From: Convergent validity of EQ-5D with core outcomes in dementia: a systematic review
 | Inter-rater agreement (PwD and proxy) | |
---|---|---|
EQ-5D dimension | Evidence | Source |
Mobility | Mobility was the only dimension to produce an acceptable level of agreement (kappa = 0.53 formal, 0.44 informal proxy) | Ankri et al. [19] |
Mobility dimension produced the best agreement on the dimensions (kappa coefficient indicate moderate agreement) | Orgeta et al. [37] | |
Proxies rated more problems in the mobility dimension (than PwD had self-rated) | Vogel et al. [32] | |
Self-care | PwD self-rated self-care significantly more optimistically than proxies (1.0 ± 0.2 vs 1.1 ± 0.4, P = 0.031 | Bonfiglio et al. [41] |
Self-care was the only EQ-5D dimension to showed a significant correlation between self and proxy report (r = 0.51, p < 0.01) | Vogel et al. [32] | |
Usual activities | Agreement (across proxy type) was lowest with PwD for usual activities dimension | Orgeta et al. [37] |
The difference between the kappa-coefficients in the subgroups of mild vs moderate PwD was statistically significant (p > 0.05) | Kunz et al. [29] | |
PwD self-rated usual activities significantly more optimistically than proxies (1.1 ± 0.4 vs 1.6 ± 0.8, P = 0.000) | Bonfiglio et al. [41] | |
Proxies rated more problems in the usual activities dimension (than PwD had self-rated) | Vogel et al. [32] | |
PwD self-rated pain/discomfort significantly more optimistically than proxies (1.5 ± 0.7 vs 1.7 ± 0.9, P = 0.015) | Bonfiglio et al. [41] | |
Proxies rated more problems in the pain/discomfort dimension (than PwD had self-rated) | Vogel et al. [32] | |
Anxiety/depression | PwD self-rated anxiety/depression significantly more optimistically than proxies (1.1 ± 0.5 vs 1.3 ± 0.5, P = 0.008) | Bonfiglio et al. [41] |
Anxiety/depression was the only dimension that PwD self-rated more problems than proxies | Vogel et al. [32] | |
EQ-5D index score | Intraclass correlation coefficient for EQ-5D total scores on PwD and proxy responses reflected average concordance – informal: ICC = 0.41, p < 0.001), formal: ICC = 0.42, p < 0.001) | Ankri et al. [19] |
Proxy EQ-5D ratings were significantly worse, with a mean difference of 0.1 in total score | Kunz et al. [29] | |
Relationships between EQ-5D scores and clinical variables (CSDD, NPI, ADCS-ADL) were stronger for proxy assessments | Bhatttacharya et al. [20] | |
Proxy EQ-5D index scores were significantly lower than self-report (0.8 ± 0.1 vs 0.9 ± 0.1, P = 0.000) | Bonfiglio et al. [41] | |
MMSE and NPI scores were significantly associated with EQ-5D proxy (p = 0.00), but not EQ-5D self report (p = 0.63 | Farina et al. [35] | |
EQ-5D index scores were significantly different based on the rater: 0.67 (± 0.33) for self-report and 0.45 (± 0.36) for proxy, p < 0.001 | Heßmann et al. [28] | |
Self-completed EQ-5D was poor at reflecting clinically important differences and changes in clinical measures, vs EQ-5D proxy which did capture these changes | Martin et al. [36] | |
EQ-5D proxy index scores were significantly lower than self-scores | Orgeta et al. [37] | |
Self-rated EQ-5D scores were significantly higher than proxy EQ-5D (patient mean EQ5D score 0.71, 95% CI 0.64–0.77, proxies mean EQ5D score 0.30, 95% CI 0.22–0.38), mean difference 0.40 (95% CI 0.32–0.48, p 5 0.001) | Sheehan et al. [38] |