Skip to main content
SpringerLink
Log in

Construct validity of the RAND-12 and Health Utilities Index Mark 2 and 3 in type 2 diabetes

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Objective: To assess the cross-sectional construct validity of the RAND-12 and the Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) in type 2 diabetes. Methods: Parametric tests were used to test for differences in HRQL scores between known groups with type 2 diabetes, defined in terms of treatment intensity, duration of diabetes and glycemic control. Results: The PHC of the RAND-12 was significantly lower for individuals treated with insulin (40.28 ± 10.97) than diet alone (45.18 ± 12.02, p < 0.01), as was the MHC (42.83 ± 10.75 vs. 46.87 ± 10.89, p < 0.05). MHC (43.56 ± 10.20 vs. 46.18 ± 9.94, p < 0.05) and PHC (41.04 ± 10.64 vs. 45.62 ± 10.48, p < 0.001) were both lower for those with longer duration of diabetes. Overall HUI3 scores were lower in individuals above the median duration of diabetes (5.0 years) as compared to those with a shorter duration (0.60 ± 0.29 vs. 0.67 ± 0.29, p < 0.01) and for individuals whose diabetes was managed using insulin compared to diet alone (0.59 ± 0.30 vs. 0.69 ± 0.30, p < 0.05). Disease severity was associated with impairment on the ambulation, dexterity and pain attributes of the HUI3. Similar results were found for the HUI2. Overall HUI2 scores were highest for individuals managed with diet alone compared to those managed with insulin. Disease severity was associated with the mobility and self-care attributes of the HUI2. No relationship was found between any of the measures of HRQL and glycemic control. Conclusions: Scores for individuals presumed to have more severe or advanced disease were significantly lower for many comparisons using the RAND-12, HUI2 and HUI3. The results of this study contribute evidence of construct validity of the HUI2, HUI3 and RAND-12 in type 2 diabetes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hays RD, Anderson R, Revicki D. Psychometric considerations in evaluating health-related quality of life measures. Qual Life Res 1993; 2: 441-449.

    Google Scholar 

  2. Luscombe FA. Health-related quality of life measurement in type 2 diabetes. Value Health 2000; 3(1): S15-S28.

    Google Scholar 

  3. The Diabetic Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New Engl J Med 1993; 329: 977-986.

    Google Scholar 

  4. Wandell PE, Brorsson B, Aberg H. Quality of life in diabetic patients registered with primary health care services in Sweden. Scand J Prim Health Care 1997; 15: 97-102.

    Google Scholar 

  5. Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Annals of Internal Medicine 1993; 118(8): 622-629.

    Google Scholar 

  6. Ahroni JH, Boyko EJ, Davignon DR, Pecoraro RE. The health and functional status of veterans with diabetes. Diabetes Care 1994; 17(4): 318-321.

    Google Scholar 

  7. Peyrot M, Rubin RR. Levels and risks of depression and anxiety symptomology among diabetic adults. Diabetes Care 1997; 20: 585-590.

    Google Scholar 

  8. Jacobson AM, de Groot M, Samson JA. The evaluation of two measures of quality of life in type 1 and type 2 diabetes. Diabetes Care 1994; 17: 267-274.

    Google Scholar 

  9. Keinanenn-Kiukaanniemi S, Ohinma A, Pjunpaa H, Koivukangas P. Health related quality of life in diabetic patients measured by the Nottingham health profile. Diabetic Med 1996; 13: 382-388.

    Google Scholar 

  10. Anderson RM, Fitzgerald JT, Wisdom K, Davis WK, Hiss RG. A comparison of global versus disease-specific quality-of-life measures in patients with NIDDM. Diabetes Care 1997; 20: 299-305.

    Google Scholar 

  11. Glasgow RE, Ruggiero L, Eakin EG, Dryfoos J, Chobanian L. Quality of life and associated characteristics in a large national sample of adults with diabetes. Diabetes Care 1997; 20: 562-567.

    Google Scholar 

  12. Aalto AM, Uutemla A, Kangas T. Health behavior, social integration, perceived health and dysfunction. A comparison between type 1 and 2 diabetes and controls. Scand J Soc Med 1996; 24: 272-281.

    Google Scholar 

  13. The Diabetes Control and Complications Trial Research Group. Influence of intensive diabetes treatment on quality-of-life outcomes in the diabetes control and complications trial. Diabetes Care 1996; 19: 195-203.

    Google Scholar 

  14. Wandell PE, Brorsson B, Aberg H. Quality of life in diabetic patients registered with primary health care services in Sweden. Scand J Prim Health Care 1997; 15: 97-102.

    Google Scholar 

  15. Aalto AM, Uutemla A, Kangas T. Health behavior, social integration, perceived health and dysfunction. A comparison between type 1 and 2 diabetes and controls. Scand J Soc Med 1996; 24: 272-281.

    Google Scholar 

  16. Gafvels G, Borjesson B, Lithner F. The social consequences of insulin-treated diabetes mellitus in patients 20–50 years of age. An epidemiological case-control study. Scand J Soc Med 1991; 19: 86-93.

    Google Scholar 

  17. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes. Diabetes Care 2001; 24(6): 1069-1078.

    Google Scholar 

  18. Bourdel-Marchasson I, Dubroca B, Manciet G, Deschamps A, Emeriau JP, Dartigues JF. Prevalence of diabetes and effect on quality of life in older French living in the community: The PAQUID Epidemiological Survey. J Am Geriatr Soc 1997; 45: 295-301.

    Google Scholar 

  19. Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes/Metab Res 1999; 15: 205-218.

    Google Scholar 

  20. Peterson T, Lee P, Young B, Dornan T. Well-being and treatment satisfaction in older people with diabetes. Diabetes Care 1998; 21: 930-935.

    Google Scholar 

  21. Aalto M, Uutela A, Aro AR. Health related quality of life among insulin dependent diabetics: Disease-related and psychosocial correlates. Patient Educ Couns 1997; 30: 215-225.

    Google Scholar 

  22. Klein BE, Klein R, Moss SE. Self-rated health and diabetes of long duration. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. Diabetes Care 1998; 21: 236-240.

    Google Scholar 

  23. Wredling R, Stalhammar J, Adamson U, Berne C, Larsson Y, Oestman J. Well-being and treatment satisfaction in adults with diabetes: A Swedish population-based study. Qual Life Res 1995; 5: 515-522.

    Google Scholar 

  24. Van der Does FE, de Neeling JN, Snoek FJ, et al. Symptoms and well-being in relation to glycemic control in type II diabetes. Diabetes Care 1993; 19: 204-210.

    Google Scholar 

  25. Testa MA, Simonson D. Health economic benefits and quality of life during improved glycemic control in patients with type 2 diabetes mellitus: A randomized, controlled, double-blind trial. J Am Med Assoc 1998; 280(17): 1490-1496.

    Google Scholar 

  26. UK Prospective Diabetes Study Group. Quality of life in type 2 diabetic patients is affected by complications but not by intensive policies to improve blood glucose or blood pressure control (UKPDS 37). Diabetes Care 1999; 22(7): 1125-1136.

    Google Scholar 

  27. Holmes J, McGill S, Kind P, Bottomley J, Gillam S, Murphy M. Health-related quality of life in type 2 diabetes (T2ARDIS-2). Value Health 2000; 3(Suppl 1): S47-S51.

    Google Scholar 

  28. Johnson JA, Maddigan SL. Performance of RAND-12 and SF-12 in type 2 diabetes. Qual Life Res 2003; 13: 449-456.

    Google Scholar 

  29. Majumdar SR, Johnson JA, Guirguis LM, Lewanczuk RZ, Lee TK, Toth EL. A prospective controlled trial of an intervention to improve care for patients with diabetes in rural communities: Rationale and design for the DOVE study. Can Diabetes Care 2001; 25(3): 173-179.

    Google Scholar 

  30. Hays RD. RAND-36 Health Status Inventory. San Antonio: The Psychological Corporation, 1998.

    Google Scholar 

  31. Feeny D, Furlong W, Boyle M, Torrance GW. Multi-attribute health status classification systems: Health Utilities Index. PharmacoEconomics 1995; 7: 490-502.

    Google Scholar 

  32. Feeny DH, Furlong WJ, Torrance GW, et al. Health Utilities Index: Multi-attribute and single-attribute utility functions for the Health Utilities Index Mark 3 system. Medical Care 2002; 40(2): 113-128.

    Google Scholar 

  33. www.healthutilities.com. Accessed March 5, 2003.

  34. Clinical practice guidelines for the management of diabetes in Canada. Can Med Assoc J 1998; 159(Suppl 8): S1-S29.

  35. Cohen J. A power primer. Psychol Bull 1992; 112: 155-159.

    Google Scholar 

  36. Schapansky LA, Johnson JA, Majumdar S, Lewanczuk R, Lee TK, Toth EL. The burden of pharmacotherapy for patients with type 2 diabetes in rural Alberta: Data from the DOVE study. Canadian Association of Population Therapeutics Annual Meeting, Banff, AB, April 1–3, 2001. [Can J Clin Pharmacol 2001; 8: 22].

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Public Health Sciences, University of Alberta, Edmonton, Canada

    Sheri L. Maddigan, David H. Feeny & Jeffrey A. Johnson

  2. Institute of Health Economics, Edmonton, Canada

    Sheri L. Maddigan, David H. Feeny & Jeffrey A. Johnson

  3. Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Canada

    David H. Feeny

  4. Health Utilities Inc., Dundas, Ontario, Canada

    David H. Feeny

Authors
  1. Sheri L. Maddigan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David H. Feeny
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jeffrey A. Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Maddigan, S.L., Feeny, D.H. & Johnson, J.A. Construct validity of the RAND-12 and Health Utilities Index Mark 2 and 3 in type 2 diabetes. Qual Life Res 13, 435–448 (2004). https://doi.org/10.1023/B:QURE.0000018497.06539.8f

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:QURE.0000018497.06539.8f

Search

Navigation