Journal
DIABETES CARE
Volume 36, Issue 7, Pages 1891-1897Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc12-1708
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Funding
- Centers for Disease Control and Prevention [00097, DP-05-069, DP-10-001]
- National Institute of Diabetes and Digestive and Kidney Diseases [U48/CCU919219, U01 DP-000246, U18 DP-002714, U48/CCU819241-3, U01 DP-000247, U18 DP-000247-06A1]
- Kuakini Medical Center [U58CCU919256, U01 DP-000245]
- Children's Hospital Medical Center (Cincinnati) [U48/CCU519239, U01 DP-000248, U18 DP-002709]
- University of North Carolina at Chapel Hill [U48/CCU419249, U01 DP-000254, U18 DP-002708-01]
- University of Washington School of Medicine [U58/CCU019235-4, U01 DP-000244, U18 DP-002710-01]
- Wake Forest University School of Medicine [U48/CCU919219, U01 DP-000250, 200-2010-35171]
- General Clinical Research Centers at the South Carolina Clinical and Translational Research Institute at the Medical University of South Carolina: National Institutes of Health (NIH)/National Center for Research Resources (NCRR) [UL1 RR-029882]
- Children's Hospital and Regional Medical Center [M01 RR-00037]
- Colorado Pediatric General Clinical Research Center [M01 RR-00069]
- Barbara Davis Center at the University of Colorado at Denver [NIH P30 DK-57516]
- Institutional Clinical and Translational Science Award, NIH/NCRR at the University of Cincinnati [1UL1 RR-026314-01]
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OBJECTIVE-To establish minimal clinically important difference (MCID) scores representing the smallest detectable change in quality of life (QOL), using the Pediatric Quality of Life Inventory (PedsQL) Generic Core and Diabetes Module among youth with diabetes and their parents, and to identify demographic and clinical correlates of QOL change over 1 year. RESEARCH DESIGN AND METHODS-Participants in the SEARCH for Diabetes in Youth Study aged >5 years and parents of youth aged <18 years completed PedsQL surveys at their initial and 12-month study visits. MCIDs for each PedsQL module were calculated using one standard error of measurement. Demographic and clinical characteristics associated with QOL change were identified through multiple linear and logistic regression analyses. RESULTS-The sample comprised 5,004 youth (mean age, 12.5 +/- 4.7 years; mean diabetes duration, 3.4 +/- 3.7 years). Of 100 possible points, PedsQL total score MCIDs for youth with type 1 and type 2 diabetes, respectively, were Generic Core, 4.88, 6.27 (parent) and 4.72, 5.41 (youth); Diabetes Module, 4.54, 6.06 (parent) and 5.27, 5.96 (youth). Among 1,402 youth with a follow-up visit, lower baseline QOL, male sex, private insurance, having type I diabetes, longer diabetes duration, and better glycemic control predicted improvements in youth- and parent-reported PedsQL total scores over 1 year. Clinically meaningful (>= 1 MCID) improvements in total score for at least one PedsQL module were predicted by private insurance, lower BMI, and lower AlC at baseline. CONCLUSIONS-These diabetes-specific reference points to interpret clinically meaningful change in PedsQL scores can be used in clinical care and research for youth with type 1 and type 2 diabetes.
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