Patient–Proxy Agreement Regarding Health-Related Quality of Life in Survivors with Lymphoma: A Propensity-Score Matching Analysis

SIMPLE SUMMARY: This study investigated the difference in self- and proxy-reported Health-related quality of life (HRQoL), and their associations with sociodemographic and other health characteristics in a sample of Chinese lymphoma survivors. Propensity-score matching approach was used to reduce the bias by selecting a sample in which confounding factors were balanced between two patient groups. The findings show that, compared with proxy-reported patients, self-reported patients were more likely to indicate higher physical, role and emotional, but lower cognitive and social functioning. Further analysis confirmed that a statistically significant difference between self- and proxy-reported HRQoL was found when respondents reported being treated and having completed treatment. Additionally, regarding patients with different subtypes of lymphoma, the difference between patient self- and proxy-reported global HRQoL was not significant between different subtypes of lymphoma. ABSTRACT: Objective: To assess the difference between lymphoma survivors’ self- and proxy-reported health-related quality of life (HRQoL) and its association with socioeconomic and health statuses. Methods: The data used in this study were obtained from a nationwide cross-sectional online survey in 2019. Information about participants’ demographics, health status and HRQoL were collected. The propensity-score matching (PSM) method was used to control the effect of potential confounders on selection bias. A chi-squared test, one-way analysis of variance, and multiple linear regression models were used to assess the relationship between HRQoL and response type adjusted to respondents’ background characteristics. Results: Out of the total 4400 participants, data of 2350 ones were elicited for analysis after PSM process. Patients’ self-reported outcomes indicated a slightly better physical, role and emotional functioning than proxy-reported outcomes. Regression analysis showed that patients, who were older, unemployed, and who received surgery, were more likely to report a lower HRQoL. Further analysis demonstrated that proxy-reported patients who had completed treatment were more likely to report a higher HRQoL than those who were being treated. Conclusions: Our study demonstrates that the agreement between self- and proxy-reported HRQoL is low in patients with lymphoma and the heterogeneities of HRQoL among patients with different types of aggressive NHL (Non-Hodgkin’s lymphoma) is large. Differences in self- and proxy-reported HRQoL should be considered by oncologists when selecting and deciding the optimal care plan for lymphoma survivors.