Journal of Clinical Epidemiology
Volume 64, Issue 4 , Pages 358-365, April 2011

Published norms underestimate the health-related quality of life among persons with type 2 diabetes

  • Susan L. Norris

      Affiliations

    • Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA
    • Corresponding Author InformationCorresponding author. Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mail Stop B1CC, Portland, OR 97239. Tel.: +503-418-1432; fax: +503-494-4551.
    • ,
  • Tarra K. McNally

      Affiliations

    • Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA
    • ,
  • Xuanping Zhang

      Affiliations

    • Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
    • ,
  • Brittany Burda

      Affiliations

    • Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA
    • ,
  • Benjamin Chan

      Affiliations

    • Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA
    • ,
  • Farah M. Chowdhury

      Affiliations

    • Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
    • ,
  • Ping Zhang

      Affiliations

    • Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
    • ,
  • Donald Patrick

      Affiliations

    • Department of Health Services, University of Washington School of Public Health and Community Medicine, Seattle, WA, USA

Accepted 24 April 2010. published online 30 August 2010.

Abstract 

Objective

To assess health-related quality of life (HRQL) among adults with type 2 diabetes using the Short Form (SF)-36 and to obtain pooled estimates of HRQL for subpopulations defined by demographic characteristics, diabetes-related complications, and comorbidities.

Study Design and Methods

We conducted computerized searches of multiple electronic bibliographic databases, and studies in any language were selected in which HRQL was reported among adults with type 2 diabetes using the SF-36. Estimates were combined using a random-effects model.

Results

One hundred eighteen studies fulfilled the inclusion criteria. HRQL was lower in persons with type 2 diabetes, as measured by all the eight component scores of the SF-36 when compared with the existing U.S. population norms and with previously published type 2 diabetes norms. SF-36 component and summary scores were extremely heterogeneous, and subpopulation data were sparse; this precluded obtaining meaningful pooled scores for most populations of interest and made comparisons among subpopulations difficult.

Conclusion

Our data suggest that previously published norms may underestimate the effect of diabetes on HRQL, and diabetes populations are extremely heterogeneous, making broad population “norms” for HRQL in type 2 diabetes of limited use. Additional research with important subpopulations and individual-level data are needed to further explore the effect of diabetes on HRQL.

Keywords: Health-related quality of life, Type 2 diabetes, Systematic review, Meta-analysis, SF-36

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 With regard to the contributions of Xuanping Zhang, PhD; Farrah M. Chowdhury, MBBS, MPH; and Ping Zhang, PhD, the findings and conclusions in this article are those of the authors and do not necessarily represent the official positions of the Centers for Disease Control and Prevention.

PII: S0895-4356(10)00183-6

doi:10.1016/j.jclinepi.2010.04.016

Journal of Clinical Epidemiology
Volume 64, Issue 4 , Pages 358-365, April 2011

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