticleArchives of physical medicine and rehabilitation2022
Can Proxy Ratings Supplement Patient Report to Assess Functional Domains Among Hospitalized Patients?
Article in Archives of physical medicine and rehabilitation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- The Critical Care Pain Observation Tool for Families (CPOT-Fam).Canadian journal of pain = Revue canadienne de la douleur · 2026Article
- Physician and patient perspectives on PROM implementation barriers in spine care and pain management: a mixed-methods assessment.BMJ open quality · 2025Article
- Supporting Clinical Decision-Making in Emergency Departments With Patient-Reported Outcome Measures.JACC. Advances · 2023Article
- Preliminary clinical testing to inform development of the Critical Care Pain Observation Tool for Families (CPOT-Fam).Canadian journal of pain = Revue canadienne de la douleur · 2023Article
- The Significance of Pets for Vulnerable Older Adults during the COVID-19 Pandemic: An Explorative Qualitative Study.Animals : an open access journal from MDPI · 2022Article
- Adaptive Measurement of Change: A Novel Method to Reduce Respondent Burden and Detect Significant Individual-Level Change in Patient-Reported Outcome Measures.Archives of physical medicine and rehabilitation · 2022Article
- Patient-Reported Outcome Measures: An Exploration of Their Utility in Functional Assessment and Rehabilitation.Archives of physical medicine and rehabilitation · 2022Article
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo (1) characterize the agreement between patient and proxy responses on a multidimensional computerized adaptive testing measure of function, and to (2) determine whether patient, proxy, or multidimensional computerized adaptive testing score characteristics identify when a proxy report can be used as a substitute for patient report in clinical decision making.
designA psychometric study of the Functional Assessment in Acute Care Multidimensional Computerized Adaptive Testing (FAMCAT) and its 3 scales (Applied Cognition, Daily Activity, and Basic Mobility).
settingAn upper midwestern quaternary academic medical center
participantsA total of 300 pairs of patients (average age 60.9 years; range, 19-89) hospitalized on general medical services or readmitted to surgical services for postoperative complications and their proxies (average age 60.5 years; range, 20-88).
interventionNot applicable.
main outcome measuresThere were 3 outcomes: (1) agreement between patient and proxy scores on the FAMCAT domains, as well as age and sex, analyzed with univariate and multivariate analysis of variance (MANOVA); (2) associations of patient-proxy relationship and FAMCAT score characteristics with patient-proxy score agreement; and (3) presence of psychometrically significant intra-dyad differences in FAMCAT scores.
resultsThe results of the MANOVA and follow-up ANOVAs indicated that there were no statistically significant differences in FAMCAT scale scores between patient and proxy estimates for either the Daily Activity or Basic Mobility scales. There were significant differences for the Applied Cognition scale (P<.005) between mean patient and proxy scores, with proxies rating patients as functioning at a higher level (mean=0.42) than patients did themselves (mean=0.00). However, psychometrically significant intra-dyadic Applied Cognition score differences occurred in only 14% of dyads, compared with 25% in the other 2 scales. Sex and age were associated with patient-proxy agreement, but the patterns were not sufficiently consistent to permit generalizations regarding the likely validity of a proxy's scores.
conclusionsPatient and proxy FAMCAT Daily Activity and Basic Mobility scores did not differ significantly, and proxy reporting offers a creditable surrogate for patient report on these domains. Low rates of psychometrically significant intra-dyadic score differences suggest that proxy report may serve as a low-resolution screen for functional deficits in all FAMCAT domains. Approximately half the proxies provided multi-domain profile ratings on the 3 scales that did not differ significantly from these of the associated patients, but more research is needed to identify situations in which proxy profiles could be used in place of those provided by patients.
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