TY - JOUR
T1 - Diabetes-specific or generic measures for health-related quality of life? Evidence from psychometric validation of the D-39 and SF-36
AU - Huang, I. Chan
AU - Hwang, Chyng Chuang
AU - Wu, Ming Yen
AU - Lin, Wender
AU - Leite, Walter
AU - Wu, Albert W.
N1 - Funding Information:
Source of financial support: This study was supported by a grant from the Taiwan Department of Health (DOH), under contract no. DOH-9508. There are no conflicts of interest.
PY - 2008
Y1 - 2008
N2 - Objective: There is a debate regarding the use of disease-specific versus generic instruments for health-related quality of life (HRQOL) measures. We tested the psychometric properties of HRQOL measures using the Diabetes-39 (D-39) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Methods: This was a cross-sectional study collecting data from 280 patients in Taiwan. Exploratory factor analysis was conducted to evaluate construct validity of the two instruments. Known-groups validity was examined using laboratory indicators (fasting, 2-hour postprandial plasma glucose, and hemoglobin A1c), presence of diabetic complications (retinopathy, nephropathy, neuropathy, diabetic foot disorder, cardiovascular and cerebrovascular disorders), and psychosocial variables (sense of well-being and self-reported diabetes severity). Overall discriminative power of the two instruments was evaluated using the C-statistic. Results: Three distinct factors were extracted through factor analysis. These factors tapped all subscales of the D-39, fourphysical subscales of the SF-36, and four mental subscales of the SF-36, respectively. Compared with the SF-36, the D-39 demonstrated superior known-groups validity for 2-hour postprandial plasma glucose groups but was inferior for complication groups. Compared with the SF-36, the D-39 discriminated better between self-reported severity known groups, but was inferior between well-being groups. In overall discriminative power, the D-39 discriminated better between laboratory known groups. The SF-36, however, was superior in discriminating between complication known groups. Conclusions: For psychometric properties, the D-39 and the SF-36 were superior to each other in different regards. The combined use of a disease-specific instrument and a generic instrument may be a useful strategy for diabetes HRQOL assessment.
AB - Objective: There is a debate regarding the use of disease-specific versus generic instruments for health-related quality of life (HRQOL) measures. We tested the psychometric properties of HRQOL measures using the Diabetes-39 (D-39) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Methods: This was a cross-sectional study collecting data from 280 patients in Taiwan. Exploratory factor analysis was conducted to evaluate construct validity of the two instruments. Known-groups validity was examined using laboratory indicators (fasting, 2-hour postprandial plasma glucose, and hemoglobin A1c), presence of diabetic complications (retinopathy, nephropathy, neuropathy, diabetic foot disorder, cardiovascular and cerebrovascular disorders), and psychosocial variables (sense of well-being and self-reported diabetes severity). Overall discriminative power of the two instruments was evaluated using the C-statistic. Results: Three distinct factors were extracted through factor analysis. These factors tapped all subscales of the D-39, fourphysical subscales of the SF-36, and four mental subscales of the SF-36, respectively. Compared with the SF-36, the D-39 demonstrated superior known-groups validity for 2-hour postprandial plasma glucose groups but was inferior for complication groups. Compared with the SF-36, the D-39 discriminated better between self-reported severity known groups, but was inferior between well-being groups. In overall discriminative power, the D-39 discriminated better between laboratory known groups. The SF-36, however, was superior in discriminating between complication known groups. Conclusions: For psychometric properties, the D-39 and the SF-36 were superior to each other in different regards. The combined use of a disease-specific instrument and a generic instrument may be a useful strategy for diabetes HRQOL assessment.
KW - Diabetes
KW - Health-related quality of life
KW - Psychometric property
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U2 - 10.1111/j.1524-4733.2007.00261.x
DO - 10.1111/j.1524-4733.2007.00261.x
M3 - Article
C2 - 18489668
AN - SCOPUS:44249112137
SN - 1098-3015
VL - 11
SP - 450
EP - 461
JO - Value in Health
JF - Value in Health
IS - 3
ER -