The online version of this article (doi:10.1186/1475-2840-11-35) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
DR drafted and revised the manuscript. PF and DH performed the statistical analyses. DR conceived of the study. MS, DG, PZ, KN, and PO participated in its design, reviewed and provided input for drafts of the manuscript. All authors read and approved the final manuscript.
Health utility (HU) measures are used as overall measures of quality of life and to determine quality adjusted life years (QALYs) in economic analyses. We compared baseline values of three HUs including Short Form 6 Dimensions (SF-6D), and Health Utilities Index, Mark II and Mark III (HUI2 and HUI3) and the feeling thermometer (FT) among type 2 diabetes participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. We assessed relationships between HU and FT values and patient demographics and clinical variables.
ACCORD was a randomized clinical trial to test if intensive controls of glucose, blood pressure and lipids can reduce the risk of major cardiovascular disease (CVD) events in type 2 diabetes patients with high risk of CVD. The health-related quality of life (HRQOL) sub-study includes 2,053 randomly selected participants. Interclass correlations (ICCs) and agreement between measures by quartile were used to evaluate relationships between HU’s and the FT. Multivariable regression models specified relationships between patient variables and each HU and the FT.
The ICCs were 0.245 for FT/SF-6D, 0.313 for HUI3/SF-6D, 0.437 for HUI2/SF-6D, 0.338 for FT/HUI2, 0.337 for FT/HUI3 and 0.751 for HUI2/HUI3 (P < 0.001 for all). Common classification by quartile was found for the majority (62%) of values between HUI2 and HUI3, which was significantly (P < 0.001) higher than between other HUs and the FT: SF-6D/HUI3 = 40.8%, SF-6D/HUI2 = 40.9%, FT/HUI3 = 35.0%, FT/HUI2 = 34.9%, and FT/SF-6D = 31.9%. Common classification was higher between SF-6D/HUI2 and SF-6D/HUI3 (P < 0.001) than between FT/SF-6D, FT/HUI2, and FT/HUI3. The mean difference in HU values per patient ranged from −0.024 ± 0.225 for SF-6D/ HUI3 to −0.124 ± 0.133 for SF-6D/HUI2. Regression models were significant; clinical and demographic variables explained 6.1% (SF-6D) to 7.7% (HUI3) of the variance in HUs.
The agreements between the different HUs were poor except for the two HUI measures; therefore HU values derived different measures may not be comparable. The FT had low agreement with HUs. The relationships between HUs and demographic and clinical measures demonstrate how severity of diabetes and other clinical and demographic factors are associated with HUs and FT measures.
ClinicalTrials.gov Identifier: NCT00000620
Schunemann HJ, Armstrong D, Degl'innocenti A, Wiklund I, Fallone CA, Tanser L, Van Zanten SV, Heels-Ansdell D, El-Dika S, Chiba N, et al: A randomized multicenter trial to evaluate simple utility elicitation techniques in patients with gastroesophageal reflux disease. Med Care. 2004, 42 (11): 1132-1142. 10.1097/00005650-200411000-00013. CrossRefPubMed
Rashidi AA, Anis AH, Marra CA: Do visual analogue scale (VAS) derived standard gamble (SG) utilities agree with Health Utilities Index utilities? A comparison of patient and community preferences for health status in rheumatoid arthritis patients. Health Qual Life Outcomes. 2006, 4: 25-10.1186/1477-7525-4-25. PubMedCentralCrossRefPubMed
Ackermann RT, Edelstein SL, Venkat Narayan KM, Zhang P, Engelgau MM, Herman WH, Marrero DG: Changes in Health State Utilities With Changes in Body Mass in the Diabetes Prevention Program. Obesity (Silver Spring). 2009, 17 (12): 2176-2181. 10.1038/oby.2009.114. CrossRef
Sach TH, Barton GR, Doherty M, Muir KR, Jenkinson C, Avery AJ: The relationship between body mass index and health-related quality of life: comparing the EQ-5D, EuroQol VAS and SF-6D. Int J Obes (Lond). 2007, 31 (1): 189-196. 10.1038/sj.ijo.0803365. CrossRef
Sullivan MD, Anderson RT, Aron D, Atkinson HH, Bastien A, Chen GJ, Feeney P, Gafni A, Hwang W, Katz LA, et al: Health-related quality of life and cost-effectiveness components of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial: rationale and design. Am J Cardiol. 2007, 99 (12A)): 90i-102i. CrossRefPubMed
McGraw K, Wong S: Forming inferences about some Intraclass correlation coefficients. Psychol Methods. 1996, 1: 30-48. CrossRef
O'Reilly DJ, Xie F, Pullenayegum E, Gerstein HC, Greb J, Blackhouse GK, Tarride JE, Bowen J, Goeree RA: Estimation of the impact of diabetes-related complications on health utilities for patients with type 2 diabetes in Ontario, Canada. Qual Life Res. 2011, 20 (6): 939-943. 10.1007/s11136-010-9828-9. CrossRefPubMed
Marra CA, Woolcott JC, Kopec JA, Shojania K, Offer R, Brazier JE, Esdaile JM, Anis AH: A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis. Soc Sci Med. 2005, 60 (7): 1571-1582. 10.1016/j.socscimed.2004.08.034. CrossRefPubMed
Norgaard ML, Andersson C, Hansen PR, Andersen SS, Vaag A, Schramm TK, Folke F, Kober L, Torp-Pedersen C, Gislason GH: Temporal trends in the initiation of glucose-lowering medications after a first-time myocardial infarction - a nationwide study between 1997 and 2006. Cardiovasc Diabetol. 2011, 10: 5-10.1186/1475-2840-10-5. PubMedCentralCrossRefPubMed
Rahman M, Simmons RK, Hennings SH, Wareham NJ, Griffin SJ: Effect of screening for Type 2 diabetes on population-level self-rated health outcomes and measures of cardiovascular risk: 13-year follow-up of the Ely cohort. Diabet Med. 2012, 28.
- Baseline comparison of three health utility measures and the feeling thermometer among participants in the action to control cardiovascular risk in diabetes trial
Dennis W Raisch
David C Goff Jr
KM Venkat Narayan
Patrick J O’Connor
Don G Hire
Mark D Sullivan
- BioMed Central
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