What is the ‘best’ tool to measure the impact of type 1 diabetes on quality of life?

To find out, we asked adults with type 1 diabetes in Australia and the UK to complete five questionnaires

By Dr Elizabeth Holmes-Truscott

The goal of diabetes care is to improve the lives of people with diabetes overall, not just their medical outcomes. Quality of life cannot be assessed with blood or other medical tests. It is subjective. Quality of life means different things to different people, at different times.

There are many questionnaires (tools) available to assess the impact of diabetes on quality of life. Researchers and health professionals find it difficult to choose from these. Some things to consider are:

      • Context: Who, how, why, when will the tool be used?
      • Content: What is the tool measuring?
      • Psychometric proprieties: Is the tool valid and reliable?
      • Acceptability: Is the tool easy to understand, easy to complete, and relevant to people with diabetes?

In 2017, ACBRD and DAFNEplus ran the Your SAY: Quality of Life survey to identify the ‘best’ tool to measure the impact of diabetes on quality of life. We compared the psychometric properties and acceptability of five tools. They ranged in content, length, and wording.  The shortest was the 7-item DIDP, and the longest was the 57-item DSQOLS.

More than 1,500 adults with type 1 diabetes in Australia and the UK completed these five tools and gave their feedback. They rated each one for clarity, relevance, ease of completion, length and comprehensiveness. They also told us what they liked or didn’t like about each tool.

The published results show that all five tools were acceptable to participants. At least 80% of participants positively rated each tool, with one exception: more than 25% told us the 57-item DSQOLS is too long. Most tools also compared well in terms of being both valid and reliable.

Overall, the findings supported the use of the brief 7-item DIDP scale which was both acceptable to participants and performed best in terms of validity and reliability. However, selection should always be guided by the context of use (e.g., research aims, study design, population).

In 2022, we plan to publish the results from participants with type 2 diabetes, as well as the qualitative feedback about the tools.

To read more of our research about quality of life check out our previous blogs on this topic.

Holmes‐Truscott E, Cooke DD, Hendrieckx C, Coates EJ, Heller SR, Speight J. A comparison of the acceptability and psychometric properties of scales assessing the impact of type 1 diabetes on quality of life—Results of ‘YourSAY: Quality of Life’. Diabetic Medicine. 2021;38(6):e14524.

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