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New Diabetes Questionnaire to add patients' perspectives to diabetes care for adults with type 1 and type 2 diabetes : nationwide cross-sectional study of construct validity assessing associations with generic health-related quality of life and clinical variables

Svedbo Engström, Maria ; Leksell, Janeth ; Johansson, Unn Britt ; Borg, Sixten LU ; Palaszewski, Bo ; Franzén, Stefan ; Gudbjörnsdottir, Soffia and Eeg-Olofsson, Katarina (2020) In BMJ Open 10(11).
Abstract

OBJECTIVES: To study evidence for construct validity, the aim was to describe the outcome from the recently developed Diabetes Questionnaire, assess the associations of that outcome with clinical variables and generic health-related quality of life, and study the sensitivity to differences between clinically relevant groups of glycaemic control in adults with type 1 and type 2 diabetes in a nation-wide setting. DESIGN: Cross-sectional survey. SETTING: Swedish diabetes care clinics connected to the National Diabetes Register (NDR). PARTICIPANTS: Among 2479 adults with type 1 diabetes and 2469 with type 2 diabetes selected at random from the NDR, 1373 (55.4%) with type 1 and 1353 (54.8%) with type 2 diabetes chose to participate. OUTCOME... (More)

OBJECTIVES: To study evidence for construct validity, the aim was to describe the outcome from the recently developed Diabetes Questionnaire, assess the associations of that outcome with clinical variables and generic health-related quality of life, and study the sensitivity to differences between clinically relevant groups of glycaemic control in adults with type 1 and type 2 diabetes in a nation-wide setting. DESIGN: Cross-sectional survey. SETTING: Swedish diabetes care clinics connected to the National Diabetes Register (NDR). PARTICIPANTS: Among 2479 adults with type 1 diabetes and 2469 with type 2 diabetes selected at random from the NDR, 1373 (55.4%) with type 1 and 1353 (54.8%) with type 2 diabetes chose to participate. OUTCOME MEASURES: The Diabetes Questionnaire, the generic 36-item Short Form version 2 (SF-36v2) health survey and clinical variables. RESULTS: Related to the prespecified assumptions, supporting evidence for construct validity for the Diabetes Questionnaire was found. Supporting divergent validity, the statistically significant correlations with the clinical variables were few and weak. In relation to the SF-36v2 and in support of convergent validity, the strongest correlations were seen in the Diabetes Questionnaire scales General Well-being and Mood and Energy. In those scales, machine learning analyses showed that about 40%-45% of the variance was explained by the SF-36v2 results and clinical variables. In multiple regression analyses among three groups with differing levels of glycated haemoglobin adjusted for demographics, other risk factors, and diabetes complications, the high-risk group had, in support of sensitivity to clinically relevant groups, statistically significant lower scores than the well-controlled group in most Diabetes Questionnaire scales. CONCLUSIONS: This nation-wide study shows that the Diabetes Questionnaire captures some generic health-related quality-of-life dimensions, in addition to adding diabetes-specific information not covered by the SF-36v2 and clinical variables. The Diabetes Questionnaire is also sensitive to differences between clinically relevant groups of glycaemic control.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
clinical audit, general diabetes, quality in health care
in
BMJ Open
volume
10
issue
11
article number
e038966
publisher
BMJ Publishing Group
external identifiers
  • pmid:33203629
  • scopus:85096348515
ISSN
2044-6055
DOI
10.1136/bmjopen-2020-038966
language
English
LU publication?
yes
id
7069cd29-6ee8-48d6-84de-71715a46568c
date added to LUP
2020-11-30 13:56:50
date last changed
2021-03-03 02:29:24
@article{7069cd29-6ee8-48d6-84de-71715a46568c,
  abstract     = {<p>OBJECTIVES: To study evidence for construct validity, the aim was to describe the outcome from the recently developed Diabetes Questionnaire, assess the associations of that outcome with clinical variables and generic health-related quality of life, and study the sensitivity to differences between clinically relevant groups of glycaemic control in adults with type 1 and type 2 diabetes in a nation-wide setting. DESIGN: Cross-sectional survey. SETTING: Swedish diabetes care clinics connected to the National Diabetes Register (NDR). PARTICIPANTS: Among 2479 adults with type 1 diabetes and 2469 with type 2 diabetes selected at random from the NDR, 1373 (55.4%) with type 1 and 1353 (54.8%) with type 2 diabetes chose to participate. OUTCOME MEASURES: The Diabetes Questionnaire, the generic 36-item Short Form version 2 (SF-36v2) health survey and clinical variables. RESULTS: Related to the prespecified assumptions, supporting evidence for construct validity for the Diabetes Questionnaire was found. Supporting divergent validity, the statistically significant correlations with the clinical variables were few and weak. In relation to the SF-36v2 and in support of convergent validity, the strongest correlations were seen in the Diabetes Questionnaire scales General Well-being and Mood and Energy. In those scales, machine learning analyses showed that about 40%-45% of the variance was explained by the SF-36v2 results and clinical variables. In multiple regression analyses among three groups with differing levels of glycated haemoglobin adjusted for demographics, other risk factors, and diabetes complications, the high-risk group had, in support of sensitivity to clinically relevant groups, statistically significant lower scores than the well-controlled group in most Diabetes Questionnaire scales. CONCLUSIONS: This nation-wide study shows that the Diabetes Questionnaire captures some generic health-related quality-of-life dimensions, in addition to adding diabetes-specific information not covered by the SF-36v2 and clinical variables. The Diabetes Questionnaire is also sensitive to differences between clinically relevant groups of glycaemic control.</p>},
  author       = {Svedbo Engström, Maria and Leksell, Janeth and Johansson, Unn Britt and Borg, Sixten and Palaszewski, Bo and Franzén, Stefan and Gudbjörnsdottir, Soffia and Eeg-Olofsson, Katarina},
  issn         = {2044-6055},
  language     = {eng},
  number       = {11},
  publisher    = {BMJ Publishing Group},
  series       = {BMJ Open},
  title        = {New Diabetes Questionnaire to add patients' perspectives to diabetes care for adults with type 1 and type 2 diabetes : nationwide cross-sectional study of construct validity assessing associations with generic health-related quality of life and clinical variables},
  url          = {http://dx.doi.org/10.1136/bmjopen-2020-038966},
  doi          = {10.1136/bmjopen-2020-038966},
  volume       = {10},
  year         = {2020},
}