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Title: Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010
Authors: Salomon, Joshua A.
Vos, Theo
Hogan, Daniel R.
Gagnon, Michael
Naghavi, Mohsen
Mokdad, Ali
Begum, Nazma
Shah, Razibuzzaman
Karyana, Muhammad
Kosen, Soewarta
Farje, Mario Reyna
Moncada, Gilberto
Dutta, Arup
Sazawal, Sunil
Dyer, Andrew
Seiler, Jason
Aboyans, Victor
Baker, Lesley
Baxter, Amanda
Benjamin, Emelia J.
Bhalla, Kavi
Bin Abdulhak, Aref
Blyth, Fiona
Bourne, Rupert
Braithwaite, Tasanee
Brooks, Peter
Brugha, Traolach S.
Bryan-Hancock, Claire
Buchbinder, Rachelle
Burney, Peter
Calabria, Bianca
Chen, Honglei
Chugh, Sumeet S.
Cooley, Rebecca
Criqui, Michael H.
Cross, Marita
Dabhadkar, Kaustubh C.
Dahodwala, Nabila
Davis, Adrian
Degenhardt, Louisa
Diaz-Torne, Cesar
Dorsey, E. Ray
Driscoll, Tim
Edmond, Karen
Elbaz, Alexis
Ezzati, Majid
Feigin, Valery
Ferri, Cleusa Pinheiro [UNIFESP]
Flaxman, Abraham D.
Flood, Louise
Fransen, Marlene
Fuse, Kana
Gabbe, Belinda J.
Gillum, Richard F.
Haagsma, Juanita
Harrison, James E.
Havmoeller, Rasmus
Hay, Roderick J.
Hel-Baqui, Abdullah
Hoek, Hans W.
Hoffman, Howard
Hogeland, Emily
Hoy, Damian
Jarvis, Deborah
Karthikeyan, Ganesan
Knowlton, Lisa Marie
Lathlean, Tim
Leasher, Janet L.
Lim, Stephen S.
Lipshultz, Steven E.
Lopez, Alan D.
Lozano, Rafael
Lyons, Ronan
Malekzadeh, Reza
Marcenes, Wagner
March, Lyn
Margolis, David J.
McGill, Neil
McGrath, John
Mensah, George A.
Meyer, Ana-Claire
Michaud, Catherine
Moran, Andrew
Mori, Rintaro
Murdoch, Michele E.
Naldi, Luigi
Newton, Charles R.
Norman, Rosana
Omer, Saad B.
Osborne, Richard
Pearce, Neil
Perez-Ruiz, Fernando
Perico, Norberto
Pesudovs, Konrad
Phillips, David
Pourmalek, Farshad
Prince, Martin
Rehm, Juergen T.
Remuzzi, Guiseppe
Richardson, Kathryn
Room, Robin
Saha, Sukanta
Sampson, Uchechukwu
Sanchez-Riera, Lidia
Segui-Gomez, Maria
Shahraz, Saeid
Shibuya, Kenji
Singh, David
Sliwa, Karen
Smith, Emma
Soerjomataram, Isabelle
Steiner, Timothy
Stolk, Wilma A.
Stovner, Lars Jacob
Sudfeld, Christopher
Taylor, Hugh R.
Tleyjeh, Imad M.
van der Werf, Marieke J.
Watson, Wendy L.
Weatherall, David J.
Weintraub, Robert
Weisskopf, Marc G.
Whiteford, Harvey
Wilkinson, James D.
Woolf, Anthony D.
Zheng, Zhi-Jie
Murray, Christopher J. L.
Harvard Univ
Univ Queensland
Univ Washington
Projahnmo Shimantik
Minist Hlth
Inst Cuanto
Johns Hopkins Univ
Dupuytren Univ Hosp
Boston Univ
King Fahad Med City
Univ Sydney
Anglia Ruskin Univ
Moorfields Eye Hosp
Univ Leicester
Flinders Univ S Australia
Monash Univ
Cabrini Inst
Univ London Imperial Coll Sci Technol & Med
Univ New S Wales
Cedars Sinai Med Ctr
Univ Calif San Diego
Emory Univ
Univ Penn
MRC Hearing & Commun Grp
Hosp Santa Creu & St Pablo
London Sch Hyg & Trop Med
MRC HPA Ctr Environm & Hlth
Auckland Univ Technol
Universidade Federal de São Paulo (UNIFESP)
Natl Inst Populat & Social Secur Res
Howard Univ
Univ Med Ctr Rotterdam
Kings Coll Hosp NHS Fdn Trust
Kings Coll London
Karolinska Univ Hosp
Parnassia Psychiat Inst
Univ Calif San Francisco
All India Inst Med Sci
Nova SE Univ
Univ Miami
Swansea Univ
Univ Tehran Med Sci
Queen Mary Univ London
Univ Cape Town
China Med Board
Columbia Univ
Natl Ctr Child Hlth & Dev
Watford Dist Gen Hosp
Centro Studi GISED
Univ Oxford
Deakin Univ
Hosp Univ Cruces
Mario Negri Inst Pharmacol Res
Univ British Columbia
Ctr Addict & Mental Hlth
Turning Point Alcohol & Drug Ctr
Univ Cambridge
Vanderbilt Univ
Inst Invest Biomed Bellvitge
Govt Spain
Brandeis Univ
Univ Tokyo
Queens Med Ctr
Norwegian Univ Sci & Technol
Murdoch Childrens Res Inst
Royal Cornwall Hosp
Shanghai Jiao Tong Univ
Issue Date: 15-Dec-2012
Publisher: Elsevier B.V.
Citation: Lancet. New York: Elsevier Science Inc, v. 380, n. 9859, p. 2129-2143, 2012.
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.
ISSN: 0140-6736
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