title: Health utilities for children and adults with type 1 diabetes.
abstract: OBJECTIVE
  We studied health utilities in patients with type 1 diabetes to understand potential differences in health utilities as function of age, type of respondent (self report vs. proxy report), and method of assessment (direct vs. indirect).
  
  
  METHODS
  We elicited self-reported health utilities for adults (n=213) and children (n=238) with type 1 diabetes, and by parent proxy report (n=223) for overall quality of life [Health Utilities Index (HUI) Mark 3 and experienced time-trade-off (TTO) questions] and hypothetical complication states (TTO questions).
  
  
  RESULTS
  Mean health utilities for overall quality of life (QOL) ranged from 0.81 to 0.91. Children had significantly higher overall QOL compared with adults (0.89 vs. 0.85, P<0.01) by HUI, but had no significant difference in QOL by TTO. There were no significant differences in QOL between child self report and parent proxy report. Utilities were higher for HUI versus TTO for parent proxy report (P<0.01) but not for adult or child self report. Utilities for hypothetical complication states were lower than for current QOL. Values were lower for stroke (0.34 to 0.53), end stage renal disease (0.47 to 0.55), and blindness (0.52 to 0.69) than for amputation (0.73 to 0.82) and angina (0.74 to 0.80). Complication utilities for parent proxy report were higher compared with adult self report for most hypothetical complication states.
  
  
  CONCLUSIONS
  Individuals with type 1 diabetes with few complications report a relatively high QOL; however, future end stage complications are rated as having a significant impact on QOL. Differences in utilities by age, self report versus proxy report, and method raise important questions about whose utilities should be used in economic analyses.
authors.affiliation: Pediatric Endocrinology, Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, Ann Arbor, MI 48109-5456, USA. joyclee@umich.edu
authors.forename: Joyce M
authors.initials: JM
authors.lastname: Lee
authors.forename: Kirsten
authors.initials: K
authors.lastname: Rhee
authors.forename: Michael J
authors.initials: MJ
authors.lastname: O'grady
authors.forename: Anirban
authors.initials: A
authors.lastname: Basu
authors.forename: Aaron
authors.initials: A
authors.lastname: Winn
authors.forename: Priya
authors.initials: P
authors.lastname: John
authors.forename: David O
authors.initials: DO
authors.lastname: Meltzer
authors.forename: Craig
authors.initials: C
authors.lastname: Kollman
authors.forename: Lori M
authors.initials: LM
authors.lastname: Laffel
authors.forename: Jean M
authors.initials: JM
authors.lastname: Lawrence
authors.forename: William V
authors.initials: WV
authors.lastname: Tamborlane
authors.forename: Tim
authors.initials: T
authors.lastname: Wysocki
authors.forename: Dongyuan
authors.initials: D
authors.lastname: Xing
authors.forename: Elbert S
authors.initials: ES
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003362:Cost-Benefit Analysis; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000523:psychology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D019727:Proxy; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014481:United States