Do interviewer and physician health ratings predict mortality?: a comparison with self-rated health.
Do interviewer and physician health ratings predict mortality?: a comparison with self-rated health.
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DOI：
10.1097/ede.0b013e3182a713a8
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发表时间：
2013-11
期刊：
影响因子：
--
通讯作者：
Goldman N
中科院分区：
文献类型：
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作者：
Todd MA;Goldman N
尽管自我评估的健康状况存在严重的偏差，但研究人员严重依赖这些评估来预测死亡率。使用新收集的调查数据，我们检验了面试者和医生提供的对参与者健康的简单评级是否可以显著提高死亡率预测。我们使用了一项前瞻性队列研究的数据，该研究基于台湾具有全国代表性的老年人样本。我们估计了2006年访谈至2011年6月30日(平均随访4.7年)期间全因死亡率的比例风险模型。即使在控制了广泛的协变量后，面试者的评分与死亡率的相关性也比医生或自我评分更强。在包括面试者评分的模型中，受访者和医生的评分都没有实质性地改善死亡率预测。面试官评分的预测能力可能部分源于面试官将有关受访者身心健康的信息纳入他们的评估。这项研究的结果支持在面对面采访结束时常规地加入一个简单的问题，类似于自我评估的健康状况，要求面试者提供对受访者整体健康的评估。对于人口和健康研究人员来说，这种研究的成本微乎其微，而潜在的收益却是巨大的。今后的工作应该探索其他国家的采访者评分与死亡率之间的联系的强度，以及在收集关于受访者健康、功能和福祉的较少详细信息的调查中的联系。
Despite the serious biases that characterize self-rated health, researchers rely heavily on these ratings to predict mortality. Using newly collected survey data, we examine whether simple ratings of participants' health provided by interviewers and physicians can markedly improve mortality prediction. We use data from a prospective cohort study based on a nationally representative sample of older adults in Taiwan. We estimate proportional hazard models of all-cause mortality between the 2006 interview and 30 June 2011 (mean 4.7 years follow-up). Interviewer ratings were more strongly associated with mortality than physician or self-ratings, even after controlling for a wide range of covariates. Neither respondent nor physician ratings substantially improve mortality prediction in models that include interviewer ratings. The predictive power of interviewer ratings likely arises in part from interviewers' incorporation of information about the respondents' physical and mental health into their assessments. The findings of this study support the routine inclusion of a simple question at the end of face-to-face interviews, comparable to self-rated health, asking interviewers to provide an assessment of respondents' overall health. The costs of such an undertaking are minimal and the potential gains substantial for demographic and health researchers. Future work should explore the strength of the link between interviewer ratings and mortality in other countries and in surveys that collect less detailed information on respondent health, functioning, and well-being.