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. 2011 Oct;49(10):924-31.
doi: 10.1097/MLR.0b013e318216592c.

Health utilities for children and adults with type 1 diabetes

Joyce M Lee  1 , Kirsten Rhee, Michael J O'grady, Anirban Basu, Aaron Winn, Priya John, David O Meltzer, Craig Kollman, Lori M Laffel, Jean M Lawrence, William V Tamborlane, Tim Wysocki, Dongyuan Xing, Elbert S Huang; JDRF Continuous Glucose Monitoring Study Group
Collaborators, Affiliations

Health utilities for children and adults with type 1 diabetes

Joyce M Lee et al. Med Care. 2011 Oct.

Abstract

Objective: We studied health utilities in patients with type 1 diabetes to understand potential differences in health utilities as function of age, type of respondent (self report vs. proxy report), and method of assessment (direct vs. indirect).

Research design and methods: We elicited self-reported health utilities for adults (n=213) and children (n=238) with type 1 diabetes, and by parent proxy report (n=223) for overall quality of life [Health Utilities Index (HUI) Mark 3 and experienced time-trade-off (TTO) questions] and hypothetical complication states (TTO questions).

Results: Mean health utilities for overall quality of life (QOL) ranged from 0.81 to 0.91. Children had significantly higher overall QOL compared with adults (0.89 vs. 0.85, P<0.01) by HUI, but had no significant difference in QOL by TTO. There were no significant differences in QOL between child self report and parent proxy report. Utilities were higher for HUI versus TTO for parent proxy report (P<0.01) but not for adult or child self report. Utilities for hypothetical complication states were lower than for current QOL. Values were lower for stroke (0.34 to 0.53), end stage renal disease (0.47 to 0.55), and blindness (0.52 to 0.69) than for amputation (0.73 to 0.82) and angina (0.74 to 0.80). Complication utilities for parent proxy report were higher compared with adult self report for most hypothetical complication states.

Conclusions: Individuals with type 1 diabetes with few complications report a relatively high QOL; however, future end stage complications are rated as having a significant impact on QOL. Differences in utilities by age, self report versus proxy report, and method raise important questions about whose utilities should be used in economic analyses.

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Figures

Figures 1a and 1b
Figures 1a and 1b
Boxplots of health utilities for overall quality of life for adult subjects by self-report (≥19 years), pediatric subjects by parent proxy-report (8-18 years), and pediatric subjects by self-report (8-18 years)
Figures 2a and 2b
Figures 2a and 2b
Scatterplots of parent proxy-report health utilities vs. child self-report health utilities (for overall quality of life) using the Health Utilities Index (8-18 years) (n=216) or Experienced Time Tradeoff (15-18 years) (n=80)
Figures 3a, 3b, 3c
Figures 3a, 3b, 3c
Scatterplots of health utilities using the Health Utilities Index 3 vs. Experienced Time-Trade-off (for overall quality of life) for child self-report (15-18 years) (n=95), adult self-report (n=213), and parent proxy-report (n=221)
See this image and copyright information in PMC

References

    1. Nathan DM. Long-term complications of diabetes mellitus. N Engl J Med. 1993;328:1676–1685. - PubMed
    1. Tamborlane WV, Beck RW, Bode BW, et al. Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med. 2008;359:1464–1476. - PubMed
    1. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993;329:977–986. - PubMed
    1. Gold MR, Siegel JE, Russell LB, et al. Cost-Effectiveness in Health and Medicine. New York: Oxford University Press; 1996.
    1. Upton P, Lawford J, Eiser C. Parent-child agreement across child health-related quality of life instruments: a review of the literature. Qual Life Res. 2008;17:895–913. - PubMed