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Abstract

Patient-reported outcome and experience measures are increasingly important in healthcare and health research. The use of these measures is growing in the US and overseas,and performance measures that incorporate patient-reported outcomes are being considered,particularly in cancer. A major challenge for the use of these measures is patientnon-response, especially for diseases such as cancer and dementia. A commonly usedapproach is to ask a proxy such as the patient’s spouse or child to complete the measureon their behalf. Proxy reporting is used in major surveys, including those used in pay-forperformanceapproaches. No standards exist regarding how to adjust for the use of proxyreportedmeasures in analyses. As patients requiring proxies likely differ in important waysfrom those who can self-report, adjusting for these differences is important. In this paper,we evaluate the use of propensity score models when adjusting for proxy-reported data,including weighting, matching with replacement, and non-parametric multiple imputation.Additionally, because previous analyses using propensity scores for proxy reportshave employed stepwise or p value based algorithms, we evaluated the sensitivity of ourresults to the inclusion of respondent-sensitive variables such as proxy reports of patienthealth status, as well as auxiliary covariates. Under all propensity score methods, estimatesobtained from propensity scores using respondent-insensitive variables were different fromthose obtained when respondent-sensitive variables were incorporated in the propensityscore. Propensity score methods have limitations in these contexts and their assumptionsshould be carefully examined.

Item Type:	Article
Authors/Creators:	Roydhouse, J and Gutman, R and Keating, NL and Mor, V and Wilson, IB
Keywords:	proxy, patient, care experience, care quality, survey, propensity score
Journal or Publication Title:	Health Services and Outcomes Research Methodology
Publisher:	Springer New York LLC
ISSN:	1387-3741
DOI / ID Number:	https://doi.org/10.1007/s10742-019-00205-4
Copyright Information:	Copyright 2019 Springer Science+Business Media, LLC, part of Springer Nature
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