Outcome tools for diabetes-specific quality of life: Study performed in a private family practice clinic

To critically review and evaluate the psychometric properties and practical considerations of administering generic and diabetes-specific quality-of-life (QoL) tools in the clinical environment and provide recommendations.

A MEDLINE search was carried out from January 1950 to August 2015 using the MeSH terms diabetes, quality of life, and questionnaires. Four generic and 4 diabetes-specific tools were selected based on the frequency of their use and the existence of published evidence of strong psychometric properties in patients with diabetes (either type 1 or 2). The generic tools included the Short Form-36 (SF-36), Short Form-12 (SF-12), Sickness Impact Profile, and EuroQol EQ-5D instruments. Diabetes-specific tools included the Audit of Diabetes-Dependent Quality of Life, Diabetes Quality of Life, Appraisal of Diabetes Scale (ADS), and Diabetes Health Profile instruments.

The SF-36 is one of the most widely used general health measures in QoL research and it has proven reliability and validity. However, the SF-12 is a better option for a family practice owing to its shorter length. The SF-12 has been shown to be closely correlated with the SF-36. Of the diabetes-specific measures, the ADS is known be valid, short, and relatively straightforward in terms of scoring, thereby increasing its usefulness in routine clinical practice. The Audit of Diabetes-Dependent Quality of Life and Diabetes Quality of Life tools have been widely tested and have generally been found to be more valid and reliable than the ADS, but specific issues with feasibility make them unappealing for the clinical setting. The rationale was to find the most rigorously tested instrument within the scientific literature in terms of validity, reliability, and responsiveness. However, this was not done, as judging the quality of a measure is not simply a matter of determining its psychometric properties but rather requires qualitative judgment about the entirety of the evidence.

Finding ideal tools and procedures for routine data collection in the clinic setting requires organization and groundwork that will eventually assist both clinicians and researchers by providing reliable information on QoL for patients with diabetes. Further research is necessary to assess the validity and responsiveness of these tools specifically relating to evaluation of QoL for those with diabetes.