Propensity scores for proxy reports of care experience and quality: are they useful?

AbstractPatient-reported outcome and experience measures are increasingly important in health care 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 patient non-response, especially for diseases such as cancer and dementia. A commonly used approach is to ask a proxy such as the patient ’s spouse or child to complete the measure on their behalf. Proxy reporting is used in major surveys, including those used in pay-for-performance approaches. No standards exist regarding how to adjust for the use of proxy-reported measures in analyses. As patients requiring proxies likely differ i n important ways from 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, b ecause previous analyses using propensity scores for proxy reports have employed stepwise orp value based algorithms, we evaluated the sensitivity of our results to the inclusion of respondent-sensitive variables such as proxy reports of patient health status, as well as auxiliary covariates. Under all propensity score methods, estimates obtained from propensity scores using respondent-insensitive variables wer...
Source: Health Services and Outcomes Research Methodology - Category: Statistics Source Type: research