Evidence map›Paper›PMID 40390142›Full record

Observational studyCritical care (London, England)2025

Reliability of pre-admission patient-reported outcome measures postoperatively assessed via proxies: a prospective, multicenter observational study.

Julius J Grunow, Leonie Hartmann, Bernhard Ulm, Mathilde Maechler, Manfred Blobner, Katharina Seidenspinner, Lukas Schoennagel, Steffen Weber-Carstens, Kristina Fuest, Tobias Wollersheim and 1 more

Registry-linked trialAbstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03785444 (Agreement in Relatives' Assessment in Standardized Questionnaires of Patients Who Have Been Admitted to Intensive Care Compared to Patients Who Have Not Been Admitted to Intensive Care), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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.

NCT03785444 completednot on this map

Agreement in Relatives' Assessment in Standardized Questionnaires of Patients Who Have Been Admitted to Intensive Care Compared to Patients Who Have Not Been Admitted to Intensive Care (ASTON Study)

TypeobservationalSponsorTechnical University of MunichRan2019 to 2020Enrolled200ConditionsCritical Illness, Self-Assessment, Assessment, SelfArmsWHODAS 2.0, EQ5D, IADL, Barthel-Score, SF-36
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Observational
  4. 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

11 authors.

Julius J GrunowCharité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Charitéplatz 1, 10117, Berlin, Germany.ORCID http://orcid.org/0000-0003-4164-0138
Leonie HartmannCharité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Charitéplatz 1, 10117, Berlin, Germany.
Bernhard UlmTechnical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Department of Anaesthesiology and Intensive Care Medicine, Munich, Germany.
Mathilde MaechlerCharité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Charitéplatz 1, 10117, Berlin, Germany.
Manfred BlobnerTechnical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Department of Anaesthesiology and Intensive Care Medicine, Munich, Germany.
Katharina SeidenspinnerDepartment of Cardiology, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
Lukas SchoennagelCharité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Charitéplatz 1, 10117, Berlin, Germany.
Steffen Weber-CarstensCharité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Charitéplatz 1, 10117, Berlin, Germany.
Kristina FuestTechnical University of Munich, School of Medicine and Health, Klinikum rechts der Isar, Department of Anaesthesiology and Intensive Care Medicine, Munich, Germany.
Tobias Wollersheim *Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Charitéplatz 1, 10117, Berlin, Germany.
Stefan J Schaller *Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Charitéplatz 1, 10117, Berlin, Germany. stefan.schaller@charite.de.ORCID http://orcid.org/0000-0002-6683-9584

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPre-admission status obtained through patient-reported outcome measures is an essential metric in both clinical and research settings for prognostication and treatment decisions. It is frequently collected by proxies, although its reliability has yet to be thoroughly investigated. The objective was to determine the reliability of proxy assessments regarding pre-ICU admission status via patient-reported outcome measures and to explore the impact of the ICU setting on these assessments.

methodsProspective multicentre observational study in two tertiary care university hospitals in Germany, including surgical adult patients able to independently answer the patient-reported outcome measures (SF-36, EQ-5D-5L, WHODAS 2.0, IADL, and Barthel Index) with a proxy available. Patients were interviewed pre-operatively, while proxies were interviewed post-operatively in the ICU or normal ward, depending on the patient's location. The reliability of patient-reported outcome measures was analyzed using Bland-Altman plots and Cohen's kappa.

resultsOf 204 patient-proxy pairs, 102 were admitted to an ICU. The median patient and proxy age were 69 and 64 years, with 41% and 68% female, respectively. Bland-Altman plots demonstrated insufficient reliability of proxy ratings, as the 95% limits of agreement fell outside the minimal clinically important difference (MCID) for all questionnaires. However, a significant bias was evident only among ICU patients, showing worse ratings from proxies for the WHODAS 2.0, IADL, and subsets of the SF-36. For the EQ-5D, bias appeared in both the ICU and non-ICU cohorts. The dichotomous analysis of the within-pairs-difference supported the findings, revealing a high proportion of pairs with differences outside the MCID (n (%)-SF-36 PCS normal ward: 47 (46%), ICU: 58 (57%); SF-36 MCS normal ward: 59 (58%), ICU: 62 (61%); WHODAS 2.0 normal ward: 58 (57%), ICU: 78 (77%); EQ-5D-5L normal ward: 40 (39%), ICU: 46 (45%); Barthel-Index normal ward: 22 (22%), ICU: 21 (21%)). Cohen's kappa indicated moderate reliability for the IADL.

conclusionThe reliability of proxy assessment with the instruments used was insufficient, exhibiting a significant bias in the pre-admission status of ICU patients; therefore, it should be applied with caution.

trial registrationClinicalTrials.gov (NCT03785444-28th of December 2018).

Indexed as

Patient Reported Outcome MeasuresProxyAdultAgedAged, 80 and overFemaleGermanyHumansIntensive Care UnitsMaleMiddle AgedProspective StudiesPsychometricsReproducibility of ResultsSurveys and QuestionnairesCognitive functionCritical careCritical illnessHealth-related quality of lifePatient-reported outcome measuresPhysical functionPre-admission statusProxy assessment

Identifiers

PMID40390142
PMCPMC12090533

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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.