title: Disparities between Ophthalmologists and Patients in Estimating Quality of Life Associated with Diabetic Retinopathy.
abstract: BACKGROUND
  This study aimed to evaluate and compare the utility values associated with diabetic retinopathy (DR) in a sample of Chinese patients and ophthalmologists.
  
  
  METHODS
  Utility values were evaluated by both the time trade-off (TTO) and rating scale (RS) methods for 109 eligible patients with DR and 2 experienced ophthalmologists. Patients were stratified by Snellen best-corrected visual acuity (BCVA) in the better-seeing eye. The correlations between the utility values and general vision-related health status measures were analyzed. These utility values were compared with data from two other studies.
  
  
  RESULTS
  The mean utility values elicited from the patients themselves with the TTO (0.81; SD 0.10) and RS (0.81; SD 0.11) methods were both statistically lower than the mean utility values assessed by ophthalmologists. Significant predictors of patients' TTO and RS utility values were both LogMAR BCVA in the affected eye and average weighted LogMAR BCVA. DR grade and duration of visual dysfunction were also variables that significantly predicted patients' TTO utility values. For ophthalmologists, patients' LogMAR BCVA in the affected eye and in the better eye were the variables that significantly predicted both the TTO and RS utility values. Patients' education level was also a variable that significantly predicted RS utility values. Moreover, both diabetic macular edema and employment status were significant predictors of TTO and RS utility values, whether from patients or ophthalmologists. There was no difference in mean TTO utility values compared to our American and Canadian patients.
  
  
  CONCLUSIONS
  DR caused a substantial decrease in Chinese patients' utility values, and ophthalmologists substantially underestimated its effect on patient quality of life.
authors.affiliation: Department of Ophthalmology, Shanghai First People's Hospital, affiliated Shanghai Jiaotong University, Shanghai, China.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Ophthalmology, Shanghai First People's Hospital, affiliated Shanghai Jiaotong University, Shanghai, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Department of Ophthalmology, Shanghai First People's Hospital, affiliated Shanghai Jiaotong University, Shanghai, China.
authors.forename: Haidong
authors.initials: H
authors.lastname: Zou
authors.affiliation: Department of Ophthalmology, Shanghai First People's Hospital, affiliated Shanghai Jiaotong University, Shanghai, China.
authors.forename: Xun
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Ophthalmology, Shanghai First People's Hospital, affiliated Shanghai Jiaotong University, Shanghai, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D002681:China; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology; D010361:Patients; D010820:Physicians; D011788:Quality of Life / Q000523:psychology*; D014792:Visual Acuity