Patient–Proxy Agreement Regarding Health-Related Quality of Life in Survivors with Lymphoma: A Propensity-Score Matching Analysis
Abstract
:Simple Summary
Abstract
1. Introduction
2. Method
2.1. Study Design and Setting
2.2. Outcome Measures
2.3. Covariates and Prospensity-Score Matching Approach
2.4. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Before PSM (n = 4400) | After PSM (n = 2350) | ||||||
---|---|---|---|---|---|---|---|
Patient n = 2110 | Proxy n = 2290 | p-Value | Overall | Patient n = 1175 | Proxy n = 1175 | p-Value | |
Survival years, mean (range) | 1.37 (1–35) | 1.37 (1–30) | 0.99 | 1.34 (1–35) | 1.38 (1–35) | 1.31 (1–13) | 0.99 |
Sex | |||||||
Male | 1077 (51) | 1373 (59.96) | <0.001 | 1421 (60.3) | 708 (60.3) | 713 (60.3) | 0.88 |
Female | 1033 (49) | 917 (40.04) | 929 (39.7) | 467 (39.7) | 462 (39.7) | ||
Age | |||||||
18–40 | 1146 (54.3) | 459 (20) | <0.001 | 919 (39.1) | 460 (39.1) | 459 (39.1) | 0.99 |
41–60 | 810 (38.4) | 1024 (44.7) | 1143 (48.6) | 571 (48.6) | 572 (48.6) | ||
≥61 | 154 (7.3) | 807 (35.2) | 288 (12.3) | 144 (12.3) | 144 (12.3) | ||
Educational level | |||||||
Secondary or below | 772 (36.6) | 1646 (71.9) | <0.001 | 1173 (49.9) | 587 (50) | 586 (49.9) | 0.98 |
Tertiary or above | 1338 (63.4) | 644 (28.1) | 1177 (50.1) | 588 (50) | 589 (50.1) | ||
Sub-types | |||||||
HL | 426 (20.2) | 218 (9.5) | <0.001 | 335 (14.3) | 162 (13.8) | 173 (14.7) | 0.81 |
A-NHL | 977 (40) | 1467 (60) | 1263 (53.7) | 634 (54) | 629 (53.5) | ||
I-NHL | 707 (53.9) | 605 (46.1) | 752 (32) | 379 (32.2) | 373 (31.7) | ||
Family registry | |||||||
Urban resident | 1502 (71.1) | 1430 (62.4) | <0.001 | 1711 (72.9) | 853 (73.1) | 858 (72.7) | 0.84 |
Rural resident | 597 (28.3) | 854 (37.3) | 636 (27.1) | 320 (26.9) | 316 (27.3) | ||
Marital status | |||||||
Single | 340 (16.1) | 131 (5.7) | <0.001 | 245 (10.4) | 79 (6.7) | 50 (4.3) | 0.06 |
Married | 1605 (76.1) | 2014 (87.9) | 1976 (84.1) | 980 (83.4) | 996 (84.7) | ||
Divorce/widow(er) | 165 (7.8) | 145 (6.3) | 129 (5.5) | 116 (9.9) | 129 (11) | ||
Family income per year | |||||||
≤50,000 RMB | 696 (44.1) | 813 (45.3) | 0.55 | 540 (36.2) | 294 (39.4) | 246 (33.1) | 0.02 |
50,001~100,000 RMB | 637 (40.4) | 724 (40.4) | 319 (21.4) | 142 (19) | 177 (23.8) | ||
≥100,001 RMB | 245 (15.5) | 256 (14.3) | 631 (42.3) | 310 (41.6) | 321 (43.1) | ||
Employed status | |||||||
Employed | 1055 (50) | 837 (36.6) | <0.001 | 1117 (47.5) | 612 (52.1) | 505 (43) | <0.001 |
Non-employed | 764 (36.2) | 696 (30.4) | 735 (31.3) | 341 (29) | 394 (33.5) | ||
Retired | 291 (13.8) | 757 (33) | 298 (21.2) | 222 (18.9) | 272 (23.5) | ||
Health insurance | |||||||
UEBS | 1137 (63.2) | 957 (47.7) | <0.001 | 1175 (59.2) | 629 (63.9) | 546 (54.5) | <0.001 |
URBS | 214 (11.9) | 341 (17) | 294 (14.8) | 117 (11.9) | 177 (17.7) | ||
NRMS | 317 (17.6) | 610 (30.3) | 364 (18.3) | 159 (16.2) | 205 (20.5) | ||
FMS | 130 (7.2) | 102 (5.1) | 153 (7.7) | 79 (8) | 74 (7.4) | ||
Chemotherapy, Yes | 1833 (92.2) | 2002 (91.5) | 0.4 | 2038 (91.6) | 1017 (91.7) | 1021 (91.4) | 0.8 |
Immunotherapy, Yes | 776 (36.8) | 858 (37.5) | 0.9 | 893 (40.1) | 449 (39.7) | 444 (40.5) | 0.72 |
Radiotherapy, Yes | 498 (23.6) | 361 (15.8) | <0.001 | 476 (21.4) | 244 (22) | 232 (20.8) | 0.48 |
Surgery, Yes | 296 (14) | 319 (13.9) | 0.77 | 338 (15.2) | 161 (14.5) | 177 (15.8) | 0.38 |
Treatment status | |||||||
Never treated | 122 (5.8) | 102 (4.5) | <0.001 | 124 (5.3) | 58 (4.9) | 66 (5.6) | <0.001 |
Treatment not started yet | 154 (7.3) | 112 (4.9) | 150 (6.4) | 57 (4.9) | 93 (7.9) | ||
Being treated | 887 (42) | 1281 (55.9) | 1146 (48.8) | 640 (54.5) | 506 (43.1) | ||
Treatment completed | 947 (44.9) | 795 (34.7) | 930 (39.6) | 420 (35.7) | 510 (43.4) |
Mean (Standard Deviation) | |||||||
---|---|---|---|---|---|---|---|
Type of Response | Type of Caregiver | ||||||
Self- Reported | Proxy- Reported | p-Value | Children | Spouse | Others | p-Value | |
n | 1175 | 1175 | 411 (35) | 529 (45) | 235 (20) | ||
Global health status | 61.85 (22.67) | 60.48 (23) | 0.14 | 62.35 (20.44) | 61.17 (23.02) | 62.52 (25.46) | 0.93 |
Functional scales | |||||||
Physical | 80.5 (17.56) | 74.08 (22.3) | <0.001 | 75.16 (20.58) | 72.42 (23.61) | 74.52 (24.19) | 0.11 |
Role | 74.23 (26.97) | 69.33 (30.52) | <0.001 | 69.55 (31.03) | 68.65 (30.25) | 70.5 (30.3) | 0.81 |
Emotional | 67.28 (23.26) | 63.43 (24.94) | <0.001 | 63.3 (24.28) | 62.85 (25.37) | 64.72 (25.7) | 0.39 |
Cognitive | 75.42 (20.25) | 77.28 (21.63) | 0.03 | 76.84 (21.94) | 76.64 (21.09) | 79.36 (22.24) | 0.16 |
Social | 49.63 (30.75) | 51.51 (31.32) | 0.24 | 55.03 (30.58) | 49.02 (31.02) | 49.15 (32.71) | 0.003 |
Symptom scales | |||||||
Fatigue | 41.03 (23.12) | 46.66 (24.58) | <0.001 | 46.9 (24.5) | 47.64 (24.1) | 44.02 (25.69) | 0.24 |
Nausea/Vomiting | 10.24 (17.82) | 13.9 (22.18) | <0.001 | 12.45 (20.16) | 14.18 (22.28) | 15.82 (25.07) | 0.06 |
Pain | 19.67 (20.89) | 23.25 (24.16) | <0.001 | 25.02 (24.7) | 21.99 (22.95) | 22.98 (25.72) | 0.18 |
Single items | |||||||
Dyspnea | 38.64 (23.85) | 43.8 (26.05) | <0.001 | 44.28 (25.64) | 45.12 (26.47) | 40 (25.56) | 0.09 |
Insomnia | 30.27 (28.06) | 30.35 (29.85) | 0.94 | 35.36 (31.81) | 28.42 (28.37) | 25.96 (28.45) | <0.001 |
Appetite Loss | 20.6 (24.56) | 27.89 (28.17) | <0.001 | 28.71 (27.7) | 26.84 (27.41) | 28.79 (30.63) | 0.85 |
Constipation | 15.57 (23.68) | 19.23 (26.01) | <0.001 | 21.41 (27.37) | 17.64 (24.44) | 19.01 (26.83) | 0.04 |
Diarrhea | 12.91 (19.77) | 12.79 (21.09) | 0.89 | 11.35 (19.08) | 13.42 (21.67) | 13.9 (22.97) | 0.11 |
Coefficient (95% Confidence Interval) | |||||
---|---|---|---|---|---|
Model 1 Physical Model | Model 2 Role Model | Model 3 Emotional Model | Model 4 Cognitive Model | Model 5 Social Model | |
Proxy-reported patients | 4.73 (2.36, 7.1) *** | 2.25 (−1.12, 5.61) | 1.46 (−1.39, 4.32) | −3.98 (−6.53, −1.42) ** | −5.09 (−8.62, −1.55) ** |
Female | −3.72 (−6.06, −1.38) ** | −0.07 (−3.4, 3.25) | −2.28 (−5.1, 0.54) | −3.86 (−6.38, −1.33) ** | 0.06 (−3.43, 3.55) |
41–60 | −3.58 (−6.36, −0.79) * | −4.47 (−8.42, −0.52) * | −2.13 (−5.49, 1.22) | −2.65 (−5.65, 0.36) | −6.17 (−10.32, −2.02) ** |
≥61 | −8.59 (−14.11, −3.07) ** | −4.13 (−11.95, 3.7) | 3.15 (−3.49, 9.8) | 0.48 (−5.46, 6.43) | 1.77 (−6.45, 9.99) |
Tertiary and above | −2.44 (−5.17, 0.29) | −3.29 (−7.16, 0.58) | −1.11 (−4.39, 2.17) | −2.42 (−5.36, 0.52) | −3.61 (−7.67, 0.45) |
Rural resident | −0.41 (−3.71, 2.89) | −4.18 (−8.86, 0.5) | 0.54 (−3.44, 4.51) | 2.25 (−1.3, 5.81) | −1.65 (−6.57, 3.26) |
Married | 0.97 (−4.11, 6.04) | 3.34 (−3.86, 10.54) | −3.22 (−9.33, 2.89) | 1.5 (−3.97, 6.97) | 2.21 (−5.36, 9.77) |
Divorce/widow(er) | 3.54 (−2.8, 9.89) | 7.98 (−1.02, 16.98) | 0 (−7.64, 7.63) | 3.33 (−3.51, 10.16) | 1.08 (−8.37, 10.54) |
50,001~100,000 | 5.72 (2.46, 8.97) *** | 2.27 (−2.34, 6.89) | 6.81 (2.9, 10.73) *** | 5.68 (2.17, 9.19) ** | 11.52 (6.66, 16.37) *** |
≥100,001 | 3.45 (0.8, 6.1) * | 1.75 (−2, 5.5) | 2.82 (−0.36, 6.01) | 1.44 (−1.41, 4.29) | 8.22 (4.27, 12.16) *** |
Non-employed | −4.19 (−6.93, −1.44) ** | −6.93 (−10.82, −3.03) *** | −4.32 (−7.62, −1.01) * | −4.88 (−7.84, −1.93) ** | −5.98 (−10.07, −1.89) ** |
Retired | 0.57 (−3.49, 4.63) | 3.58 (−2.18, 9.34) | 0.68 (−4.21, 5.57) | −2.97 (−7.34, 1.41) | 1.18 (−4.87, 7.23) |
URBS | 1.46 (−3.69, 6.61) | 0.98 (−6.32, 8.29) | 3.27 (−2.93, 9.47) | 1.84 (−3.7, 7.39) | 4.36 (−3.31, 12.03) |
NRCS | 0.85 (−2.61, 4.3) | 3.38 (−1.52, 8.28) | 1.06 (−3.09, 5.22) | −0.73 (−4.45, 2.99) | 0.78 (−4.36, 5.93) |
FMS | 2.74 (−1.04, 6.52) | 5.15 (−0.21, 10.52) | 2 (−2.55, 6.55) | −0.54 (−4.62, 3.53) | −0.81 (−6.45, 4.82) |
Duration | 0.09 (−0.64, 0.82) | 0.51 (−0.53, 1.55) | 0.02 (−0.86, 0.9) | −0.06 (−0.85, 0.72) | 0.39 (−0.7, 1.48) |
Chemotherapy, Yes | −2.66 (−7.19, 1.87) | −6.35 (−12.78, 0.08) | −4.18 (−9.63, 1.28) | −4.17 (−9.05, 0.72) | −6.52 (−13.27, 0.24) |
Immunotherapy, Yes | 1.32 (−1.04, 3.67) | 2.12 (−1.21, 5.46) | 0.13 (−2.7, 2.96) | 0.45 (−2.08, 2.99) | 0.37 (−3.13, 3.88) |
Radiotherapy, Yes | 1.17 (−1.54, 3.88) | 3.75 (−0.09, 7.6) | 0.12 (−3.14, 3.38) | −1.37 (−4.28, 1.55) | 3.11 (−0.92, 7.15) |
Surgery, Yes | −3.68 (−6.78, −0.59) * | −5.34 (−9.73, −0.95) * | −3.39 (−7.12, 0.33) | −1.81 (−5.15, 1.52) | −5.4 (−10.02, −0.79) * |
Being treated | −11.42 (−13.72, −9.12) *** | −21.81 (−25.07, −18.54) *** | −12.62 (−15.39, −9.85) *** | −6.98 (−9.46, −4.5) *** | −16.82 (−20.25, −13.39) *** |
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Xu, R.H.; Dong, D. Patient–Proxy Agreement Regarding Health-Related Quality of Life in Survivors with Lymphoma: A Propensity-Score Matching Analysis. Cancers 2022, 14, 607. https://doi.org/10.3390/cancers14030607
Xu RH, Dong D. Patient–Proxy Agreement Regarding Health-Related Quality of Life in Survivors with Lymphoma: A Propensity-Score Matching Analysis. Cancers. 2022; 14(3):607. https://doi.org/10.3390/cancers14030607
Chicago/Turabian StyleXu, Richard Huan, and Dong Dong. 2022. "Patient–Proxy Agreement Regarding Health-Related Quality of Life in Survivors with Lymphoma: A Propensity-Score Matching Analysis" Cancers 14, no. 3: 607. https://doi.org/10.3390/cancers14030607