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

Paul Glasziou, Jan Alexander, Elaine Beller, Philip Clarke, John Chalmers, Stephen MacMahon, Mark Cooper, Eleuterio Ferrannini, Paul Glasziou, Diederick Grobbee, Pavel Hamet, Stephen Harrap, Simon Heller, Liu Lisheng, Giuseppe Mancia, Michel Marre, Carl Mogensen, Bruce Neal, Chang Yu Pan, Anushka PatelNeil Poulter, Anthony Rodgers, Bryan William, Mark Woodward, Rory Collins, Rury Holman, Peter Sleight, Mark Adams, Michael Branley, Greg Fulcher, Bronwyn Jenkins, Damien Louis, Wei Lou, Harry Lowe, Anne McCormack, Paul Mitchell, Stephen Ong, Carol Pollock, John Watson, Tien Wong, Sarah Allen, Severine Bompoint, Anna Carreras, Tom Chen, Samatha Flynn, Sophie Gibbo, Dorothy Han, Sally Hough, Kathy Jayne, Roshina Joshi, Andrew Pascal Kengne, Jennifer Linn, Helen Monaghan, Robyn Ng, Vlado Perkovic, Joanne Regaglia, Manuela Schmidt, Du Xin, Bi Yufang, Terry Holloway, Barry Gray, Amanda Milne, Alison Adderkin, Marie Renee Guertin, Danielle de Guise, Ma Liyuan, Jane Reid, Ravathi Subramaniam, Wang Wen, Karin Williamson

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Article number21
JournalHealth and Quality of Life Outcomes
Volume5
DOIs
Publication statusPublished - Apr 27 2007

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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    Glasziou, P., Alexander, J., Beller, E., Clarke, P., Chalmers, J., MacMahon, S., Cooper, M., Ferrannini, E., Glasziou, P., Grobbee, D., Hamet, P., Harrap, S., Heller, S., Lisheng, L., Mancia, G., Marre, M., Mogensen, C., Neal, B., Yu Pan, C., ... Williamson, K. (2007). Which health-related quality of life score? A comparison of alternative utility measures in patients with Type 2 diabetes in the ADVANCE trial. Health and Quality of Life Outcomes, 5, [21]. https://doi.org/10.1186/1477-7525-5-21