HERC, Department of Public Health, University of Oxford, Oxford, UK.
Health Econ. 2014 Apr;23(4):487-500. doi: 10.1002/hec.2930. Epub 2013 Jul 11.
We estimate the impact of six diabetes-related complications (myocardial infarction, ischaemic heart disease, stroke, heart failure, amputation and visual acuity) on quality of life, using seven rounds of EQ-5D questionnaires administered between 1997 and 2007 in the UK Prospective Diabetes Study. The use of cross-sectional data to make such estimates is widespread in the literature, being less expensive and easier to collect than repeated-measures data. However, analysis of this dataset suggests that cross-sectional analysis could produce biased estimates of the effect of complications on QoL. Using fixed effects estimators, we show that variation in the quality of life between patients is strongly influenced by time-invariant patient characteristics. Our results highlight the importance of studying quality-of-life changes over time to distinguish between time-invariant determinants of QoL and the effect on QoL of specific events such as diabetes complications.
我们使用英国前瞻性糖尿病研究（UK Prospective Diabetes Study）在 1997 年至 2007 年之间进行的七轮 EQ-5D 问卷调查数据，估计了六种与糖尿病相关的并发症（心肌梗死、缺血性心脏病、中风、心力衰竭、截肢和视力）对生活质量的影响。在文献中，使用横断面数据进行此类估计非常普遍，因为与重复测量数据相比，这种方法成本更低且更容易收集。然而，对该数据集的分析表明，横断面分析可能会对并发症对生活质量的影响产生有偏差的估计。使用固定效应估计量，我们表明患者之间生活质量的差异受到时间不变的患者特征的强烈影响。我们的结果强调了随着时间的推移研究生活质量变化的重要性，以区分生活质量的时间不变决定因素和特定事件（如糖尿病并发症）对生活质量的影响。
