Using the EQ-5D index score as a predictor of outcomes in patients with type 2 diabetes

Philip M. Clarke, Alison J. Hayes, Paul G. Glasziou, Russell Scott, John Simes, Anthony C. Keech

Research output: Contribution to journalArticleResearchpeer-review

33 Citations (Scopus)

Abstract

Objective: To examine whether index scores based on the EQ-5D, a 5-item generic health status measure, are an independent predictor of vascular events, other major complications and mortality in people with type 2 diabetes and to quantify the relationship between these scores and future survival. Subjects: Five-year cohort study involving 7348 patients with type 2 diabetes, aged between 50-75 years who had been recruited to the FIELD (Fenoflbrate Intervention and Event Lowering in Diabetes) study from Australia and New Zealand. Measures: Multivariate Cox proportional hazard regression models were used to estimate the hazard ratio associated with index scores derived from the EQ-5D on: (1) cardiovascular events (including coronary heart disease event, stroke, hospitalization for angina, or cardiovascular death); (2) other major diabetes-related complications (heart failure, amputation, renal dialysis, and lower extremity ulcer); and (3) death from any cause. Life table methods were used to derive expected survival for patients with different index scores. Results: After adjusting for standard risk factors, a 0.1 higher index score (derived from the UK algorithm) was associated with an additional 7% (95% CI: 4-11%) lower risk of vascular events, a 13% (95% CI: 9-17%) lower risk of complications, and up to 14% (95% CI: 8-19%) lower rate of all-cause mortality. Conclusions: Index scores derived from the EQ-5D are an independent predictor of the risk of mortality, future vascular events, and other complications in people with type 2 diabetes. This should be taken into account when extrapolating health outcomes such as quality-adjusted life years (QALYs).

Original languageEnglish
Pages (from-to)61-68
Number of pages8
JournalMedical Care
Volume47
Issue number1
DOIs
Publication statusPublished - Jan 2009
Externally publishedYes

Fingerprint

Type 2 Diabetes Mellitus
Blood Vessels
Mortality
Life Tables
Survival
Quality-Adjusted Life Years
Diabetes Complications
New Zealand
Amputation
Proportional Hazards Models
Health Status
Ulcer
Coronary Disease
Renal Dialysis
Cause of Death
Lower Extremity
Hospitalization
Cohort Studies
Heart Failure
Stroke

Cite this

Clarke, Philip M. ; Hayes, Alison J. ; Glasziou, Paul G. ; Scott, Russell ; Simes, John ; Keech, Anthony C. / Using the EQ-5D index score as a predictor of outcomes in patients with type 2 diabetes. In: Medical Care. 2009 ; Vol. 47, No. 1. pp. 61-68.
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abstract = "Objective: To examine whether index scores based on the EQ-5D, a 5-item generic health status measure, are an independent predictor of vascular events, other major complications and mortality in people with type 2 diabetes and to quantify the relationship between these scores and future survival. Subjects: Five-year cohort study involving 7348 patients with type 2 diabetes, aged between 50-75 years who had been recruited to the FIELD (Fenoflbrate Intervention and Event Lowering in Diabetes) study from Australia and New Zealand. Measures: Multivariate Cox proportional hazard regression models were used to estimate the hazard ratio associated with index scores derived from the EQ-5D on: (1) cardiovascular events (including coronary heart disease event, stroke, hospitalization for angina, or cardiovascular death); (2) other major diabetes-related complications (heart failure, amputation, renal dialysis, and lower extremity ulcer); and (3) death from any cause. Life table methods were used to derive expected survival for patients with different index scores. Results: After adjusting for standard risk factors, a 0.1 higher index score (derived from the UK algorithm) was associated with an additional 7{\%} (95{\%} CI: 4-11{\%}) lower risk of vascular events, a 13{\%} (95{\%} CI: 9-17{\%}) lower risk of complications, and up to 14{\%} (95{\%} CI: 8-19{\%}) lower rate of all-cause mortality. Conclusions: Index scores derived from the EQ-5D are an independent predictor of the risk of mortality, future vascular events, and other complications in people with type 2 diabetes. This should be taken into account when extrapolating health outcomes such as quality-adjusted life years (QALYs).",
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Using the EQ-5D index score as a predictor of outcomes in patients with type 2 diabetes. / Clarke, Philip M.; Hayes, Alison J.; Glasziou, Paul G.; Scott, Russell; Simes, John; Keech, Anthony C.

In: Medical Care, Vol. 47, No. 1, 01.2009, p. 61-68.

Research output: Contribution to journalArticleResearchpeer-review

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