The performance of marginal structural models for estimating risk differences and relative risks using weighted univariate generalized linear models
Austin PC. Stat Methods Med Res. 2024; Apr 24 [Epub ahead of print].
Objective — To estimate the burden of illness from diabetes using a population health survey linked to a population-based diabetes registry.
Research Design and Methods — Measures of health-related quality of life (HRQOL) from the 1996/97 Ontario Health Survey (n = 35,517) were combined with diabetes prevalence and mortality data from the Ontario Diabetes Database (n = 487,576) to estimate the impact of diabetes on life expectancy, health-adjusted life expectancy (HALE), and HRQOL.
Results — Life expectancy of people with diabetes was 64.7 and 70.7 years for men and women, respectively—12.8 and 12.2 years less than that for men and women without diabetes. Diabetes had a large impact on instrumental and basic activities of daily living, more so than on functional health. HALE was 58.3 and 62.7 years, respectively, for men and women—11.9 and 10.7 years less than that of men and women without diabetes. Eliminating diabetes would increase Ontario life expectancy by 2.8 years for men and 2.6 years for women; HALE would increase by 2.7 and 3.2 years for men and women, respectively.
Conclusions — The burden of illness from diabetes in Ontario is considerable. Efforts to reduce diabetes would likely result in a “compression of morbidity.” An approach of estimating diabetes burden using linked data sources provides a robust approach for the surveillance of diabetes.
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