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Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010
The Lancet, Volume: 380, Issue: 9859, Pages: 2129 - 2143
Swansea University Authors:
Belinda Gabbe , Ronan Lyons
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DOI (Published version): 10.1016/S0140-6736(12)61680-8
Abstract
Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disabilityweights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensivedebate about a range of conceptual and methodological issues concern...
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ISSN: | 0140-6736 |
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2012
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<?xml version="1.0"?><rfc1807><datestamp>2013-08-08T08:38:40.1987549</datestamp><bib-version>v2</bib-version><id>13936</id><entry>2013-01-21</entry><title>Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010</title><swanseaauthors><author><sid>4bdcc94332b2bd10530c5e71ceb04f14</sid><ORCID>0000-0001-7096-7688</ORCID><firstname>Belinda</firstname><surname>Gabbe</surname><name>Belinda Gabbe</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>83efcf2a9dfcf8b55586999d3d152ac6</sid><ORCID>0000-0001-5225-000X</ORCID><firstname>Ronan</firstname><surname>Lyons</surname><name>Ronan Lyons</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2013-01-21</date><deptcode>FGMHL</deptcode><abstract>Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disabilityweights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensivedebate about a range of conceptual and methodological issues concerning the defi nition and measurement of theseweights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden ofDisease Study 2010 through a large-scale empirical investigation in which judgments about health losses associatedwith 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-faceinterviews 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 usedpaired comparison questions, in which respondents considered two hypothetical individuals with diff erent, randomlyselected health states and indicated which person they regarded as healthier. The web survey added questions aboutpopulation health equivalence, which compared the overall health benefi ts of diff erent life-saving or diseasepreventionprogrammes. We analysed paired comparison responses with probit regression analysis on all 220 uniquestates in the study. We used results from the population health equivalence responses to anchor the results from thepaired comparisons on the disability weight scale from 0 (implying no loss of health) to 1 (implying a health lossequivalent to death). Additionally, we compared new disability weights with those used in WHO’s most recent updateof 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 pairedcomparison responses indicated a high degree of consistency across surveys: correlations between individual surveyresults 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 weightsbelow 0·05. Five (11%) states had weights below 0·01, such as mild anaemia, mild hearing or vision loss, andsecondary infertility. The health states with the highest disability weights were acute schizophrenia (0·76) and severemultiple sclerosis (0·71). We identifi ed 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 signifi cantlylower weights in our study than previously.Interpretation This study represents the most extensive empirical eff ort as yet to measure disability weights. Bycontrast with the popular hypothesis that disability assessments vary widely across samples with diff erent culturalenvironments, we have reported strong evidence of highly consistent results.</abstract><type>Journal Article</type><journal>The Lancet</journal><volume>380</volume><journalNumber>9859</journalNumber><paginationStart>2129</paginationStart><paginationEnd>2143</paginationEnd><publisher/><placeOfPublication/><issnPrint>0140-6736</issnPrint><issnElectronic/><keywords/><publishedDay>15</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2012</publishedYear><publishedDate>2012-12-15</publishedDate><doi>10.1016/S0140-6736(12)61680-8</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea 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2013-08-08T08:38:40.1987549 v2 13936 2013-01-21 Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010 4bdcc94332b2bd10530c5e71ceb04f14 0000-0001-7096-7688 Belinda Gabbe Belinda Gabbe true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 2013-01-21 FGMHL Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disabilityweights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensivedebate about a range of conceptual and methodological issues concerning the defi nition and measurement of theseweights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden ofDisease Study 2010 through a large-scale empirical investigation in which judgments about health losses associatedwith 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-faceinterviews 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 usedpaired comparison questions, in which respondents considered two hypothetical individuals with diff erent, randomlyselected health states and indicated which person they regarded as healthier. The web survey added questions aboutpopulation health equivalence, which compared the overall health benefi ts of diff erent life-saving or diseasepreventionprogrammes. We analysed paired comparison responses with probit regression analysis on all 220 uniquestates in the study. We used results from the population health equivalence responses to anchor the results from thepaired comparisons on the disability weight scale from 0 (implying no loss of health) to 1 (implying a health lossequivalent to death). Additionally, we compared new disability weights with those used in WHO’s most recent updateof 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 pairedcomparison responses indicated a high degree of consistency across surveys: correlations between individual surveyresults 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 weightsbelow 0·05. Five (11%) states had weights below 0·01, such as mild anaemia, mild hearing or vision loss, andsecondary infertility. The health states with the highest disability weights were acute schizophrenia (0·76) and severemultiple sclerosis (0·71). We identifi ed 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 signifi cantlylower weights in our study than previously.Interpretation This study represents the most extensive empirical eff ort as yet to measure disability weights. Bycontrast with the popular hypothesis that disability assessments vary widely across samples with diff erent culturalenvironments, we have reported strong evidence of highly consistent results. Journal Article The Lancet 380 9859 2129 2143 0140-6736 15 12 2012 2012-12-15 10.1016/S0140-6736(12)61680-8 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2013-08-08T08:38:40.1987549 2013-01-21T11:08:09.3539013 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Joshua A Salomon 1 Theo Vos 2 Daniel R Hogan 3 Michael Gagnon 4 Mohsen Naghavi 5 Ali Mokdad 6 Nazma Begum 7 Razibuzzaman Shah 8 Muhammad Karyana 9 Soewarta Kosen 10 Mario Reyna Farje 11 Gilberto Moncada 12 Arup Dutta 13 Sunil Sazawal 14 Andrew Dyer 15 Jason Seiler 16 Victor Aboyans 17 Lesley Baker 18 Amanda Baxter 19 Emelia J Benjamin 20 Kavi Bhalla 21 Aref Bin Abdulhak 22 Fiona Blyth 23 Rupert Bourne 24 Tasanee Braithwaite 25 Peter Brooks 26 Traolach S Brugha 27 Claire Bryan-Hancock 28 Rachelle Buchbinder 29 Peter Burney 30 Bianca Calabria 31 Honglei Chen 32 Sumeet S Chugh 33 Rebecca Cooley 34 Michael H Criqui 35 Marita Cross 36 Kaustubh C Dabhadkar 37 Nabila Dahodwala 38 Adrian Davis 39 Louisa Degenhardt 40 Cesar Díaz-Torné 41 E Ray Dorsey 42 Tim Driscoll 43 Karen Edmond 44 Alexis Elbaz 45 Majid Ezzati 46 Valery Feigin 47 Cleusa P Ferri 48 Abraham D Flaxman 49 Louise Flood 50 Marlene Fransen 51 Kana Fuse 52 Belinda Gabbe 0000-0001-7096-7688 53 Richard F Gillum 54 Juanita Haagsma 55 James E Harrison 56 Rasmus Havmoeller 57 Roderick J Hay 58 Abdullah Hel-Baqui 59 Hans W Hoek 60 Howard Hoffman 61 Emily Hogeland 62 Damian Hoy 63 Deborah Jarvis 64 Ganesan Karthikeyan 65 Lisa Marie Knowlton 66 Tim Lathlean 67 Janet L Leasher 68 Stephen S Lim 69 Steven E Lipshultz 70 Alan D Lopez 71 Rafael Lozano 72 Ronan Lyons 0000-0001-5225-000X 73 Reza Malekzadeh 74 Wagner Marcenes 75 Lyn March 76 David J Margolis 77 Neil McGill 78 John McGrath 79 George A Mensah 80 Ana-Claire Meyer 81 Catherine Michaud 82 Andrew Moran 83 Rintaro Mori 84 Michele E Murdoch 85 Luigi Naldi 86 Charles R Newton 87 Rosana Norman 88 Saad B Omer 89 Richard Osborne 90 Neil Pearce 91 Fernando Perez-Ruiz 92 Norberto Perico 93 Konrad Pesudovs 94 David Phillips 95 Farshad Pourmalek 96 Martin Prince 97 Jürgen T Rehm 98 Guiseppe Remuzzi 99 Kathryn Richardson 100 Robin Room 101 Sukanta Saha 102 Uchechukwu Sampson 103 Lidia Sanchez-Riera 104 Maria Segui-Gomez 105 Saeid Shahraz 106 Kenji Shibuya 107 David Singh 108 Karen Sliwa 109 Emma Smith 110 Isabelle Soerjomataram 111 Timothy Steiner 112 Wilma A Stolk 113 Lars Jacob Stovner 114 Christopher Sudfeld 115 Hugh R Taylor 116 Imad M Tleyjeh 117 Marieke J van der Werf 118 Wendy L Watson 119 David J Weatherall 120 Robert Weintraub 121 Marc G Weisskopf 122 Harvey Whiteford 123 James D Wilkinson 124 Anthony D Woolf 125 Zhi-Jie Zheng 126 Christopher JL Murray 127 |
title |
Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010 |
spellingShingle |
Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010 Belinda Gabbe Ronan Lyons |
title_short |
Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010 |
title_full |
Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010 |
title_fullStr |
Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010 |
title_full_unstemmed |
Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010 |
title_sort |
Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010 |
author_id_str_mv |
4bdcc94332b2bd10530c5e71ceb04f14 83efcf2a9dfcf8b55586999d3d152ac6 |
author_id_fullname_str_mv |
4bdcc94332b2bd10530c5e71ceb04f14_***_Belinda Gabbe 83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons |
author |
Belinda Gabbe Ronan Lyons |
author2 |
Joshua A Salomon Theo Vos Daniel R Hogan Michael Gagnon Mohsen Naghavi Ali Mokdad Nazma Begum Razibuzzaman Shah Muhammad Karyana Soewarta Kosen Mario Reyna Farje Gilberto Moncada Arup Dutta Sunil Sazawal Andrew Dyer Jason Seiler Victor Aboyans Lesley Baker Amanda Baxter Emelia J Benjamin Kavi Bhalla Aref Bin Abdulhak Fiona Blyth Rupert Bourne Tasanee Braithwaite Peter Brooks Traolach S Brugha Claire Bryan-Hancock Rachelle Buchbinder Peter Burney Bianca Calabria Honglei Chen Sumeet S Chugh Rebecca Cooley Michael H Criqui Marita Cross Kaustubh C Dabhadkar Nabila Dahodwala Adrian Davis Louisa Degenhardt Cesar Díaz-Torné E Ray Dorsey Tim Driscoll Karen Edmond Alexis Elbaz Majid Ezzati Valery Feigin Cleusa P Ferri Abraham D Flaxman Louise Flood Marlene Fransen Kana Fuse Belinda Gabbe Richard F Gillum Juanita Haagsma James E Harrison Rasmus Havmoeller Roderick J Hay Abdullah Hel-Baqui Hans W Hoek Howard Hoffman Emily Hogeland Damian Hoy Deborah Jarvis Ganesan Karthikeyan Lisa Marie Knowlton Tim Lathlean Janet L Leasher Stephen S Lim Steven E Lipshultz Alan D Lopez Rafael Lozano Ronan Lyons Reza Malekzadeh Wagner Marcenes Lyn March David J Margolis Neil McGill John McGrath George A Mensah Ana-Claire Meyer Catherine Michaud Andrew Moran Rintaro Mori Michele E Murdoch Luigi Naldi Charles R Newton Rosana Norman Saad B Omer Richard Osborne Neil Pearce Fernando Perez-Ruiz Norberto Perico Konrad Pesudovs David Phillips Farshad Pourmalek Martin Prince Jürgen T Rehm Guiseppe Remuzzi Kathryn Richardson Robin Room Sukanta Saha Uchechukwu Sampson Lidia Sanchez-Riera Maria Segui-Gomez Saeid Shahraz Kenji Shibuya David Singh Karen Sliwa Emma Smith Isabelle Soerjomataram Timothy Steiner Wilma A Stolk Lars Jacob Stovner Christopher Sudfeld Hugh R Taylor Imad M Tleyjeh Marieke J van der Werf Wendy L Watson David J Weatherall Robert Weintraub Marc G Weisskopf Harvey Whiteford James D Wilkinson Anthony D Woolf Zhi-Jie Zheng Christopher JL Murray |
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The Lancet |
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380 |
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9859 |
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2129 |
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2012 |
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Swansea University |
issn |
0140-6736 |
doi_str_mv |
10.1016/S0140-6736(12)61680-8 |
college_str |
Faculty of Medicine, Health and Life Sciences |
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facultyofmedicinehealthandlifesciences |
hierarchy_top_title |
Faculty of Medicine, Health and Life Sciences |
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facultyofmedicinehealthandlifesciences |
hierarchy_parent_title |
Faculty of Medicine, Health and Life Sciences |
department_str |
Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine |
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description |
Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disabilityweights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensivedebate about a range of conceptual and methodological issues concerning the defi nition and measurement of theseweights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden ofDisease Study 2010 through a large-scale empirical investigation in which judgments about health losses associatedwith 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-faceinterviews 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 usedpaired comparison questions, in which respondents considered two hypothetical individuals with diff erent, randomlyselected health states and indicated which person they regarded as healthier. The web survey added questions aboutpopulation health equivalence, which compared the overall health benefi ts of diff erent life-saving or diseasepreventionprogrammes. We analysed paired comparison responses with probit regression analysis on all 220 uniquestates in the study. We used results from the population health equivalence responses to anchor the results from thepaired comparisons on the disability weight scale from 0 (implying no loss of health) to 1 (implying a health lossequivalent to death). Additionally, we compared new disability weights with those used in WHO’s most recent updateof 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 pairedcomparison responses indicated a high degree of consistency across surveys: correlations between individual surveyresults 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 weightsbelow 0·05. Five (11%) states had weights below 0·01, such as mild anaemia, mild hearing or vision loss, andsecondary infertility. The health states with the highest disability weights were acute schizophrenia (0·76) and severemultiple sclerosis (0·71). We identifi ed 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 signifi cantlylower weights in our study than previously.Interpretation This study represents the most extensive empirical eff ort as yet to measure disability weights. Bycontrast with the popular hypothesis that disability assessments vary widely across samples with diff erent culturalenvironments, we have reported strong evidence of highly consistent results. |
published_date |
2012-12-15T03:15:56Z |
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1763750294871605248 |
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11.021648 |