There are two ways to complete a proxy report—from the proxy’s own perspective (proxy-proxy, Proxy 1) or answer as the child would (proxy-child, Proxy 2). The implications of utilising these two perspectives on agreement with child self-report is not clear.

Based on a community-based dyadic sample comprising generally healthy children and their parents, who completed the EQ-5D-Y-3L (self, proxy-proxy and proxy-child), we found that proxy perspective influenced the agreement between child and proxy ratings of health-related quality of life (HRQoL).

Proxy-child perspective showed a stronger agreement at the dimension level for the psychosocial dimension compared with the traditional proxy-proxy perspective. While no statistically significant difference was observed for the preference-weighted HRQoL across the two proxy perspectives, the child- and parent-reported EQ VAS scores differed significantly when the proxy-child perspective was adopted, indicating that perspective may influence this aspect of HRQoL measurement.