title: Evaluation of patient and proxy responses on the activity measure for postacute care.
abstract: OBJECTIVE
  Our objective was to examine the agreement between adult patients with stroke and family member or clinician proxies in activity measure for postacute care (AM-PAC) summary scores for daily activity, basic mobility, and applied cognitive function.
  
  
  METHODS
  This study involved 67 patients with stroke admitted to a hospital within the Kaiser Permanente of Northern California system and were participants in a parent study on stroke outcomes. Each participant and proxy respondent completed the AM-PAC by personal or telephone interview at the point of hospital discharge or during ≥1 transitions to different postacute care settings.
  
  
  RESULTS
  The results suggest that for patients with a stroke proxy, AM-PAC data are robust for family or clinician proxy assessment of basic mobility function and clinician proxy assessment of daily activity function, but less robust for family proxy assessment of daily activity function and for all proxy groups' assessments of applied cognitive function. The pattern of disagreement between patient and proxy was, on average, relatively small and random. There was little evidence of systematic bias between proxy and patient reports of their functional status. The degree of concordance between patient and proxy was similar for those with moderate to severe strokes compared with mild strokes.
  
  
  CONCLUSIONS
  Patient and proxy ratings on the AM-PAC achieved adequate agreement for use in stroke research when using proxy respondents could reduce sample selection bias. The AM-PAC data can be implemented across institutional as well as community care settings while achieving precision and reducing respondent burden.
authors.affiliation: Boston University Medical Campus, School of Public Health, Health & Disability Research Institute, 715 Albany Street, T5W, Boston, MA 02118-2526, USA. Ajette@bu.edu
authors.forename: Alan M
authors.initials: AM
authors.lastname: Jette
authors.forename: Pengsheng
authors.initials: P
authors.lastname: Ni
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Rasch
authors.forename: Jed
authors.initials: J
authors.lastname: Appelman
authors.forename: M Elizabeth
authors.initials: ME
authors.lastname: Sandel
authors.forename: Joseph
authors.initials: J
authors.lastname: Terdiman
authors.forename: Leighton
authors.initials: L
authors.lastname: Chan
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology / Q000628:therapy; D003625:Data Collection; D005190:Family; D005260:Female; D006801:Humans; D007297:Inpatients; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009483:Neuropsychological Tests; D010045:Outpatients; D010361:Patients / Q000706:statistics & numerical data*; D010820:Physicians; D019727:Proxy / Q000706:statistics & numerical data*; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*; D017741:Survivors