Which health-related quality of life score? A comparison of alternative utility measures in patients with Type 2 diabetes in the ADVANCE trial.

Journal article

BACKGROUND: Diabetes has a high burden of illness both in life years lost and in disability through related co-morbidities. Accurate assessment of the non-mortality burden requires appropriate health-related quality of life and summary utility measures of which there are several contenders. The study aimed to measure the impact of diabetes on various health-related quality of life domains, and compare several summary utility measures. METHODS: In the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation) study, 978 Australian patients with Type 2 diabetes completed two health-related quality of life questionnaires at baseline: the EQ-5D and the SF-36v2, from which nine summary utility measures were calculated, and compared. The algorithms were grouped into four classes: (i) based on the EQ-5D; (ii) using fewer items than those in the SF-12 (iii) using the items in the SF-12; and (iv) using all items of the SF-36. RESULTS: Overall health-related quality of life of the subjects was good (mean utility ranged from 0.68 (+/-0.08) to 0.85(+/-0.14) over the nine utility measures) and comparable to patients without diabetes. Summary indices were well correlated with each other (r = 0.76 to 0.99), and showed lower health-related quality of life in patients with major diabetes-related events such as stroke or myocardial infarction. Despite the smaller number of items used in the scoring of the EQ-5D, it generally performed at least as well as SF-36 based methods. However, all utility measures had some limitation such as limited range or ceiling effects. CONCLUSION: The summary utility measures showed good agreement, and showed good discrimination between major and minor health state changes. However, EQ-5D based measures performed as well and are generally simpler to use.

Authors: Glasziou, P; Alexander, J; Beller, E; Clarke, P

• Journal: Health and quality of life outcomes
• Volume: 5
• Issue: 1
• Pages: 21
• Publication date: 2007-01-01
• DOI: 10.1186/1477-7525-5-21
• EISSN: 1477-7525
• ISSN: 1477-7525
• Language: English
• Keywords: Female; Linear Models; Cohort Studies; Comorbidity; Male; ADVANCE Collaborative Group; Diabetes Mellitus, Type 2; Quality of Life; Health Status Indicators; Algorithms; Diabetic Angiopathies; Cost of Illness; Australia; Aged, 80 and over; Middle Aged; Reproducibility of Results; Humans; Aged