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

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 cl...

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Main Authors: Unn-Britt Johansson, Sixten Borg, Katarina Eeg-Olofsson, Bo Palaszewski, Maria Svedbo Engström, Soffia Gudbjörnsdottir, Stefan Franzén, Janeth Leksell
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e038966.full
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author Unn-Britt Johansson
Sixten Borg
Katarina Eeg-Olofsson
Bo Palaszewski
Maria Svedbo Engström
Soffia Gudbjörnsdottir
Stefan Franzén
Janeth Leksell
author_facet Unn-Britt Johansson
Sixten Borg
Katarina Eeg-Olofsson
Bo Palaszewski
Maria Svedbo Engström
Soffia Gudbjörnsdottir
Stefan Franzén
Janeth Leksell
author_sort Unn-Britt Johansson
collection DOAJ
description 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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spelling doaj-art-e64db4007d944a408397ab2a625ce1db2024-11-27T14:45:09ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-038966New 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 variablesUnn-Britt Johansson0Sixten Borg1Katarina Eeg-Olofsson2Bo Palaszewski3Maria Svedbo Engström4Soffia Gudbjörnsdottir5Stefan Franzén6Janeth Leksell7Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, SwedenDepartment of Clinical Sciences in Malmö, Health Economics Unit, Medicon Village, Lund University, Lund, SwedenSwedish National Diabetes Register, Gothenburg, SwedenDepartment of Data Management and Analysis, Västra Götalandsregionen, Gothenburg, SwedenDepartment of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden8 Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, SwedenCentre of Registers Västra Götaland, Gothenburg, SwedenDepartment of Medical Science, Clinical Diabetology and Metabolism, Uppsala University Faculty of Medicine, Uppsala, SwedenObjectives 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.https://bmjopen.bmj.com/content/10/11/e038966.full
spellingShingle Unn-Britt Johansson
Sixten Borg
Katarina Eeg-Olofsson
Bo Palaszewski
Maria Svedbo Engström
Soffia Gudbjörnsdottir
Stefan Franzén
Janeth Leksell
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
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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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 https://bmjopen.bmj.com/content/10/11/e038966.full
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