HUI3 (Health Utilities Index Mark 3) in Diabetes: Evaluating construct validity from population health survey data
Objective: To assess the impact of comorbid heart disease, stroke and arthritis on health-related quality of life (HRQL) in people with diabetes in the general Canadian population.
Methods: Data was collected as part of the 1996-1997 Canadian National Population Health Survey. HRQL was assessed using overall Health Utilities Index Mark 3 (HUI3) and single attribute utility scores. Respondents (N=66,093) were classified into 1 of 16 groups based on the presence or absence of diabetes, heart disease, stroke, and arthritis, in all possible combinations and HRQL scores were compared using analysis of covariance.
Results: Overall HUI3 scores for respondents with diabetes alone (0.88, 95% CI: 0.87-0.89) were lower than controls (0.92: 95% CI: 0.92-0.92, p<0.001). Overall HUI3 scores for diabetes in combination with heart disease (0.77, 95% CI: 0.74-0.79), arthritis (0.78, 95% CI: 0.77-0.79) or stroke (0.79, 95% CI: 0.74-0.85) were considerably lower than diabetes alone. Triplets of comorbidities were associated with overall HRQL deficits of approximately 0.26 to 0.30, relative to controls.
Conclusions: The illness burden experienced by individuals with diabetes is not only associated with diabetes itself, but largely with comorbid medical conditions.
Jeff Johnson, David Feeny, Sheri Maddigan
Alberta Heritage Foundation for Medical Research
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Maddigan SL, Feeny DH, Johnson JA. Health-Related Quality of Life Deficits Associated with Diabetes and Comorbidities in a Canadian National Population Health Survey. Quality of Life Research 2005;14:1311-1320.
Maddigan SL, Feeny DH, Majumdar SR, Farris KB, Johnson JA. Health Utilities Index Mark 3 demonstrated construct validity in a population-based sample with type-2 diabetes. Journal of Clinical Epidemiology 2006;59:472-477. Epub 2006 Mar 14.
Maddigan SL, Feeny DH, Majumdar SR, Farris KB, Johnson JA. Health Utilities Index Mark 3 demonstrated construct validity in a population-based sample with type-2 diabetes. Journal of Clinical Epidemiology 2006;59:472-477.Maddigan SL, Feeny DH, Majumdar SR, Farris KB, Johnson JA. Understanding the determinants of health in type 2 diabetes. American Journal of Public Health 2006;96(9):1649-1655.