Document Detail

Reports of fewer activity limitations: recovery, survey fatigue, or switching respondent?
MedLine Citation:
PMID:  16625067     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Very little is known about the validity and reliability of disability dynamics reported in household surveys, and some researchers argue that measurement error likely plays a large part in reported recovery from disability. OBJECTIVES: We assessed the reliability of reported recovery from activity limitations elicited from 2 types of questions. We assessed competing hypotheses explaining reported recoveries from disability: people are less likely to recover from more severe disabilities, switching between self- and proxy-response affects reported recovery, and survey fatigue reduces reported disability. METHODS: Using the second panel of the Medical Expenditure Panel Survey, we estimated kappas for 2 types of questions in the same interview about limitations in activities of daily living and instrumental activities of daily living. We estimated multinomial logit models of consistently reported recovery, consistently reported ongoing limitations, and inconsistent responses. Recovery is a function of severity, switching respondent, measures of survey burden (such as family size), age, and education. RESULTS: Within an interview, we found substantial reliability for both instrumental activities of daily living and activities of daily living limitations (kappa = 0.62 and 0.70, respectively). Sample members with more severe disabilities are less likely to report recovery, which is consistent with accurate reporting. Controlling for severity, the type of respondent affects reported recovery. Measures of survey burden did not affect reports. CONCLUSION: Researchers can be confident in reports of recovery in the Medical Expenditure Panel Survey, especially when disability status was self-reported in both interviews. Researchers may also want to control for proxy respondents and switching respondents in their analyses.
Steven C Hill; Yuriy Pylypchuk
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  Medical care     Volume:  44     ISSN:  0025-7079     ISO Abbreviation:  Med Care     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-20     Completed Date:  2006-05-23     Revised Date:  2006-10-13    
Medline Journal Info:
Nlm Unique ID:  0230027     Medline TA:  Med Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  I73-81     Citation Subset:  IM    
Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland 50850, USA.
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MeSH Terms
Activities of Daily Living*
Disability Evaluation*
Disabled Persons / rehabilitation*,  statistics & numerical data
Family Characteristics
Health Expenditures / statistics & numerical data
Logistic Models
Needs Assessment
Recovery of Function
Reproducibility of Results
Sickness Impact Profile*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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