Diabetes and Quality of Life: Comparing Results from Utility Instruments and Diabetes-39

Gang Chen, Angelo Iezzi, John McKie, Munir Khan, Jeff Richardson

    Research output: Contribution to journalArticlepeer-review

    19 Citations (Scopus)


    Objective: To compare the Diabetes-39 (D-39) with six multi-attribute utility (MAU) instruments (15D, AQoL-8D, EQ-5D, HUI3, QWB, and SF-6D), and to develop mapping algorithms which could be used to transform the D-39 scores into the MAU scores. Research design and methods: Self-reported diabetes sufferers (N = 924) and members of the healthy public (N = 1760), aged 18 years and over, were recruited from 6 countries (Australia 18%, USA 18%, UK 17%, Canada 16%, Norway 16%, and Germany 15%). Apart from the QWB which was distributed normally, non-parametric rank tests were used to compare subgroup utilities and D-39 scores. Mapping algorithms were estimated using ordinary least squares (OLS) and generalised linear models (GLM). Results: MAU instruments discriminated between diabetes patients and the healthy public; however, utilities varied between instruments. The 15D, SF-6D, AQoL-8D had the strongest correlations with the D-39. Except for the HUI3, there were significant differences by gender. Mapping algorithms based on the OLS estimator consistently gave better goodness-of-fit results. The mean absolute error (MAE) values ranged from 0.061 to 0.147, the root mean square error (RMSE) values 0.083 to 0.198, and the R-square statistics 0.428 and 0.610. Based on MAE and RMSE values the preferred mapping is D-39 into 15D. R-square statistics and the range of predicted utilities indicate the preferred mapping is D-39 into AQoL-8D. Conclusions: Utilities estimated from different MAU instruments differ significantly and the outcome of a study could depend upon the instrument used. The algorithms reported in this paper enable D-39 data to be mapped into utilities predicted from any of six instruments. This provides choice for those conducting cost-utility analyses.

    Original languageEnglish
    Pages (from-to)326-333
    Number of pages8
    JournalDiabetes Research and Clinical Practice
    Issue number2
    Publication statusPublished - 1 Aug 2015


    • Diabetes-39
    • Mapping
    • Multi attribute utility
    • Quality of life


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