Development and application of a model to estimate the impact of type 1 diabetes on health-related quality of life.
OBJECTIVE
To develop a simulation model to assess the impact of type 1 diabetes and its associated complications on health-related quality of life of a population.


METHODS
The methodology builds upon 1) an existing population model of type 1 diabetes progression, 2) an empirical study designed to measure state- and age-specific health statuses of type 1 diabetes, and 3) existing literature to quantify quality of life of the corresponding health status. Health statuses were measured in a group of type 1 diabetic patients using the Medical Outcomes Study short form 36 (SF-36). A published empirical regression equation was then used to predict corresponding Quality of Well-Being Index (QWB) scores from these assessments. The QWB scores were incorporated into a previously developed type 1 diabetes progression and cost simulation model. Sensitivity analyses on key parameters were performed, and the model was found to be robust.


RESULTS
The augmented model can estimate quality-adjusted life years (QALYs) as well as costs associated with type 1 diabetes on any population of interest over any period of time. The model is used to compare intensive versus conventional treatment strategies using a simplified set of assumptions regarding the relative effects of these alternative treatments. With these assumptions, intensive strategy produces more QALYs than does conventional strategy and is cost-beneficial after 5 years.


CONCLUSIONS
The model enables health planners to perform cost-effectiveness analyses to compare alternative treatment strategies for type 1 diabetes and support subsequent decision making.
Wu
S Y
SY
Department of Industrial Engineering, University of Wisconsin-Madison 53706, USA.
Sainfort
F
F
Tomar
R H
RH
Tollios
J L
JL
Fryback
D G
DG
Klein
R
R
Klein
B E
BE
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003922:Diabetes Mellitus, Type 1 / Q000191:economics / Q000523:psychology / Q000628:therapy; D003928:Diabetic Nephropathies / Q000191:economics / Q000523:psychology / Q000628:therapy; D003929:Diabetic Neuropathies / Q000191:economics / Q000523:psychology / Q000628:therapy; D003930:Diabetic Retinopathy / Q000191:economics / Q000523:psychology / Q000628:therapy; D017048:Health Care Costs; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D011795:Surveys and Questionnaires