Comparison of patient and proxy reporting of health-related quality of life in adolescent athletes who suffer a sports-related injury and require orthopaedic consultation.

ABSTRACT

CONTEXT Accurate assessment of health-related quality of life (HRQoL) is important for quality patient care. Evaluation of HRQoL typically occurs with patient self-report, but some instruments, such as the Pediatric Quality of Life Inventory (PedsQL), allow for proxy reporting. Limited information exists comparing patient and proxy reports of HRQoL after sport-related injury in adolescent athletes. OBJECTIVE: To compare patient ratings and parent-proxy ratings of HRQoL in adolescent athletes who suffer musculoskeletal injuries requiring orthopedic consultation. The authors hypothesized poor agreement between patient and parent-proxy ratings of HRQoL. DESIGN: Cross-sectional study. SETTING: Orthopedic practice. PATIENTS Thirteen adolescent patients with a sport-related musculoskeletal injury requiring orthopedic consultation and 1 of their parents participated. INTERVENTIONS: During the initial visit to the physician's office, each patient was asked to complete the PedsQL, and the patient's parent was asked to complete the parent-proxy version of the PedsQL. MAIN OUTCOME MEASUREMENTS The PedsQL is a pediatric generic outcome measure that consists of a total score and 4 subscale scores physical, emotional, social, and school functioning. Means and standard deviations were calculated for all scores, and comparisons between patient-self report and parent-proxy ratings of HRQoL were made for the PedsQL total score and subscale scores using Pearson product-moment correlations (r). RESULTS: Pearson product-moment correlations showed little to fair insignificant relationships between patient self-report and parent-proxy report of the PedsQL for the total score (r = -.1) and all subscales (range r = .1 to .4). CONCLUSIONS: Our results suggest a lack of agreement between patient and parent-proxy ratings of HRQoL, with patients rating their HRQoL lower than their parent. Patient perception of HRQoL may be more accurate than proxy report, which supports the use of patient-rated HRQoL in patient evaluation. Assessments of HRQoL made by proxies, even those close to the patient, may not represent patient health status.