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Wherein lies the truth? Assessment of agreement between parent proxy and child respondents
1Epidemiology and Population Health Unit, Queensland Institute of Medical Research, Herston, Australia.
Insights
Parental reports on children's health characteristics show varying agreement levels. Agreement is highest for stable traits like eye color and lowest for subjective details like skin moles, regardless of child's age or sex.
Area of Science:
- Pediatric Epidemiology
- Biostatistics
- Dermatology
Background:
- Epidemiological studies in children often rely on proxy respondents (parents) due to the index subject's age.
- Research on the reliability of parent proxies in pediatric epidemiology is less extensive than for adult surrogates.
Purpose of the Study:
- To assess the agreement between children's and their parents' responses to identical questions in a pediatric case-control study.
- To evaluate the reliability of parent proxy data in childhood disease research.
Main Methods:
- A case-control study of childhood melanoma in Queensland, Australia, was conducted.
- Agreement was measured using weighted kappa statistics and log-linear modeling for ordinal data.
Main Results:
- High agreement was observed for unchanging physical characteristics (e.g., eye color, kappa=0.88) and farm residence history (kappa=0.84).
- Moderate agreement was found for facial freckling density (kappa=0.62), sunburn propensity (kappa=0.46), and tanning ability (kappa=0.47).
- Low agreement was noted for shoulder freckling density (kappa=0.28) and skin moles at age 5 (kappa=0.24). Agreement was independent of child's age or sex.
Conclusions:
- The reliability of parent proxy responses in pediatric studies is primarily determined by the nature of the information requested.
- Respondent characteristics like age or sex do not significantly influence agreement levels.
Background:
The epidemiological study of diseases of childhood presents a special situation in that the principal respondent is almost always a person other than the index. Use of proxy respondents in paediatric epidemiology has been little studied compared with the use of surrogate respondents for adults.
Methods:
Agreement between responses from children and their parents to identical questions about the children was assessed in a case-control study of childhood melanoma in Queensland, Australia. Weighted kappa and log-linear modelling techniques were used to measure agreement for ordinal data.
Results:
Highest agreement was found for reports of unchanging physical characteristics such as eye colour (kappa = 0.88), hair colour (kappa = 0.76), and for history of residing on a farm (kappa = 0.84). Moderate agreement was seen for density of facial freckling (kappa = 0.62), propensity to sunburn (kappa = 0.46) and tanning ability (kappa = 0.47). Variables with low levels of agreement between parent proxy and child respondents included density of freckling on the shoulders (kappa = 0.28) and degree of moliness of the skin at age 5 years (kappa = 0.24). Agreement did not vary according to age or sex of the children. Log-linear modelling was performed to determine the type and magnitude of components of agreement.
Conclusions:
Agreement between responses from children and parent proxies depends largely upon the type of information sought, rather than characteristics of the respondents.
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