title: 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: BACKGROUND
  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.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Orthopedic practice.
  
  
  METHODS
  Thirteen adolescent patients with a sport-related musculoskeletal injury requiring orthopedic consultation and 1 of their parents participated.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Athletic Training Program, A.T. Still University, Mesa, AZ.
authors.forename: Alison R
authors.initials: AR
authors.lastname: Snyder Valier
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Swank
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Lam
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Hansen
authors.forename: Tamara C
authors.initials: TC
authors.lastname: Valovich McLeod
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009141:Musculoskeletal System / Q000293:injuries*; D009985:Orthopedics; D010290:Parents; D019727:Proxy; D011788:Quality of Life; D012017:Referral and Consultation; D057566:Self Report; D011795:Surveys and Questionnaires