Validation of the Generic Version of China Health Related Outcomes Measures (CHROME-G) among individuals with type 2 diabetes in China

Meixuan Li; Shitong Xie; Minyan Yang; Yanan Wu; Zijun Li; Rui Li; Xiuxia Li; Xue Li; Yijun Liu; Jing Wu; Kun Zhao; Feng Xie; Kehu Yang

doi:10.1111/jebm.12642

Journal of Evidence-Based Medicine ›› 2024, Vol. 17 ›› Issue (3) :615 -625. DOI: 10.1111/jebm.12642

ARTICLE

Validation of the Generic Version of China Health Related Outcomes Measures (CHROME-G) among individuals with type 2 diabetes in China

Meixuan Li ¹^,²^,³
, Shitong Xie ⁴^,⁵
, Minyan Yang ¹^,²^,³
, Yanan Wu ²^,³
, Zijun Li ²^,³
, Rui Li ⁶
, Xiuxia Li ¹^,²^,³
, Xue Li ⁶
, Yijun Liu ⁷
, Jing Wu ⁴^,⁵
, Kun Zhao ⁶^,⁸
, Feng Xie ⁹^,^†
, Kehu Yang ¹^,²^,³^,^†

Author information +

¹. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China

². Evidence-Based Social Science Research Center, Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China

³. Gansu Key Laboratory of Evidence-Based Medicine, Lanzhou University, Lanzhou, Gansu, China

⁴. School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China

⁵. Center for Social Science Survey and Data, Tianjin University, Tianjin, China

⁶. Department of Health Technology Assessment, China National Health Development Research Center, Beijing, China

⁷. Department of Integrated Traditional Chinese and Western Medicine, Wuwei People's Hospital, Wuwei, Gansu, China

⁸. Vanke School of Public Health, Tsinghua University, Beijing, China

⁹. Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada

fengxie@mcmaster.ca

yangkh-ebm@lzu.edu.cn

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Abstract

Objective: The Generic Version of China Health Related Outcomes Measures (CHROME-G) was a new preference-based health-related quality of life (HRQoL) instrument designed specifically for the Chinese population. This study aimed to validate and compare measurement properties of CHROME-G with EuroQol-5 Dimensions-5 Levels (EQ-5D-5L), Short Form-6 Dimensions version 2 (SF-6Dv2), and Diabetes-Specific Quality of Life (DSQL) scales among the elderly Chinese population with type 2 diabetes.

Methods: A representative sample population was recruited across the country. Internal consistency was assessed using Cronbach’s alpha. Hypotheses testing including convergent validity and known-groups validity were evaluated using Spearman’s rank correlation and effect sizes, respectively. Sensitivity was examined using relative efficiency and receiver operating characteristic curve.

Results: A total of 131 individuals with type 2 diabetes (54.20% male; mean age 69.03 years) were enrolled. Cronbach’s alpha was 0.94 for DSQL, 0.93 for CHROME-G, 0.87 for EQ-5D-5L, and 0.88 for SF-6Dv2. For the convergent validity of CHROME-G, 24/29 (82.76%) correlations met the predefined hypotheses, with Spearman’s rank correlation coefficients ranging from 0.51 to 0.96. Among the different health subgroups, the effect sizes for CHROME-G, DSQL, EQ-5D-5L, and SF-6Dv2 were 0.19–1.26, 0.36–1.62, 0.22–1.06, and 0.49–0.87, respectively. CHROME-G, DSQL, and SF-6Dv2 had higher efficiency compared with EQ-5D-5L in detecting differences in self-reported health status, with relative efficiency of 3.18 and 1.76, 4.38 and 6.52, and 1.56 and 2.09, respectively.

Conclusions: CHROME-G demonstrates relatively good measurement properties compared with EQ-5D-5L and SF-6Dv2 for measuring the HRQoL among the elderly Chinese population with type 2 diabetes. The sensitivity of DSQL appears to be better than that of the three generic instruments.

Keywords

China / CHROME-G / health-related quality of life / measurement properties / older adults / type 2 diabetes

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Meixuan Li, Shitong Xie, Minyan Yang, Yanan Wu, Zijun Li, Rui Li, Xiuxia Li, Xue Li, Yijun Liu, Jing Wu, Kun Zhao, Feng Xie, Kehu Yang. Validation of the Generic Version of China Health Related Outcomes Measures (CHROME-G) among individuals with type 2 diabetes in China. Journal of Evidence-Based Medicine, 2024, 17(3): 615-625 DOI:10.1111/jebm.12642