Diabetes-specific or generic measures for health-related quality of life? Evidence from psychometric validation of the D-39 and SF-36

I. Chan Huang, Chyng Chuang Hwang, Ming Yen Wu, Wender Lin, Walter Leite, Albert W Wu

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)450-461
Number of pages12
JournalValue in Health
Volume11
Issue number3
DOIs
StatePublished - May 2008

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Psychometrics
psychometrics
chronic illness
quality of life
Quality of Life
Statistical Factor Analysis
health
evidence
Cerebrovascular Disorders
Glucose
Diabetic Foot
Group
Diabetic Retinopathy
Diabetes Complications
Health Surveys
Taiwan
Fasting
Hemoglobins
Cross-Sectional Studies
Outcome Assessment (Health Care)

Keywords

  • Diabetes
  • Health-related quality of life
  • Psychometric property

ASJC Scopus subject areas

  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Diabetes-specific or generic measures for health-related quality of life? Evidence from psychometric validation of the D-39 and SF-36. / Huang, I. Chan; Hwang, Chyng Chuang; Wu, Ming Yen; Lin, Wender; Leite, Walter; Wu, Albert W.

In: Value in Health, Vol. 11, No. 3, 05.2008, p. 450-461.

Research output: Contribution to journalArticle

Huang, I. Chan ; Hwang, Chyng Chuang ; Wu, Ming Yen ; Lin, Wender ; Leite, Walter ; Wu, Albert W. / Diabetes-specific or generic measures for health-related quality of life? Evidence from psychometric validation of the D-39 and SF-36. In: Value in Health. 2008 ; Vol. 11, No. 3. pp. 450-461.
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AU - Leite, Walter

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