Dataset Information

Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010.

ABSTRACT:

Background

Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these weights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden of Disease Study 2010 through a large-scale empirical investigation in which judgments about health losses associated with many causes of disease and injury were elicited from the general public in diverse communities through a new, standardised approach.

Methods

We surveyed respondents in two ways: household surveys of adults aged 18 years or older (face-to-face interviews in Bangladesh, Indonesia, Peru, and Tanzania; telephone interviews in the USA) between Oct 28, 2009, and June 23, 2010; and an open-access web-based survey between July 26, 2010, and May 16, 2011. The surveys used paired comparison questions, in which respondents considered two hypothetical individuals with different, randomly selected health states and indicated which person they regarded as healthier. The web survey added questions about population health equivalence, which compared the overall health benefits of different life-saving or disease-prevention programmes. We analysed paired comparison responses with probit regression analysis on all 220 unique states in the study. We used results from the population health equivalence responses to anchor the results from the paired comparisons on the disability weight scale from 0 (implying no loss of health) to 1 (implying a health loss equivalent to death). Additionally, we compared new disability weights with those used in WHO's most recent update of the Global Burden of Disease Study for 2004.

Findings

13,902 individuals participated in household surveys and 16,328 in the web survey. Analysis of paired comparison responses indicated a high degree of consistency across surveys: correlations between individual survey results and results from analysis of the pooled dataset were 0·9 or higher in all surveys except in Bangladesh (r=0·75). Most of the 220 disability weights were located on the mild end of the severity scale, with 58 (26%) having weights below 0·05. Five (11%) states had weights below 0·01, such as mild anaemia, mild hearing or vision loss, and secondary infertility. The health states with the highest disability weights were acute schizophrenia (0·76) and severe multiple sclerosis (0·71). We identified a broad pattern of agreement between the old and new weights (r=0·70), particularly in the moderate-to-severe range. However, in the mild range below 0·2, many states had significantly lower weights in our study than previously.

Interpretation

This study represents the most extensive empirical effort as yet to measure disability weights. By contrast with the popular hypothesis that disability assessments vary widely across samples with different cultural environments, we have reported strong evidence of highly consistent results.

Funding

Bill & Melinda Gates Foundation.

SUBMITTER: Salomon JA

PROVIDER: S-EPMC10782811 | biostudies-literature | 2012 Dec

REPOSITORIES: biostudies-literature

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Publications

Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010.

Salomon Joshua A JA Vos Theo T Hogan Daniel R DR Gagnon Michael M Naghavi Mohsen M Mokdad Ali A Begum Nazma N Shah Razibuzzaman R Karyana Muhammad M Kosen Soewarta S Farje Mario Reyna MR Moncada Gilberto G Dutta Arup A Sazawal Sunil S Dyer Andrew A Seiler Jason J Aboyans Victor V Baker Lesley L Baxter Amanda A Benjamin Emelia J EJ Bhalla Kavi K Bin Abdulhak Aref A Blyth Fiona F Bourne Rupert R Braithwaite Tasanee T Brooks Peter P Brugha Traolach S TS Bryan-Hancock Claire C Buchbinder Rachelle R Burney Peter P Calabria Bianca B Chen Honglei H Chugh Sumeet S SS Cooley Rebecca R Criqui Michael H MH Cross Marita M Dabhadkar Kaustubh C KC Dahodwala Nabila N Davis Adrian A Degenhardt Louisa L Díaz-Torné Cesar C Dorsey E Ray ER Driscoll Tim T Edmond Karen K Elbaz Alexis A Ezzati Majid M Feigin Valery V Ferri Cleusa P CP Flaxman Abraham D AD Flood Louise L Fransen Marlene M Fuse Kana K Gabbe Belinda J BJ Gillum Richard F RF Haagsma Juanita J Harrison James E JE Havmoeller Rasmus R Hay Roderick J RJ Hel-Baqui Abdullah A Hoek Hans W HW Hoffman Howard H Hogeland Emily E Hoy Damian D Jarvis Deborah D Karthikeyan Ganesan G Knowlton Lisa Marie LM Lathlean Tim T Leasher Janet L JL Lim Stephen S SS Lipshultz Steven E SE Lopez Alan D AD Lozano Rafael R Lyons Ronan R Malekzadeh Reza R Marcenes Wagner W March Lyn L Margolis David J DJ McGill Neil N McGrath John J Mensah George A GA Meyer Ana-Claire AC Michaud Catherine C Moran Andrew A Mori Rintaro R Murdoch Michele E ME Naldi Luigi L Newton Charles R CR Norman Rosana R Omer Saad B SB Osborne Richard R Pearce Neil N Perez-Ruiz Fernando F Perico Norberto N Pesudovs Konrad K Phillips David D Pourmalek Farshad F Prince Martin M Rehm Jürgen T JT Remuzzi Guiseppe G Richardson Kathryn K Room Robin R Saha Sukanta S Sampson Uchechukwu U Sanchez-Riera Lidia L Segui-Gomez Maria M Shahraz Saeid S Shibuya Kenji K Singh David D Sliwa Karen K Smith Emma E Soerjomataram Isabelle I Steiner Timothy T Stolk Wilma A WA Stovner Lars Jacob LJ Sudfeld Christopher C Taylor Hugh R HR Tleyjeh Imad M IM van der Werf Marieke J MJ Watson Wendy L WL Weatherall David J DJ Weintraub Robert R Weisskopf Marc G MG Whiteford Harvey H Wilkinson James D JD Woolf Anthony D AD Zheng Zhi-Jie ZJ Murray Christopher J L CJ Jonas Jost B JB

Lancet (London, England) 20121201 9859

<h4>Background</h4>Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these weights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden of Disease Study 2010 through a large ...[more]

PMID: 23245605

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Project description:IntroductionMeasurement of the burden of disease using disability-adjusted life years requires disability weights to quantify health losses for non-fatal consequences of disease and injury. We aimed to obtain a set of disability weights for environmental and non-environmental noise-related health states (NOISE) using a nationally representative sample survey among the general population of four European countries; and to compare the resulting NOISE disability weights with those estimated in the Global Burden of Disease 2010 (GBD 2010) and European (EURO) disability weights measurement studies.MethodsWe administered a web-based survey among a cohort of individuals from Hungary, Italy, Sweden and the Netherlands. It included paired comparison questions on 82 different health states. Each respondent performed 13 paired comparison tasks. We analysed paired comparison responses with probit regression analysis, and regression results were anchored on the disability weight scale between 0 (equivalent to full health) and 1 (equivalent to death).ResultsIn total, 4056 respondents participated in the study. Comparison of the regression results from paired comparison responses for each country-specific dataset with those run on the pooled dataset showed high linear correlations (0.96-0.98, p<0.001). The resulting disability weights ranged from 0.005 for mild impairment of distance vision and mild anaemia to 0.761 for intensive care unit admission. The disability weight for moderate and severe annoyance was 0.006 and 0.011, respectively. Comparison of disability weights showed a higher correlation between EURO and NOISE disability weights (pseudo R-squared=0.955, Pearson correlation=0.954) compared with GBD 2010 and NOISE disability weights (pseudo R-squared=0.893, Pearson correlation=0.946).ConclusionsThe NOISE disability weights are consistent and highly correlated across the four European countries. The NOISE disability weights set can be used to estimate the burden of disease attributable to noise-related outcomes across Europe.

Project description:BackgroundLeprosy is a chronic bacterial infection caused by Mycobacterium leprae, which may lead to physical disability, stigma, and discrimination. The chronicity of the disease and disabilities are the prime contributors to the disease burden of leprosy. The current figures of the disease burden in the 2017 global burden of disease study, however, are considered to be under-estimated. In this study, we aimed to systematically review the literature and perform individual patient data meta-analysis to estimate new disability weights for leprosy, using Health-Related Quality of Life (HRQOL) data.Methodology/principal findingsThe search strategy included all major databases with no restriction on language, setting, study design, or year of publication. Studies on human populations that have been affected by leprosy and recorded the HRQOL with the Short form tool, were included. A consortium was formed with authors who could share the anonymous individual-level data of their study. Mean disability weight estimates, sorted by the grade of leprosy disability as defined by WHO, were estimated for individual participant data and pooled using multivariate random-effects meta-analysis. Eight out of 14 studies from the review were included in the meta-analysis due to the availability of individual-level data (667 individuals). The overall estimated disability weight for grade 2 disability was 0.26 (95%CI: 0.18-0.34). For grade 1 disability the estimated weight was 0.19 (95%CI: 0.13-0.26) and for grade 0 disability it was 0.13 (95%CI: 0.06-0.19). The revised disability weight for grade 2 leprosy disability is four times higher than the published GBD 2017 weights for leprosy and the grade 1 disability weight is nearly twenty times higher.Conclusions/significanceThe global burden of leprosy is grossly underestimated. Revision of the current disability weights and inclusion of disability caused in individuals with grade 0 leprosy disability will contribute towards a more precise estimation of the global burden of leprosy.

Project description:BackgroundThe disability weight (DW) quantifies the severity of health states from disease sequela and is a pivotal parameter for disease burden calculation. We conducted a national and subnational DW measurement in China.MethodsIn 2020-2021, we conducted a web-based survey to assess DWs for 206 health states in 31 Chinese provinces targeting health workers via professional networks. We fielded questions of paired comparison (PC) and population health equivalence (PHE). The PC data were analysed by probit regression analysis, and the regression results were anchored by results from the PHE responses on the DW scale between 0 (no loss of health) and 1 (health loss equivalent to death).FindingsWe used PC responses from 468,541 respondents to estimate DWs of health states. Eight of 11 domains of health had significantly negative coefficients in the regression of the difference between Chinese and Global Burden of Disease (GBD) DWs, suggesting lower DW values for health states with mention of these domains in their lay description. We noted considerable heterogeneity within domains, however. After applying these Chinese DWs to the 2019 GBD estimates for China, total years lived with disability (YLDs) increased by 14·9% to 177 million despite lower estimates for musculoskeletal disorders, cardiovascular diseases, mental disorders, diabetes and chronic kidney disease. The lower estimates of YLDs for these conditions were more than offset by higher estimates of common, low-severity conditions.InterpretationThe differences between the GBD and Chinese DWs suggest that there might be some contextual factors influencing the valuation of health states. While the reduced estimates for mental disorders, alcohol use disorder, and dementia could hint at a culturally different valuation of these conditions in China, the much greater shifts in YLDs from low-severity conditions more likely reflects methodological difficulty to distinguish between health states that vary a little in absolute DW value but a lot in relative terms.FundingThis work was supported by the National Natural Science Foundation of China [grant number 82173626], the National Key Research and Development Program of China [grant numbers 2018YFC1315302], Wuhan Medical Research Program of Joint Fund of Hubei Health Committee [grant number WJ2019H304], and Ningxia Natural Science Foundation Project [grant number 2020AAC03436].

Project description:BackgroundThe disability weight is an essential factor to estimate the healthy time that is lost due to living with a certain state of illness. A 2014 review showed a considerable variation in methods used to derive disability weights. Since then, several sets of disability weights have been developed. This systematic review aimed to provide an updated and comparative overview of the methodological design choices and surveying techniques that have been used in disability weights measurement studies and how they evolved over time.MethodsA literature search was conducted in multiple international databases (early-1990 to mid-2021). Records were screened according to pre-defined eligibility criteria. The quality of the included disability weights measurement studies was assessed using the Checklist for Reporting Valuation Studies (CREATE) instrument. Studies were collated by characteristics and methodological design approaches. Data extraction was performed by one reviewer and discussed with a second.ResultsForty-six unique disability weights measurement studies met our eligibility criteria. More than half (n = 27; 59%) of the identified studies assessed disability weights for multiple ill-health outcomes. Thirty studies (65%) described the health states using disease-specific descriptions or a combination of a disease-specific descriptions and generic-preference instruments. The percentage of studies obtaining health preferences from a population-based panel increased from 14% (2004-2011) to 32% (2012-2021). None of the disability weight studies published in the past 10 years used the annual profile approach. Most studies performed panel-meetings to obtain disability weights data.ConclusionsOur review reveals that a methodological uniformity between national and GBD disability weights studies increased, especially from 2010 onwards. Over years, more studies used disease-specific health state descriptions in line with those of the GBD study, panel from general populations, and data from web-based surveys and/or household surveys. There is, however, a wide variation in valuation techniques that were used to derive disability weights at national-level and that persisted over time.

Dataset Information

Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010.

Background

Methods

Findings

Interpretation

Funding

Publications

Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010.

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