Diabetes & Metabolic Syndrome: Clinical Research & Reviews
Original ArticleValidity and reliability of the EQ-5D-3L (a generic preference-based instrument used for calculating quality-adjusted life -years) for patients with type 2 diabetes in Iran
Section snippets
introduction
The Middle East and North Africa (MENA) region has the highest age-adjusted diabetes prevalence (12.2%) of all the International Diabetes Federation Regions. Globally, diabetes-related health expenditure in the MENA region was USD 24.9 billion in 2019 and is expected to increase by 30.3% to USD 32.5 billion by 2030 [1]. The high prevalence of the disease and its high health expenditures impose economic burdens on healthcare system of countries in this region such as Iran. It seems that economic
Study design and data collection
This cross-sectional survey was conducted on 590 type 2 diabetes patients who referred to the Diabetes Research Center and Clinics in Yazd. Yazd, a world heritage city, is located in center of Iran. According to a report by WHO, it has the highest prevalence of DM based on HbA1c among cities of Iran [12]. The center is one of the most important centers in Iran that provides specialized services for the patients of diabetes and covers over 10,000 diabetic patients. The patients were selected
Results
Totally, data of 11 patients were excluded from the study because of missing more than 20% of the responses on items of the SF-36 and DQoL questionnaires. Thus, characteristics of 579 patients included in the final analysis of the initial survey (Table 1). The mean age of patients was 59.4 years (SD 20), and mean of WHR, duration of diabetes, and HbA1c level was 0.98(0.38), 8.40 years (5.61) and 8.58 (1.90), respectively (Table 1).
Out of 110 patients who were selected for the repeated survey,
Discussion
In this study, the psychometric properties of the EQ-5D-3L were evaluated among type 2 diabetes patients with a variety of socio-demographic and clinical characteristics. This study was conducted on a large sample size based on the COSMIN study design checklist for patient-reported outcome measurement instruments [23], and is, to the best of our knowledge, the first study assessing the psychometric aspects of the EQ-5D-3L in a country of the Middle East region whose value set was generated in
Conclusion
This is the first report of the validity and reliability of EQ-5D-3L for any type of disease in Iran and Middle East region.The findings of convergent, discriminant, and known-groups validity support the construct validity of the EQ-5D for use in type 2 diabetes patients, while the ceiling effects are relatively high for the instrument. In addition, we found that criterion of the reliability was moderate to good levels. Thus, the construct validity and reliability of the EQ-5D-3L were both
Authors’ contributions
HA conceptualized the study and the design of study. HA, FA and FM participated in data analysis and data interpretation. HA and M R-A wrote the original draft of the manuscript. All authors read and approved the final manuscript.
Compliance with ethical standards
This report is part of a MSc project that was approved by the committee of Shahid Sadoughi University of Medical Sciences (registration number: IR.SSU·SPH.REC.1398.134). Informed consent was completed for each patient.
Funding
This study was funded by Shahid Sadoughi University of Medical Sciences (grant number: 6843).
Declaration of competing interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgements
The authors hereby bestow much gratitude to the departments of Diabetes Research Center and Clinics in Yazd for their valuable collaboration in the present study. We express our gratitude to Shahid Sadoughi University of Medical Sciences (grant number: 6843) that provide fund for this project.
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