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González-Colom R, Mitra K, Vela E, Gezsi A, Paajanen T, Gál Z, Hullam G, Mäkinen H, Nagy T, Kuokkanen M, Piera-Jiménez J, Roca J, Antal P, Juhasz G, Cano I. Multicentric Assessment of a Multimorbidity-Adjusted Disability Score to Stratify Depression-Related Risks Using Temporal Disease Maps: Instrument Validation Study. J Med Internet Res 2024; 26:e53162. [PMID: 38913991 DOI: 10.2196/53162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/23/2023] [Accepted: 05/23/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Comprehensive management of multimorbidity can significantly benefit from advanced health risk assessment tools that facilitate value-based interventions, allowing for the assessment and prediction of disease progression. Our study proposes a novel methodology, the Multimorbidity-Adjusted Disability Score (MADS), which integrates disease trajectory methodologies with advanced techniques for assessing interdependencies among concurrent diseases. This approach is designed to better assess the clinical burden of clusters of interrelated diseases and enhance our ability to anticipate disease progression, thereby potentially informing targeted preventive care interventions. OBJECTIVE This study aims to evaluate the effectiveness of the MADS in stratifying patients into clinically relevant risk groups based on their multimorbidity profiles, which accurately reflect their clinical complexity and the probabilities of developing new associated disease conditions. METHODS In a retrospective multicentric cohort study, we developed the MADS by analyzing disease trajectories and applying Bayesian statistics to determine disease-disease probabilities combined with well-established disability weights. We used major depressive disorder (MDD) as a primary case study for this evaluation. We stratified patients into different risk levels corresponding to different percentiles of MADS distribution. We statistically assessed the association of MADS risk strata with mortality, health care resource use, and disease progression across 1 million individuals from Spain, the United Kingdom, and Finland. RESULTS The results revealed significantly different distributions of the assessed outcomes across the MADS risk tiers, including mortality rates; primary care visits; specialized care outpatient consultations; visits in mental health specialized centers; emergency room visits; hospitalizations; pharmacological and nonpharmacological expenditures; and dispensation of antipsychotics, anxiolytics, sedatives, and antidepressants (P<.001 in all cases). Moreover, the results of the pairwise comparisons between adjacent risk tiers illustrate a substantial and gradual pattern of increased mortality rate, heightened health care use, increased health care expenditures, and a raised pharmacological burden as individuals progress from lower MADS risk tiers to higher-risk tiers. The analysis also revealed an augmented risk of multimorbidity progression within the high-risk groups, aligned with a higher incidence of new onsets of MDD-related diseases. CONCLUSIONS The MADS seems to be a promising approach for predicting health risks associated with multimorbidity. It might complement current risk assessment state-of-the-art tools by providing valuable insights for tailored epidemiological impact analyses of clusters of interrelated diseases and by accurately assessing multimorbidity progression risks. This study paves the way for innovative digital developments to support advanced health risk assessment strategies. Further validation is required to generalize its use beyond the initial case study of MDD.
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Affiliation(s)
- Rubèn González-Colom
- Fundació de Recerca Clínic Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Kangkana Mitra
- Fundació de Recerca Clínic Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Emili Vela
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare - Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain
| | - Andras Gezsi
- Department of Measurement and Information Systems, Budapest University of Technology and Economics, Budapest, Hungary
| | - Teemu Paajanen
- Department of Public Health and Welfare, Finnish Health and Welfare Institute, Helsinki, Finland
| | - Zsófia Gál
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
| | - Gabor Hullam
- Department of Measurement and Information Systems, Budapest University of Technology and Economics, Budapest, Hungary
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
| | - Hannu Mäkinen
- Department of Public Health and Welfare, Finnish Health and Welfare Institute, Helsinki, Finland
| | - Tamas Nagy
- Department of Measurement and Information Systems, Budapest University of Technology and Economics, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
| | - Mikko Kuokkanen
- Department of Public Health and Welfare, Finnish Health and Welfare Institute, Helsinki, Finland
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, School of Medicine at University of Texas Rio Grande Valley, Brownsville, TX, United States
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jordi Piera-Jiménez
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare - Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain
- Faculty of Informatics, Telecommunications and Multimedia, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Josep Roca
- Fundació de Recerca Clínic Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Hospital Clínic de Barcelona, Barcelona, Spain
- Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Peter Antal
- Department of Measurement and Information Systems, Budapest University of Technology and Economics, Budapest, Hungary
| | - Gabriella Juhasz
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
| | - Isaac Cano
- Fundació de Recerca Clínic Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
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Andreella A, Monasta L, Campostrini S. A novel comorbidity index in Italy based on diseases detected by the surveillance system PASSI and the Global Burden of Diseases disability weights. Popul Health Metr 2023; 21:18. [PMID: 37904213 PMCID: PMC10617130 DOI: 10.1186/s12963-023-00317-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/16/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Understanding comorbidity and its burden characteristics is essential for policymakers and healthcare providers to allocate resources accordingly. However, several definitions of comorbidity burden can be found in the literature. The main reason for these differences lies in the available information about the analyzed diseases (i.e., the target population studied), how to define the burden of diseases, and how to aggregate the occurrence of the detected health conditions. METHODS In this manuscript, we focus on data from the Italian surveillance system PASSI, proposing an index of comorbidity burden based on the disability weights from the Global Burden of Disease (GBD) project. We then analyzed the co-presence of ten non-communicable diseases, weighting their burden thanks to the GBD disability weights extracted by a multi-step procedure. The first step selects a set of GBD weights for each disease detected in PASSI using text mining. The second step utilizes an additional variable from PASSI (i.e., the perceived health variable) to associate a single disability weight for each disease detected in PASSI. Finally, the disability weights are combined to form the comorbidity burden index using three approaches common in the literature. RESULTS The comorbidity index (i.e., combined disability weights) proposed allows an exploration of the magnitude of the comorbidity burden in several Italian sub-populations characterized by different socioeconomic characteristics. Thanks to that, we noted that the level of comorbidity burden is greater in the sub-population characterized by low educational qualifications and economic difficulties than in the rich sub-population characterized by a high level of education. In addition, we found no substantial differences in terms of predictive values of comorbidity burden adopting different approaches in combining the disability weights (i.e., additive, maximum, and multiplicative approaches), making the Italian comorbidity index proposed quite robust and general.
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Affiliation(s)
- Angela Andreella
- Department of Economics, Ca' Foscari University of Venice, Venice, Italy.
| | - Lorenzo Monasta
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
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Lin SM, Yang SC, Wu TI, Wang JD, Liu LF. Estimation of disability free life expectancy in non small cell lung cancer based on real world data. Sci Rep 2023; 13:13318. [PMID: 37587142 PMCID: PMC10432474 DOI: 10.1038/s41598-023-40117-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/04/2023] [Indexed: 08/18/2023] Open
Abstract
To quantify the societal impact of disability in patients with non-small cell lung cancer (NSCLC), this study estimated the disability-free life expectancy (DFLE), loss-of-DFLE and explored their associations with quality-adjusted life expectancy (QALE) and loss-of-QALE. We interlinked national databases and applied a rolling-over algorithm to estimate the lifetime survival function for patients with NSCLC. Using the EuroQOL-5 Dimension (EQ-5D) and Barthel index (BI), we repeatedly measured the quality-of-life and disability functions of NSCLC patients who visited our hospital from 2011 to 2020. Age-, sex-matched referents were simulated from lifetables of the same calendar year of diagnosis. We categorized BI scores ≤ 70 as in need of long-term care and constructed linear mixed models to estimate the utility values and disability scores. We collected 960 cases and 3088 measurements. The proportions of measurements without disability at age 50-64 and in stage I-IIIa, 50-64 and stage IIIb-IV, 65-89 and stage I-IIIa and 65-89 and stage IIIb-IV were 97.3%, 89.3%, 94.8%,78.3%, corresponding to DFLEs of 15.3, 2.4, 6.8, 1.2 years and losses-of-DFLE of 8.1, 20.7, 4.0, 8.6 years, respectively, indicating that advanced stage had a stronger effect than old age. Survivors in advanced stages showed increased demands for assistance in almost all subitems. The DFLEs seemed to be approximate to the QALEs and the latter were shorter than the former due to discomfort and depression. From a societal perspective, future health technology assessment should consider the impact of lifetime duration of functional disability. Early diagnosis of NSCLC may decrease the burden of long-term care.
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Affiliation(s)
- Shin-Mao Lin
- Department of Environmental and Occupational Medicine, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan
| | - Szu-Chun Yang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzu-I Wu
- Department of Environmental and Occupational Medicine, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan
| | - Jung-Der Wang
- Department of Environmental and Occupational Medicine, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan
- Department of Environmental and Occupational Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Li-Fan Liu
- Department of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Geriatric, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng-Li Road, Tainan, 70428, Taiwan.
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Lei S, Zheng R, Zhang S, Huang Y, Qiao L, Song B, He Y, Du L, Wang N, Xi Y, Liu Y, Zhou J, Zhang M, Zheng Y, Zhang Y, Ju W, Wei W. Years lived with disability of cancer in China: findings from disability weights measurement with a focus on the effect of disease burden. Sci Bull (Beijing) 2023; 68:1430-1438. [PMID: 37349162 DOI: 10.1016/j.scib.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/25/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023]
Abstract
Disability weights are crucial for quantifying health loss associated with non-fatal outcomes and were not well assessed in different countries, especially for specific cancer. Therefore, this study aimed to identify disability weights with a focus on specific cancer in a large Chinese population. Two types of web surveys were conducted, and 254 health states, including 30 new states for specific cancer, were investigated using paired comparison methods. The years lived with disability (YLDs) of cancer were calculated as the sum of the prevalence of each sequela of cancer multiplied by its relative disability weight. In total, 44,069 participants were eligible for the disability weights study. The disability weights of 254 health states were estimated. Among those, the disability weights of 18 specific cancer types varied greatly at diagnosis and primary treatment stage, with the value ranging from 0.619 (95% uncertainty interval (UI) 0.606-0.632) for brain cancer to 0.167 (95% UI 0.158-0.176) for oropharyngeal cancer. The discrepancy in YLDs calculated by different disability weights was high, and the largest gap for all cancer combined was approximately 30.14%. When calculated using the cancer-specific disability weights, a total of 1,967,830 (95% UI 1,928,880-2,008,060) YLDs of cancer were recorded in China. The disability weights of cancer varied greatly among cancer types and populations, which had considerable influence on the estimation of the disease burden. Cancer-specific disability weights could provide a more accurate evaluation of the cancer burden.
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Affiliation(s)
- Shaoyuan Lei
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; Department of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Rongshou Zheng
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Shaokai Zhang
- Department of Cancer Epidemiology and Prevention, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - Yunchao Huang
- Yunnan Cancer Center/Yunnan Cancer Hospital, Kunming 650118, China
| | - Liang Qiao
- Department of Cancer Prevention and Control, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610042, China
| | - Bingbing Song
- Institute of Cancer Prevention and Treatment, Harbin Medical University/Institute of Cancer Prevention and Treatment, Heilongjiang Academy of Medical Sciences, Heilongjiang Cancer Centre, Harbin 150081, China
| | - Yutong He
- Department of Cancer Prevention and Control, Hebei Medical University Fourth Hospital, Shijiazhuang 050000, China
| | - Lingbin Du
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310005, China
| | - Ning Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Yunfeng Xi
- The Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention, Hohhot 750306, China
| | - Yuqin Liu
- Cancer Epidemiology Research Center, Gansu Cancer Hospital, Lanzhou 730050, China
| | - Jinyi Zhou
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Min Zhang
- Office of Cancer Prevention and Treatment, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, China
| | - Ying Zheng
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yongzhen Zhang
- Department of Epidemiology, Shanxi Cancer Hospital, Taiyuan 030013, China
| | - Wen Ju
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wenqiang Wei
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
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Liu X, Guo Y, Wang F, Yu Y, Yan Y, Wen H, Shi F, Wang Y, Wang X, Shen H, Li S, Gong Y, Ke S, Zhang W, Jin Q, Zhang G, Wu Y, Zhou M, Yu C. Disability weight measurement for the severity of different diseases in Wuhan, China. Popul Health Metr 2023; 21:5. [PMID: 37143047 PMCID: PMC10157574 DOI: 10.1186/s12963-023-00304-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/16/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Measurement of the Chinese burden of disease with disability-adjusted life-years (DALYs) requires disability weight (DW) that quantify health losses for all non-fatal consequences of disease and injury. The Global Burden of Disease (GBD) 2013 DW study indicates that it is limited by lack of geographic variation in DW data and by the current measurement methodology. We aim to estimate DW for a set of health states from major diseases in the Wuhan population. METHODS We conducted the DW measurement study for 206 health states through a household survey with computer-assisted face-to-face interviews and a web-based survey. Based on GBD 2013 DW study, paired comparison (PC) and Population health equivalence (PHE) method was used and different PC/PHE questions were randomly assigned to each respondent. In statistical analysis, the PC data was analyzed by probit regression. The probit regression results will be anchored by results from the PHE data analyzed by interval regression on the DW scale units between 0 (no loss of health) and 1 (loss equivalent to death). RESULTS A total of 2610 and 3140 individuals were included in the household and web-based survey, respectively. The results from the total pooled data showed health state "mild anemia" (DW = 0.005, 95% UI 0.000-0.027) or "allergic rhinitis (hay fever)" (0.005, 95% UI 0.000-0.029) had the lowest DW and "heroin and other opioid dependence, severe" had the highest DW (0.699, 95% UI 0.579-0.827). A high correlation coefficient (Pearson's r = 0.876; P < 0.001) for DWs of same health states was observed between Wuhan's survey and GBD 2013 DW survey. Health states referred to mental symptom, fatigue, and the residual category of other physical symptoms were statistically significantly associated with a lower Wuhan's DWs than the GBD's DWs. Health states with disfigurement and substance use symptom had a higher DW in Wuhan population than the GBD 2013 study. CONCLUSIONS This set of DWs could be used to calculate local diseases burden for health policy-decision in Wuhan population. The DW differences between the GBD's survey and Wuhan's survey suggest that there might be some contextual or culture factors influencing assessment on the severity of diseases.
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Affiliation(s)
- Xiaoxue Liu
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
- Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Yan Guo
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Fang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, China
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, 442000, Hubei, China
| | - Yaqiong Yan
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Haoyu Wen
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Fang Shi
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Yafeng Wang
- Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Xuyan Wang
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Hui Shen
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Shiyang Li
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Yanyun Gong
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Sisi Ke
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Wei Zhang
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Qiman Jin
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Gang Zhang
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Yu Wu
- Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Nanwei Road 27, Xicheng District, Beijing, 100050, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China.
- Global Health Institute, Wuhan University, Wuhan, 430072, Hubei, China.
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Tisavipat N, Jitpratoom P, Siritho S, Prayoonwiwat N, Apiwattanakul M, Boonyasiri A, Rattanathamsakul N, Jitprapaikulsan J. The epidemiology and burden of neuromyelitis optica spectrum disorder, multiple sclerosis, and MOG antibody-associated disease in a province in Thailand: A population-based study. Mult Scler Relat Disord 2023; 70:104511. [PMID: 36640562 DOI: 10.1016/j.msard.2023.104511] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Central nervous system inflammatory demyelinating diseases (CNSIDDs) have notable interracial heterogeneity. The epidemiology of CNSIDDs in Thailand, a mainland Southeast Asian country, is unknown. OBJECTIVES To determine the cumulative incidence, point prevalence, and disease burden of neuromyelitis optica spectrum disorder (NMOSD) and other CNSIDDs in Thailand using population-based data of Chumphon. METHODS Searching for CNSIDD patients at a public secondary care hospital in Chumphon, the only neurology center in the province, from January 2016 to December 2021 was implemented using relevant ICD-10-CM codes. All diagnoses were individually ascertained by a retrospective chart review. Cumulative incidence, point prevalence, attack rate, mortality rate, and disability-adjusted life years (DALYs) were calculated. RESULTS Aquaporin 4-IgG-positive NMOSD was the most prevalent CNSIDD in the Thai population at 3.08 (1.76-5.38) per 100,000 persons. The prevalence of multiple sclerosis (MS) followed at 0.77 (0.26-2.26) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) at 0.51(0.14-1.87) per 100,000 adults. In the pediatric population, the incidence of acute disseminated encephalomyelitis was 0.28 (0.08-1.02) per 100,000 persons/year. Among other idiopathic demyelinating diseases, idiopathic optic neuritis had the highest incidence at 0.58 (0.24-0.92) per 100,000 persons/year, followed by acute transverse myelitis at 0.44 (0.14-0.74). Idiopathic demyelinating brainstem syndrome was also observed at 0.04 (0.01-0.25) per 100,000 persons/year. Although most had a fair recovery, disability was worst among NMOSD patients with DALYs of 3.61 (3.00-4.36) years per 100,000 persons. Mortality rate was the highest in NMOSD as well. CONCLUSION CNSIDDs are rare diseases in Thailand. The prevalence is comparable to that of East Asian populations. A nationwide CNSIDDs registry would better elaborate the epidemiology of these diseases.
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Affiliation(s)
- Nanthaya Tisavipat
- Siriraj Neuroimmunology Center, Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pornpong Jitpratoom
- Department of Medicine, Chumphon Khet Udomsak Hospital, Chumphon 86000, Thailand
| | - Sasitorn Siritho
- Siriraj Neuroimmunology Center, Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Bumrungrad International Hospital, Bangkok 10110, Thailand
| | - Naraporn Prayoonwiwat
- Siriraj Neuroimmunology Center, Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Metha Apiwattanakul
- Department of Neurology, Neurological Institute of Thailand, Bangkok 10400, Thailand
| | - Adhiratha Boonyasiri
- Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Natthapon Rattanathamsakul
- Siriraj Neuroimmunology Center, Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Jiraporn Jitprapaikulsan
- Siriraj Neuroimmunology Center, Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand; Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
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Wang F, Lui J, Wang JD. Losses of Life Expectancy and Productivity Associated with COVID-19 Pandemic in Canada: Policy Implication for Future Communicable Disease Control. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2419. [PMID: 36767785 PMCID: PMC9916087 DOI: 10.3390/ijerph20032419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
This research examines whether the Coronavirus disease 2019 (COVID-19) did harm to the population's health through comparing the changes in the life expectancy of Canadians with those of Australians over the period from March 2019 to February 2021 by using a difference-in-differences (DID) estimation method. We found that the pandemic did cause differences in life expectancies between Canada and Australia, probably because of different initial control policies for COVID-19. This study uses the indicator of disability-adjusted life years (DALYs) to measure the societal health burden, which was corroborated by estimating temporal productivity loss (TPL) and permanent productivity loss (PPL) based on the human capital approach (HCA) using data from Health Canada. The societal health burden in Canada amounted to 6.493 DALYs per 1000 male persons and 5.316 DALYs per 1000 female persons. The economy's permanent productivity loss was around USD 5.3 billion, while the temporary productivity loss was around USD 3 billion from February 2020 to April 2022. The sum of the above two losses amounted to 0.477% of the GDP in 2019. Swift and decisive decisions at the very early stage of a pandemic can nip contagions in the bud before numbers get out of hand and would be less damaging to people's health and the economy, as seen in Australia, in contrast to what happened in Canada. We thus recommend that such policies plus telecommunication systems in healthcare services be implemented early on to cope with the future outbreak of any emerging infectious diseases such as COVID-19.
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Affiliation(s)
- Fuhmei Wang
- Department of Economics, College of Social Science, National Cheng Kung University, Tainan 704, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Jinwei Lui
- Department of Economics, College of Social Science, National Cheng Kung University, Tainan 704, Taiwan
| | - Jung-Der Wang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
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Burden of infectious disease studies in Europe and the United Kingdom: a review of methodological design choices. Epidemiol Infect 2023; 151:e19. [PMID: 36621004 PMCID: PMC9990389 DOI: 10.1017/s0950268823000031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.
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Disability weights for castration-resistant prostate cancer: an empirical investigation. GLOBAL & REGIONAL HEALTH TECHNOLOGY ASSESSMENT 2022; 9:146-154. [PMID: 36628321 PMCID: PMC9668063 DOI: 10.33393/grhta.2022.2431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/12/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Health state valuation and diagnostic-therapeutic pathways at the junction between non-metastatic and metastatic castration-resistant prostate cancer (CRPC) are not well documented. We aimed at: (i) estimating the disability weights (DWs) for health states across a continuum of disease from asymptomatic non-metastatic (nmCRPC) to symptomatic metastatic state (mCRPC); (ii) mapping the diagnostic-therapeutic pathway of nmCRPC in Italy. Methods Structured qualitative interviews were performed with clinical experts to gather information on nmCRPC clinical pathway. An online survey was administered to clinical experts to estimate DWs for four CRPC health states defined from interviews and literature review (i.e., nmCRPC, asymptomatic mCRPC, symptomatic mCRPC, mCRPC in progression during or after chemotherapy). Clinicians' preferences for health states were elicited using the Person-Trade-Off (PTO) and Visual Analogue Scale (VAS) methods. DWs associated with each health state, from 0 (best imaginable health state) and 1 (worst imaginable health state), were estimated. Results We found that the management of nmCRPC is heterogeneous across Italian regions and hospitals, especially with respect to diagnostic imaging techniques. DWs for PTO ranged from 0.415 (95% confidence interval [CI] 0.208-0.623) in nmCRPC to 0.740 (95% CI 0.560-0.920) in mCRPC, in progression during or after chemotherapy. DWs for VAS ranged between 0.246 (95% CI 0.131-0.361) in nmCRPC to 0.689 (95% CI 0.583-0.795) in mCRPC, in progression during or after chemotherapy. Conclusions Estimated DWs suggest that delaying transition to a metastatic state might ease the disease burden at both patient and societal levels.
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10
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Farmakis IT, Barco S, Mavromanoli AC, Agnelli G, Cohen AT, Giannakoulas G, Mahan CE, Konstantinides SV, Valerio L. Cost-of-Illness Analysis of Long-Term Health Care Resource Use and Disease Burden in Patients With Pulmonary Embolism: Insights From the PREFER in VTE Registry. J Am Heart Assoc 2022; 11:e027514. [PMID: 36250664 DOI: 10.1161/jaha.122.027514] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background As mortality from pulmonary embolism (PE) decreases, the personal and societal costs among survivors are receiving increasing attention. Detailing this burden would support an efficient public health resource allocation. We aimed to provide estimates for the economic and disease burden of PE also accounting for long-term health care use and both direct and indirect costs beyond the acute phase. Methods and Results This is a cost-of-illness analysis with a bottom-up approach based on data from the PREFER in VTE registry (Prevention of Thromboembolic Events-European Registry in Venous Thromboembolism). We calculated direct (clinical events and anticoagulation) and indirect costs (loss of productivity) of an acute PE event and its 12-month follow-up in 2020 Euros. We estimated a disability weight for the 12-month post-PE status and corresponding disability adjusted life years presumably owing to PE. Disease-specific costs in the first year of follow-up after an incident PE case ranged between 9135 Euros and 10 620 Euros. The proportion of indirect costs was 42% to 49% of total costs. Costs were lowest in patients with ongoing cancer, mainly because productivity loss was less evident in this already burdened population. The calculated disability weight for survivors who were cancer free 12 months post-PE was 0.017, and the estimated disability adjusted life years per incident case were 1.17. Conclusions The economic burden imposed by PE to society and affected patients is considerable, and productivity loss is its main driver. The disease burden from PE is remarkable and translates to the loss of roughly 1.2 years of healthy life per incident PE case.
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Affiliation(s)
- Ioannis T Farmakis
- Center for Thrombosis and Hemostasis University Medical Center of the Johannes Gutenberg University Mainz Germany
| | - Stefano Barco
- Center for Thrombosis and Hemostasis University Medical Center of the Johannes Gutenberg University Mainz Germany.,Department of Angiology University Hospital Zurich Zurich Switzerland
| | - Anna C Mavromanoli
- Center for Thrombosis and Hemostasis University Medical Center of the Johannes Gutenberg University Mainz Germany
| | - Giancarlo Agnelli
- Internal Vascular and Emergency Medicine-Stroke Unit University of Perugia Perugia Italy
| | - Alexander T Cohen
- Department of Haematology, Guy's and St Thomas' NHS Foundation Trust King's College London London UK
| | - George Giannakoulas
- Department of Cardiology, AHEPA University Hospital Aristotle University of Thessaloniki Thessaloniki Greece
| | | | - Stavros V Konstantinides
- Center for Thrombosis and Hemostasis University Medical Center of the Johannes Gutenberg University Mainz Germany.,Department of Cardiology Democritus University of Thrace Alexandroupolis Greece
| | - Luca Valerio
- Center for Thrombosis and Hemostasis University Medical Center of the Johannes Gutenberg University Mainz Germany.,Department of Cardiology University Medical Center of the Johannes Gutenberg University Mainz Germany
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11
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Liu X, Wang F, Yu C, Zhou M, Yu Y, Qi J, Yin P, Yu S, Zhou Y, Lin L, Liu Y, Wang Q, Zhong W, Huang S, Li Y, Liu L, Liu Y, Ma F, Zhang Y, Tian Y, Yu Q, Zeng J, Pan J, Zhou M, Kang W, Zhou JY, Yu H, Liu Y, Li S, Yu H, Wang C, Xia T, Xi J, Ren X, Xing X, Cheng Q, Fei F, Wang D, Zhang S, He Y, Wen H, Liu Y, Shi F, Wang Y, Sun P, Bai J, Wang X, Shen H, Ma Y, Yang D, Mubarik S, Cao J, Meng R, Zhang Y, Guo Y, Yan Y, Zhang W, Ke S, Zhang R, Wang D, Zhang T, Nomura S, Hay SI, Salomon JA, Haagsma JA, Murray CJ, Vos T. Eliciting national and subnational sets of disability weights in mainland China: Findings from the Chinese disability weight measurement study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 26:100520. [PMID: 35910433 PMCID: PMC9335373 DOI: 10.1016/j.lanwpc.2022.100520] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
BACKGROUND The 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. METHODS In 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). FINDINGS We 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. INTERPRETATION The 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. FUNDING This 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].
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Affiliation(s)
- Xiaoxue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Fang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou 221004, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
- Global Health Institute, Wuhan University, Wuhan 430072, China
- Corresponding authors.
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
- Corresponding authors.
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan 442000, Hubei, China
| | - Jinlei Qi
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Peng Yin
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Shicheng Yu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuchang Zhou
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Lin Lin
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Yunning Liu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Qiqi Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenling Zhong
- Fujian Provincial Center for Disease Control and Prevention, No. 78 Jintai Road, Gulou District, Fuzhou City 350001, Fujian province, China
| | - Shaofen Huang
- Fujian Provincial Center for Disease Control and Prevention, No. 78 Jintai Road, Gulou District, Fuzhou City 350001, Fujian province, China
| | - Yanxia Li
- Liaoning Provincial Center for Disease Control and Prevention, No. 79 Jixian Street, Heping District, Shenyang City 110005, China
| | - Li Liu
- Liaoning Provincial Center for Disease Control and Prevention, No. 79 Jixian Street, Heping District, Shenyang City 110005, China
| | - Yuan Liu
- Hunan Provincial Center for Disease Control and Prevention, No. 450 first section of Middle Furong Road, Changsha City 410005, Hunan Province, China
| | - Fang Ma
- Ningxia Center for Disease Control and Prevention, No. 528 Shengli Street, Xingqing District, Yinchuan City 750004, Ningxia, China
| | - Yine Zhang
- Ningxia Center for Disease Control and Prevention, No. 528 Shengli Street, Xingqing District, Yinchuan City 750004, Ningxia, China
| | - Yuan Tian
- Ningxia Center for Disease Control and Prevention, No. 528 Shengli Street, Xingqing District, Yinchuan City 750004, Ningxia, China
| | - Qiuli Yu
- Yunnan Center for Disease Control and Prevention, No. 158 Dongsi Street, Xishan District, Kunming City 650022, Yunnan Province, China
| | - Jing Zeng
- Sichuan Center for Disease Control and Prevention, No. 6 Middle School Road, Wuhou District, Chengdu City 610041, Sichuan Province, China
| | - Jingju Pan
- Hubei Provincial Center for Disease Control and Prevention, No. 6 Zhuodaoquan North Road, Hongshan District, Wuhan City 430079, Hubei Province, China
| | - Mengge Zhou
- Hubei Provincial Center for Disease Control and Prevention, No. 6 Zhuodaoquan North Road, Hongshan District, Wuhan City 430079, Hubei Province, China
| | - Weiwei Kang
- Inner Mongolia Integrative Center for Disease Control and Prevention, No. 50 Ordos Street, Hohhot 010031, China
| | - Jin-Yi Zhou
- Jiangsu Provincial Center for disease Control and Prevention, Public Health Research Institute of Jiangsu Province, Jiangsu Road No. 172, Gulou District, Nanjing city 210009, Jiangsu Province, China
| | - Hao Yu
- Jiangsu Provincial Center for disease Control and Prevention, Public Health Research Institute of Jiangsu Province, Jiangsu Road No. 172, Gulou District, Nanjing city 210009, Jiangsu Province, China
| | - Yuehua Liu
- Heilongjiang Provincial Center for Disease Control and Prevention, No. 40 Youfang Street, Xiangfang District, Harbin City 150030, China
| | - Shaofang Li
- Henan Provincial Center for Disease Control and Prevention, No. 105 Nongye South Street, Zhengdong New District, Zhengzhou City 450016, China
| | - Huiting Yu
- Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhongshan West Street, Changning District, Shanghai City 200051, China
| | - Chunfang Wang
- Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhongshan West Street, Changning District, Shanghai City 200051, China
| | - Tian Xia
- Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhongshan West Street, Changning District, Shanghai City 200051, China
| | - Jinen Xi
- Gansu Provincial Center for Disease Control and Prevention, No. 230 Donggang West Street, Chengguan District, Lanzhou City 73000, China
| | - Xiaolan Ren
- Gansu Provincial Center for Disease Control and Prevention, No. 230 Donggang West Street, Chengguan District, Lanzhou City 73000, China
| | - Xiuya Xing
- Anhui Provincial Center for Disease Control and Prevention, No. 12560 Fanhua Avenue, Economic and Technological Development District, Hefei City 230601, China
| | - Qianyao Cheng
- Anhui Provincial Center for Disease Control and Prevention, No. 12560 Fanhua Avenue, Economic and Technological Development District, Hefei City 230601, China
| | - Fangrong Fei
- Zhejiang Provincial Center for Disease Control and Prevention, No. 3399 Binsheng Street, Binjiang District, Hangzhou City 310051, China
| | - Dezheng Wang
- Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Street, Hedong District, Tianjin City 300011, China
| | - Shuang Zhang
- Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Street, Hedong District, Tianjin City 300011, China
| | - Yuling He
- Shanxi Center for Disease Control and Prevention, No. 6 Xiaonanguan Shuangta West Street, Yingze District, Taiyuan City 030012, China
| | - Haoyu Wen
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Yan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Fang Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Yafeng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Panglin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Jianjun Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Xuyan Wang
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Hui Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Yudiyang Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Donghui Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Jinhong Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China
| | - Runtang Meng
- Department of Preventive Medicine, School of Medicine, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Yunquan Zhang
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yan Guo
- Wuhan Centers for Disease Control and Prevention, Wuhan 430024, Hubei, China
| | - Yaqiong Yan
- Wuhan Centers for Disease Control and Prevention, Wuhan 430024, Hubei, China
| | - Wei Zhang
- Wuhan Centers for Disease Control and Prevention, Wuhan 430024, Hubei, China
| | - Sisi Ke
- Wuhan Centers for Disease Control and Prevention, Wuhan 430024, Hubei, China
| | - Runhua Zhang
- Beijing Tiantan Hospital, Capital Medical University Beijing, China
| | - Dingyi Wang
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital; National Center for Respiratory Medicine, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Tingting Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100083, China
| | - Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Japan
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Joshua A. Salomon
- Department of Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Juanita A. Haagsma
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
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12
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Nandi A, Counts N, Chen S, Seligman B, Tortorice D, Vigo D, Bloom DE. Global and regional projections of the economic burden of Alzheimer's disease and related dementias from 2019 to 2050: A value of statistical life approach. EClinicalMedicine 2022; 51:101580. [PMID: 35898316 PMCID: PMC9310134 DOI: 10.1016/j.eclinm.2022.101580] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND The burden of Alzheimer's disease and related dementias (ADRDs) is expected to grow rapidly with population aging, especially in low- and middle-income countries, in the next few decades. We used a willingness-to-pay approach to project the global, regional, and national economic burden of ADRDs from 2019 to 2050 under status quo. METHODS We projected age group and country-specific disability-adjusted life years (DALYs) lost to ADRDs in future years based on historical growth in disease burden and available population projections. We used country-specific extrapolations of the value of a statistical life (VSL) year and its future projections based on historical income growth to estimate the economic burden - measured in terms of the value of lost DALYs - of ADRDs. A probabilistic uncertainty analysis was used to calculate point estimates and 95% uncertainty bounds of the economic burden. FINDINGS In 2019, the global VSL-based economic burden of ADRDs was an estimated $2.8 trillion. The burden was projected to increase to $4.7 trillion (95% uncertainty bound: $4 trillion-$5.5 trillion) in 2030, $8.5 trillion ($6.8 trillion-$10.8 trillion) in 2040, and $16.9 trillion ($11.3 trillion-$27.3 trillion) in 2050. Low- and middle-income countries (LMICs) would account for 65% of the global VSL-based economic burden in 2050, as compared with only 18% in 2019. Within LMICs, upper-middle income countries would carry the largest VSL-based economic burden by 2050 (92% of LMICs burden and 60% of global burden). INTERPRETATION ADRDs have a large and inequitable projected future VSL-based economic burden. FUNDING The Davos Alzheimer's Collaborative.
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Affiliation(s)
- Arindam Nandi
- The Population Council, New York, NY, USA
- One Health Trust, Washington DC, USA
- Corresponding author.
| | - Nathaniel Counts
- Mental Health America, New York, NY, USA
- Albert Einstein Medical College, New York, NY, USA
| | | | - Benjamin Seligman
- Division of Geriatric Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Geriatrics Research, Education, and Clinical Center, Greater Los Angeles VA Health Care System, Los Angeles, CA, USA
| | | | - Daniel Vigo
- University of British Columbia, Vancouver, BC, Canada
| | - David E. Bloom
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
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13
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Charalampous P, Pallari E, Gorasso V, von der Lippe E, Devleesschauwer B, Pires SM, Plass D, Idavain J, Ngwa CH, Noguer I, Padron-Monedero A, Sarmiento R, Majdan M, Ádám B, AlKerwi A, Cilovic-Lagarija S, Clarsen B, Corso B, Cuschieri S, Dopelt K, Economou M, Fischer F, Freitas A, García-González JM, Gazzelloni F, Gkitakou A, Gulmez H, Hynds P, Isola G, Jakobsen LS, Kabir Z, Kissimova-Skarbek K, Knudsen AK, Konar NM, Ladeira C, Lassen B, Liew A, Majer M, Mechili EA, Mereke A, Monasta L, Mondello S, Morgado JN, Nena E, Ng ESW, Niranjan V, Nola IA, O'Caoimh R, Petrou P, Pinheiro V, Ortiz MR, Riva S, Samouda H, Santos JV, Santoso CMA, Milicevic MS, Skempes D, Sousa AC, Speybroeck N, Tozija F, Unim B, Uysal HB, Vaccaro FG, Varga O, Vasic M, Violante FS, Wyper GMA, Polinder S, Haagsma JA. Methodological considerations in injury burden of disease studies across Europe: a systematic literature review. BMC Public Health 2022; 22:1564. [PMID: 35978333 PMCID: PMC9382747 DOI: 10.1186/s12889-022-13925-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background Calculating the disease burden due to injury is complex, as it requires many methodological choices. Until now, an overview of the methodological design choices that have been made in burden of disease (BoD) studies in injury populations is not available. The aim of this systematic literature review was to identify existing injury BoD studies undertaken across Europe and to comprehensively review the methodological design choices and assumption parameters that have been made to calculate years of life lost (YLL) and years lived with disability (YLD) in these studies. Methods We searched EMBASE, MEDLINE, Cochrane Central, Google Scholar, and Web of Science, and the grey literature supplemented by handsearching, for BoD studies. We included injury BoD studies that quantified the BoD expressed in YLL, YLD, and disability-adjusted life years (DALY) in countries within the European Region between early-1990 and mid-2021. Results We retrieved 2,914 results of which 48 performed an injury-specific BoD assessment. Single-country independent and Global Burden of Disease (GBD)-linked injury BoD studies were performed in 11 European countries. Approximately 79% of injury BoD studies reported the BoD by external cause-of-injury. Most independent studies used the incidence-based approach to calculate YLDs. About half of the injury disease burden studies applied disability weights (DWs) developed by the GBD study. Almost all independent injury studies have determined YLL using national life tables. Conclusions Considerable methodological variation across independent injury BoD assessments was observed; differences were mainly apparent in the design choices and assumption parameters towards injury YLD calculations, implementation of DWs, and the choice of life table for YLL calculations. Development and use of guidelines for performing and reporting of injury BoD studies is crucial to enhance transparency and comparability of injury BoD estimates across Europe and beyond. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13925-z.
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Affiliation(s)
- Periklis Charalampous
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Elena Pallari
- Health Innovation Network, Minerva House, Montague Close, London, UK
| | - Vanessa Gorasso
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Sara M Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Dietrich Plass
- Department for Exposure Assessment, and Environmental Health Indicators, German Environment Agency, Berlin, Germany
| | - Jane Idavain
- Department of Health Statistics, National Institute for Health Development, Tallinn, Estonia
| | - Che Henry Ngwa
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Isabel Noguer
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | | | - Rodrigo Sarmiento
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.,Medicine School, University of Applied and Environmental Sciences, Bogota, Colombia
| | - Marek Majdan
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
| | - Balázs Ádám
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ala'a AlKerwi
- Directorate of Health, Service Epidemiology and Statistics, Luxembourg, Luxembourg
| | | | - Benjamin Clarsen
- Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.,Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Barbara Corso
- Institute of Neuroscience, National Research Council, Rome, Italy
| | - Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel.,Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Alberto Freitas
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | | | | | - Artemis Gkitakou
- Department of Internal Medicine and Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Hakan Gulmez
- Department of Family Medicine, Faculty of Medicine, İzmir Democracy University, Izmir, Turkey
| | - Paul Hynds
- Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Lea S Jakobsen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Zubair Kabir
- Public Health & Epidemiology, School of Public Health, University College Cork, Cork, Ireland
| | - Katarzyna Kissimova-Skarbek
- Department of Health Economics and Social Security, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Ann Kristin Knudsen
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Naime Meriç Konar
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey
| | - Carina Ladeira
- H&TRC - Health & Technology Research Center, Escola Superior de Tecnologia da Saúde (ESTeSL), Instituto Politécnico de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Brian Lassen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Aaron Liew
- Clinical Sciences Institute, School of Medicine, National University of Ireland, Galway, Galway City, Ireland
| | - Marjeta Majer
- Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Enkeleint A Mechili
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece.,Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania
| | - Alibek Mereke
- Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Lorenzo Monasta
- Institute of Maternal, Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Joana Nazaré Morgado
- Environmental Health and Nutrition Laboratory, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Evangelia Nena
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Vikram Niranjan
- School of Public Health, Physiotherapy and Sport Sciences, University College Dublin, Dublin, Ireland
| | - Iskra Alexandra Nola
- Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Rónán O'Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, Cork City, Ireland
| | - Panagiotis Petrou
- Pharmacoepidemiology-Pharmacovigilance, Pharmacy School, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
| | - Vera Pinheiro
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Silvia Riva
- Department of Psychology and Pedagogic Science, St Mary's University, London, UK
| | - Hanen Samouda
- Population Health Department, Luxembourg Institute of Health, Nutrition and Health Research Group, Luxembourg, Luxembourg
| | - João Vasco Santos
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.,Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Lisbon, Portugal
| | | | | | | | - Ana Catarina Sousa
- Department of Biology, School of Science and Technology, University of Évora, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | - Niko Speybroeck
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Fimka Tozija
- Institute of Public Health of Republic of North Macedonia, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia.,Faculty of Medicine, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore Di Sanità, Rome, Italy
| | - Hilal Bektaş Uysal
- Department of Internal Medicine, Adnan Menderes University School of Medicine, Aydin, Turkey
| | | | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Milena Vasic
- Faculty of Dentistry Pancevo, University Business Academy in Novi Sad, Pancevo, Serbia.,Institute of Public Health of Serbia Dr Milan Jovanović Batut, Belgrade, Serbia
| | - Francesco Saverio Violante
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.,Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Grant M A Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland, UK
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Larkins A, Bruce M, Di Bari C, Devleesschauwer B, Pigott DM, Ash A. A scoping review of burden of disease studies estimating disability-adjusted life years due to Taenia solium. PLoS Negl Trop Dis 2022; 16:e0010567. [PMID: 35793356 PMCID: PMC9292123 DOI: 10.1371/journal.pntd.0010567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/18/2022] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Taenia solium is the most significant global foodborne parasite and the leading cause of preventable human epilepsy in low and middle-income countries in the form of neurocysticercosis.
Objectives
This scoping review aimed to examine the methodology of peer-reviewed studies that estimate the burden of T. solium using disability-adjusted life years.
Eligibility criteria
Studies must have calculated disability-adjusted life years relating to T. solium.
Charting methods
The review process was managed by a single reviewer using Rayyan. Published data relating to disease models, data sources, disability-adjusted life years, sensitivity, uncertainty, missing data, and key limitations were collected.
Results
15 studies were included for review, with seven global and eight national or sub-national estimates. Studies primarily employed attributional disease models that relied on measuring the occurrence of epilepsy before applying an attributable fraction to estimate the occurrence of neurocysticercosis-associated epilepsy. This method relies heavily on the extrapolation of observational studies across populations and time periods; however, it is currently required due to the difficulties in diagnosing neurocysticercosis. Studies discussed that a lack of data was a key limitation and their results likely underestimate the true burden of T. solium. Methods to calculate disability-adjusted life years varied across studies with differences in approaches to time discounting, age weighting, years of life lost, and years of life lived with disability. Such differences limit the ability to compare estimates between studies.
Conclusions
This review illustrates the complexities associated with T. solium burden of disease studies and highlights the potential need for a burden of disease reporting framework. The burden of T. solium is likely underestimated due to the challenges in diagnosing neurocysticercosis and a lack of available data. Advancement in diagnostics, further observational studies, and new approaches to parameterising disease models are required if estimates are to improve.
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Affiliation(s)
- Andrew Larkins
- Global Burden of Animal Diseases Programme https://animalhealthmetrics.org
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Australia
- School of Veterinary Medicine, Murdoch University, Perth, Australia
- * E-mail:
| | - Mieghan Bruce
- Global Burden of Animal Diseases Programme https://animalhealthmetrics.org
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Australia
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Carlotta Di Bari
- Global Burden of Animal Diseases Programme https://animalhealthmetrics.org
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Brecht Devleesschauwer
- Global Burden of Animal Diseases Programme https://animalhealthmetrics.org
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - David M. Pigott
- Global Burden of Animal Diseases Programme https://animalhealthmetrics.org
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Amanda Ash
- Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, Perth, Australia
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15
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Liang LY, Tsai MC, Shih KC, Huang SM, Morisky DE, Fu E. Tooth life expectancy and burden of tooth loss: Two cross-sectional studies in Taiwan. J Dent Sci 2022; 17:1364-1370. [PMID: 35784138 PMCID: PMC9236957 DOI: 10.1016/j.jds.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/04/2022] [Indexed: 11/27/2022] Open
Abstract
Background/purpose Materials and methods Results Conclusion
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16
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Charalampous P, Polinder S, Wothge J, von der Lippe E, Haagsma JA. A systematic literature review of disability weights measurement studies: evolution of methodological choices. Arch Public Health 2022; 80:91. [PMID: 35331325 PMCID: PMC8944058 DOI: 10.1186/s13690-022-00860-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/18/2022] [Indexed: 12/13/2022] Open
Abstract
Background The 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. Methods A 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. Results Forty-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. Conclusions Our 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. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00860-z.
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Affiliation(s)
- Periklis Charalampous
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Jördis Wothge
- German Environment Agency, Section Noise Abatement of Industrial Plants and Products, Noise Impact, Wörlitzer Pl. 1, 06844, Dessau-Roßlau, Germany
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitorin, Robert Koch Institute, Berlin, Germany
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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17
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Herrman H, Patel V, Kieling C, Berk M, Buchweitz C, Cuijpers P, Furukawa TA, Kessler RC, Kohrt BA, Maj M, McGorry P, Reynolds CF, Weissman MM, Chibanda D, Dowrick C, Howard LM, Hoven CW, Knapp M, Mayberg HS, Penninx BWJH, Xiao S, Trivedi M, Uher R, Vijayakumar L, Wolpert M. Time for united action on depression: a Lancet-World Psychiatric Association Commission. Lancet 2022; 399:957-1022. [PMID: 35180424 DOI: 10.1016/s0140-6736(21)02141-3] [Citation(s) in RCA: 276] [Impact Index Per Article: 138.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Sangath, Goa, India; Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Michael Berk
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | - Claudia Buchweitz
- Graduate Program in Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Mario Maj
- Department of Psychiatry, University of Campania L Vanvitelli, Naples, Italy
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Myrna M Weissman
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Dixon Chibanda
- Department of Psychiatry, University of Zimbabwe, Harare, Zimbabwe; Centre for Global Mental Health, The London School of Hygiene and Tropical Medicine, London, UK
| | - Christopher Dowrick
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Louise M Howard
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christina W Hoven
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Shuiyuan Xiao
- Central South University Xiangya School of Public Health, Changsha, China
| | - Madhukar Trivedi
- Peter O'Donnell Jr Brain Institute and the Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Lakshmi Vijayakumar
- Sneha, Suicide Prevention Centre and Voluntary Health Services, Chennai, India
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18
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Fink G, Tediosi F, Felder S. Burden of Covid-19 restrictions: National, regional and global estimates. EClinicalMedicine 2022; 45:101305. [PMID: 35224471 PMCID: PMC8856030 DOI: 10.1016/j.eclinm.2022.101305] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/13/2022] [Accepted: 01/28/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND A growing literature has documented the high global morbidity, mortality and mental health burden associated with the current Covid-19 pandemic. In this paper, we aimed to quantify the total utility and quality of life loss resulting from Covid-19-related government restrictions imposed at the national, regional and global levels. METHODS We conducted quality of life online surveys in France, India, Italy, UK and the United States of America between June 21st and September 13th 2021, and used regression models to estimate the average quality of life loss due to light and severe restrictions in these countries. We then combined estimated disutility weights from the pooled sample with the latest data on Covid-19 restrictions exposure in each country to estimate the total disutility generated by restrictions at the national, regional and global level. We also embedded a discrete choice experiment (DCE) into the online survey to estimate average willingness to pay to avoid specific restrictions. FINDINGS A total of 947 surveys were completed. Thirty-five percent of respondents were female, and 69.5% were between 18 and 39 years old. The weighted average utility weight was 0.71 (95% CIs 0.69-0.74) for light restrictions, and 0.65 (0.63-0.68) for severe restrictions. At the global scale, this implies a total loss of 3259 million QALYs (95% 3021, 3496) as of September 6th, 2021, with the highest burden in lower and upper middle-income countries. Utility losses appear to be particularly large for closures of schools and daycares as well as restaurants and bars, and seem relatively small for wearing masks and travel restrictions. INTERPRETATION The results presented here suggest that the QALY losses due to restrictions are substantial. Future mitigation strategies should try to balance potential reductions in disease transmission achievable through specific measures against their respective impact on quality of life. Additional research is needed to determine differences in restriction-specific disutilities across countries, and to determine optimal policy responses to similar future disease threats. FUNDING No funding was received for this project.
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Affiliation(s)
- Günther Fink
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Business and Economics, University of Basel, Basel, Switzerland
- Corresponding author at: Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland.
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- University of Basel, Switzerland
| | - Stefan Felder
- Faculty of Business and Economics, University of Basel, Basel, Switzerland
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19
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Karamagi HC, Berhane A, Ngusbrhan Kidane S, Nyawira L, Ani-Amponsah M, Nyanjau L, Maoulana K, Seydi ABW, Nzinga J, Dangou JM, Nkurunziza T, K Bisoborwa G, Sillah JS, W Muriithi A, Nirina Razakasoa H, Bigirimana F. High impact health service interventions for attainment of UHC in Africa: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000945. [PMID: 36962639 PMCID: PMC10021619 DOI: 10.1371/journal.pgph.0000945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022]
Abstract
African countries have prioritized the attainment of targets relating to Universal Health Coverage (UHC), Health Security (HSE) and Coverage of Health Determinants (CHD)to attain their health goals. Given resource constraints, it is important to prioritize implementation of health service interventions with the highest impact. This is important to be identified across age cohorts and public health functions of health promotion, disease prevention, diagnostics, curative, rehabilitative and palliative interventions. We therefore explored the published evidence on the effectiveness of existing health service interventions addressing the diseases and conditions of concern in the Africa Region, for each age cohort and the public health functions. Six public health and economic evaluation databases, reports and grey literature were searched. A total of 151 studies and 357 interventions were identified across different health program areas, public health functions and age cohorts. Of the studies, most were carried out in the African region (43.5%), on communicable diseases (50.6%), and non-communicable diseases (36.4%). Majority of interventions are domiciled in the health promotion, disease prevention and curative functions, covering all age cohorts though the elderly cohort was least represented. Neonatal and communicable conditions dominated disease burden in the early years of life and non-communicable conditions in the later years. A menu of health interventions that are most effective at averting disease and conditions of concern across life course in the African region is therefore consolidated. These represent a comprehensive evidence-based set of interventions for prioritization by decision makers to attain desired health goals. At a country level, we also identify principles for identifying priority interventions, being the targeting of higher implementation coverage of existing interventions, combining interventions across all the public health functions-not focusing on a few functions, provision of subsidies or free interventions and prioritizing early identification of high-risk populations and communities represent these principles.
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Affiliation(s)
- Humphrey Cyprian Karamagi
- Data Analytics and Knowledge Management, World Health Organization (WHO) Regional Office for Africa, Brazzaville, Republic of Congo
| | - Araia Berhane
- Conmmunicable Diseases Control Division, Ministry of Health, Asmara, Eritrea
| | - Solyana Ngusbrhan Kidane
- Data Analytics and Knowledge Management, World Health Organization (WHO) Regional Office for Africa, Brazzaville, Republic of Congo
| | - Lizah Nyawira
- Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | | | | | - Koulthoume Maoulana
- Ministry of Health, Solidarity, Social Protection and Gender Promotion, Moroni, Comoros
| | - Aminata Binetou Wahebine Seydi
- Data Analytics and Knowledge Management, World Health Organization (WHO) Regional Office for Africa, Brazzaville, Republic of Congo
| | - Jacinta Nzinga
- Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
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20
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Opio CK, Kazibwe F, Rejani L, Kabatereine NB, Ocama P. Hepatic schistosomiasis, upper gastrointestinal bleeding, and health related quality of life measurements from the Albert Nile Basin. J Patient Rep Outcomes 2021; 5:112. [PMID: 34718894 PMCID: PMC8557235 DOI: 10.1186/s41687-021-00389-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 10/17/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Health related quality of life measurements are vital elements of public health surveillance that uncover unmet health needs and predict the success of health interventions. We described health related quality of life measurements using the EuroQoL 5-dimension (EQ-VAS/EQ-5D) instrument and associated factors among patients with upper gastrointestinal bleeding (UGIB) and hepatic schistosomiasis at a rural health facility in the Albert Nile Basin, Uganda. METHODS AND MATERIALS This was a cross-sectional study at Pakwach Health Centre IV. Participants included adult inpatients and outpatients with a history of UGIB and ultrasound evidence of hepatic schistosomiasis. We evaluated and recorded each participant's medical history, physical examination, laboratory tests results, ultrasound results, and endoscopy findings. We also recorded health related quality of life measurements using the EuroQoL 5-dimension instrument and derived disability weights from EQ-VAS and EQ-5D measurements. These were our dependent variables. Descriptive and inferential statistics were generated summarizing our findings. RESULTS We found 103 participants had a history of upper gastrointestinal bleeding and hepatosplenic schistosomiasis. Sixty percent were between the ages of 30-49 years, 59% were females, 74% were farmers, 92% had splenomegaly, 88% had varices at endoscopy, 22% were medical emergencies with acute variceal upper gastrointestinal bleeding, and 62% had anemia. Measures of the different dimensions of health from 101 participants with patient reported outcomes revealed 77 (76%) participants experienced problems in self-care, 89 (88%) participants reported anxiety or depression, and 89 (88%) participants experienced pain or discomfort. The median EQ-VAS derived disability weights and median EQ-5D index-derived disability weights were 0.3 and 0.34, respectively. Acute upper gastrointestinal bleeding, praziquantel drug treatment, and age by decade predicted higher EQ-VAS derived disability weights (p value < 0.05). Under weight (Body mass index ≤ 18.5), acute upper gastrointestinal bleeding, ascites, age by decade, female gender, and praziquantel drug treatment predicted higher EQ-5D index- derived disability weights (p value < 0.05). CONCLUSION Adult patients with upper gastrointestinal bleeding and hepatic schistosomiasis from this primary health facility experience poor health and considerable health loss. Several factors predicted increased health loss. These factors probably represent key areas of health intervention towards mitigating increased health loss in this population.
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Affiliation(s)
- Christopher K. Opio
- Aga Khan University Hospital, 3rd Parkland Avenue, PO Box 30270-00100, Nairobi, Kenya
| | - Francis Kazibwe
- Public Health Department, Bishop Stuart University, PO Box 9, Mbarara, Uganda
| | - Lalitha Rejani
- Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda
| | | | - Ponsiano Ocama
- Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda
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21
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Nomura S, Yamamoto Y, Yoneoka D, Haagsma JA, Salomon JA, Ueda P, Mori R, Santomauro D, Vos T, Shibuya K. How do Japanese rate the severity of different diseases and injuries?-an assessment of disability weights for 231 health states by 37,318 Japanese respondents. Popul Health Metr 2021; 19:21. [PMID: 33892742 PMCID: PMC8063365 DOI: 10.1186/s12963-021-00253-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 04/08/2021] [Indexed: 12/03/2022] Open
Abstract
Background Disability weights (DWs) are weight factors that reflect the severity of health states for estimates of disability-adjusted life years. A new set of global DWs was published for the Global Burden of Diseases and Injuries (GBD) 2013 study, which relied on sampling from various world regions, but included little data for countries in East Asia. This study aimed to measure DWs in Japan using comparable methods, and compare the results with previous estimates from the GBD 2013 DW study. Methods We conducted a web-based survey in 2019 to estimate DWs for 231 health states for the Japanese population. The survey included five new health states but otherwise followed the method of the GBD DW measurement study. The survey consisted of 15 paired comparison (PC) questions and 3 population health equivalence questions (PHE) per respondent. We analyzed PC data using probit regression and rescaled results to DW units between 0 (equivalent to full health) and 1 (equivalent to death). Findings We considered 37,318 nationally representative respondents. The values of the resulting DWs ranged from 0.707 (95% uncertainty interval (UI) 0.527–0.842) for spinal cord injury at neck level (untreated) to 0.004 (UI 0.001–0.009) for mild anemia. High correlation between Japanese DW and GBD 2013 DW was observed, but there was considerable disagreement. Out of 226 comparable health states, 55 (24.3%) showed more than a factor-of-two difference, of which 41 (74.6%) had a higher value in Japanese DW. Many of the health states with higher DW in the Japan study were injuries, including amputation and fracture, and hearing and vision loss, while mental, behavioral, and substance use disorders generally tended to be lower. Conclusions This study has created an empirical basis for assessment of Japanese DWs of health status. The findings from this study based on the Japanese population suggest that there might be contextual differences in rating the severity of health states compared to previous surveys conducted elsewhere. Supplementary Information The online version contains supplementary material available at 10.1186/s12963-021-00253-4.
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Affiliation(s)
- Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan. .,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | | | - Daisuke Yoneoka
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Division of Biostatistics and Bioinformatics, Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Joshua A Salomon
- Center for Primary Care and Outcomes Research, Stanford University School of Medicine, California, USA
| | - Peter Ueda
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Rintaro Mori
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Damian Santomauro
- School of Public Health, The University of Queensland, Queensland, Australia.,Queensland Centre for Mental Health Research, Queensland, Australia.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Kenji Shibuya
- Institute for Population Health, King's College London, London, UK
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Dixon MA, Winskill P, Harrison WE, Basáñez MG. Taenia solium taeniasis/cysticercosis: From parasite biology and immunology to diagnosis and control. ADVANCES IN PARASITOLOGY 2021; 112:133-217. [PMID: 34024358 DOI: 10.1016/bs.apar.2021.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Infection with the pork tapeworm (Taenia solium) is responsible for a substantial global burden of disease, not only restricted to its impact on human health, but also resulting in a considerable economic burden to smallholder pig farmers due to pig cysticercosis infection. The life-cycle, parasitology and immunology of T. solium are complex, involving pigs (the intermediate host, harbouring the larval metacestode stage), humans (the definitive host, harbouring the adult tapeworm, in addition to acting as accidental intermediate hosts) and the environment (the source of infection with eggs/proglottids). We review the parasitology, immunology, and epidemiology of the infection associated with each of the T. solium life-cycle stages, including the pre-adult/adult tapeworm responsible for human taeniasis; post-oncosphere and cysticercus associated with porcine and human cysticercosis, and the biological characteristics of eggs in the environment. We discuss the burden associated, in endemic settings, with neurocysticercosis (NCC) in humans, and the broader cross-sectoral economic impact associated both with NCC and porcine cysticercosis, the latter impacting food-value chains. Existing tools for diagnostics and control interventions that target different stages of the T. solium transmission cycle are reviewed and their limitations discussed. Currently, no national T. solium control programmes have been established in endemic areas, with further work required to identify optimal strategies according to epidemiological setting. There is increasing evidence suggesting that cross-sectoral interventions which target the parasite in both the human and pig host provide the most effective approaches for achieving control and ultimately elimination. We discuss future avenues for research on T. solium to support the attainment of the goals proposed in the revised World Health Organisation neglected tropical diseases roadmap for 2021-2030 adopted at the 73rd World Health Assembly in November 2020.
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Affiliation(s)
- Matthew A Dixon
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom; Schistosomiasis Control Initiative Foundation (SCI Foundation), London, United Kingdom
| | - Peter Winskill
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Wendy E Harrison
- Schistosomiasis Control Initiative Foundation (SCI Foundation), London, United Kingdom
| | - Maria-Gloria Basáñez
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.
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Peterson A, Aas S, Wasserman D. What Justifies the Allocation of Health Care Resources to Patients with Disorders of Consciousness? AJOB Neurosci 2021; 12:127-139. [PMID: 33787458 DOI: 10.1080/21507740.2021.1896594] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This paper critically engages ethical issues in the allocation of novel, and potentially costly, health care resources to patients with disorders of consciousness. First, we review potential benefits of novel health care resources for patients and their families and outline preliminary considerations to address concerns about cost. We then address two problems regarding the allocation of health care resources to patients with disorders of consciousness: (1) the problem of uncertain moral status; and (2) the problem of accurately measuring the welfare burdens these resources would relieve. We conclude by suggesting that opportunity-based frameworks might complement standard approaches for justifying resources allocation to patients with disorders of consciousness.
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Affiliation(s)
- Andrew Peterson
- Institute for Philosophy and Public Policy, George Mason University
| | - Sean Aas
- Kennedy Institute of Ethics, Georgetown University
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24
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Nanjan Chandran SL, Tiwari A, Lustosa AA, Demir B, Bowers B, Albuquerque RGR, Prado RBR, Lambert S, Watanabe H, Haagsma J, Richardus JH. Revised estimates of leprosy disability weights for assessing the global burden of disease: A systematic review and individual patient data meta-analysis. PLoS Negl Trop Dis 2021; 15:e0009209. [PMID: 33651814 PMCID: PMC7954345 DOI: 10.1371/journal.pntd.0009209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/12/2021] [Accepted: 02/05/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Leprosy 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 FINDINGS The 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/SIGNIFICANCE The 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.
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Affiliation(s)
- Shri Lak Nanjan Chandran
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anuj Tiwari
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Betul Demir
- Department of Dermatology, Firat University Hospital, Elazig, Turkey
| | - Bob Bowers
- The Leprosy Mission International- Bangladesh, Dhaka, Bangladesh
| | | | | | - Saba Lambert
- Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Juanita Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- * E-mail:
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von der Lippe E, Devleesschauwer B, Gourley M, Haagsma J, Hilderink H, Porst M, Wengler A, Wyper G, Grant I. Reflections on key methodological decisions in national burden of disease assessments. Arch Public Health 2020; 78:137. [PMID: 33384020 PMCID: PMC7774238 DOI: 10.1186/s13690-020-00519-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/08/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Summary measures of population health are increasingly used in different public health reporting systems for setting priorities for health care and social service delivery and planning. Disability-adjusted life years (DALYs) are one of the most commonly used health gap summary measures in the field of public health and have become the key metric for quantifying burden of disease (BoD). BoD methodology is, however, complex and highly data demanding, requiring a substantial capacity to apply, which has led to major disparities across researchers and nations in their resources to perform themselves BoD studies and interpret the soundness of available estimates produced by the Global Burden of Disease Study. METHODS BoD researchers from the COST Action European Burden of Disease network reflect on the most important methodological choices to be made when estimating DALYs. The paper provides an overview of eleven methodological decisions and challenges drawing on the experiences of countries working with BoD methodology in their own national studies. Each of these steps are briefly described and, where appropriate, some examples are provided from different BoD studies across the world. RESULTS In this review article we have identified some of the key methodological choices and challenges that are important to understand when calculating BoD metrics. We have provided examples from different BoD studies that have developed their own strategies in data usage and implementation of statistical methods in the production of BoD estimates. CONCLUSIONS With the increase in national BoD studies developing their own strategies in data usage and implementation of statistical methods in the production of BoD estimates, there is a pressing need for equitable capacity building on the one hand, and harmonization of methods on the other hand. In response to these issues, several BoD networks have emerged in the European region that bring together expertise across different domains and professional backgrounds. An intensive exchange in the experience of the researchers in the different countries will enable the understanding of the methods and the interpretation of the results from the local authorities who can effectively integrate the BoD estimates in public health policies, intervention and prevention programs.
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Affiliation(s)
- Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | | | - Michelle Gourley
- Indigenous Data Analysis and Reporting Unit, Australian Institute of Health and Welfare, Canberra, Australia
| | - Juanita Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Henk Hilderink
- Centre for Public Health Forecasting, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Michael Porst
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Annelene Wengler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Grant Wyper
- Public Health Scotland, Edinburgh, Scotland, UK
| | - Ian Grant
- Public Health Scotland, Edinburgh, Scotland, UK
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Harris JA, Ritchie CA, Hanna GJ, McCain JP, Ji YD. The Inequitable Global Burden of Lip and Oral Cancers: Widening Disparities Across Countries. J Oral Maxillofac Surg 2020; 79:1364-1372. [PMID: 33497647 DOI: 10.1016/j.joms.2020.12.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE In light of continued innovation in cancer immunotherapy regimens and surgical management, no studies currently exist assessing the effect of these advances on global disparities in lip and oral cavity cancer disease burden. The purpose of this study is to characterize longitudinal trends in disease burden caused by lip and oral cavity cancers globally. MATERIALS AND METHODS This retrospective, longitudinal cohort study extracted data on lip and oral cavity cancer disease burden from The Global Health Data Exchange for 1990-2017. The primary predictor variable was country human development index (HDI). The primary outcome variable was disease burden, measured by age-standardized disability-adjusted life years (DALYs) per 100,000 population, listed for each individual country. Additional variables assessed include country-level data on alcohol consumption and tobacco smoking. Concentration indices were also calculated. Mann-Whitney U and Kruskal-Wallis one-way analysis of variance tests with Bonferroni correction were utilized with a significance threshold of 0.008. RESULTS A total of 185 countries met inclusion criteria. Global age-standardized DALYs increased from 44.5 ± 35.7 to 51.1 ± 41.1 from 1990 to 2017. High HDI and medium HDI countries showed a +37.6% and +22.4% median increase in DALYs, respectively, which is significantly greater than very-high HDI (+3.8%) and low HDI countries (-0.5%) (P < .001). The concentration index for lip and oral cavity cancer became increasingly negative from -0.064 to -0.077 from 1990 to 2015. In 2017, disease burden was concentrated in South Asia and Eastern Europe. CONCLUSIONS High and medium HDI countries experienced a disproportionate growth in lip and oral cavity cancer disease burden. These findings may have resulted from increased life expectancy among these countries. Global and public health policy initiatives should focus on understanding the mechanisms driving these disparities with the goal of reducing disease burden globally.
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Affiliation(s)
- Jack A Harris
- DMD Candidate, Harvard School of Dental Medicine, Boston, MA.
| | | | - Glenn J Hanna
- Assistant Professor of Medicine, Department of Medical Oncology, Center for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA; and Assistant Professor of Medicine, Harvard Medical School, Boston, MA
| | - Joseph P McCain
- Associate Professor of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA
| | - Yisi D Ji
- MD Candidate, Harvard Medical School, Boston, MA
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Mohtashami S, Safa N, Guadagno E, Baird R, Poenaru D. Derivation of a complication burden score based on disability-adjusted life years to assess patient burden following surgery: a pilot study. Can J Surg 2020. [PMID: 33155974 DOI: 10.1503/cjs.004819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Comparing adverse outcomes following alternative surgical interventions is a complex process for both patients and providers. Disability-adjusted life years (DALYs) are used globally as a quantitative indicator of burden of disease. However, DALYs have not been applied to the burden of postoperative complications. This study explores the feasibility and utility of DALYs in measuring the burden of postoperative complications, using 2 pediatric surgical procedures as a test model. METHODS A literature review was undertaken of postoperative complications following pediatric inguinal hernia repair and intestinal atresia repair. Relevant studies were included, and incidence rates and durations of all key complications were identified. Using existing disability weights of equivalent health states to the complications, we estimated the burden in DALYs of each complication. These estimates were combined into a unitary procedure-specific complication burden score. RESULTS The key complications contributing to the postoperative burden following inguinal hernia repair were recurrence (0.016 DALYs), hydrocele (0.010), metachronous hernia (0.014) and port-site hernia (0.012). In the case of intestinal atresia repair, death (6.278), reoperation (12.100), stenosis (5.025) and anastomotic stricture (5.327) accounted for most of the postoperative DALYs. The complication burden score was 0.06 DALYs for inguinal hernia and 36.86 for intestinal atresia repair. CONCLUSION As a proof of concept, this study supports the feasibility of using DALYs to derive a complication burden score following surgical intervention, and to our knowledge it represents the first application of burden of disease metrics to postoperative adverse outcomes. Future studies should focus on deriving de novo disability weights for common postoperative complications and adverse outcomes.
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Affiliation(s)
- Sadaf Mohtashami
- From the Harvey E. Beardmore Division of Pediatric Surgery, Montreal Children's Hospital, McGill University Health Centre, Montréal, Que. (Mohtashami, Safa, Guadagno, Poenaru); and the Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, B.C. (Baird)
| | - Nadia Safa
- From the Harvey E. Beardmore Division of Pediatric Surgery, Montreal Children's Hospital, McGill University Health Centre, Montréal, Que. (Mohtashami, Safa, Guadagno, Poenaru); and the Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, B.C. (Baird)
| | - Elena Guadagno
- From the Harvey E. Beardmore Division of Pediatric Surgery, Montreal Children's Hospital, McGill University Health Centre, Montréal, Que. (Mohtashami, Safa, Guadagno, Poenaru); and the Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, B.C. (Baird)
| | - Robert Baird
- From the Harvey E. Beardmore Division of Pediatric Surgery, Montreal Children's Hospital, McGill University Health Centre, Montréal, Que. (Mohtashami, Safa, Guadagno, Poenaru); and the Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, B.C. (Baird)
| | - Dan Poenaru
- From the Harvey E. Beardmore Division of Pediatric Surgery, Montreal Children's Hospital, McGill University Health Centre, Montréal, Que. (Mohtashami, Safa, Guadagno, Poenaru); and the Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, B.C. (Baird)
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Kim YE, Jo MW, Park H, Oh IH, Yoon SJ, Pyo J, Ock M. Updating Disability Weights for Measurement of Healthy Life Expectancy and Disability-adjusted Life Year in Korea. J Korean Med Sci 2020; 35:e219. [PMID: 32657086 PMCID: PMC7358061 DOI: 10.3346/jkms.2020.35.e219] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/21/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The present study aimed to update the methodology to estimate cause-specific disability weight (DW) for the calculation of disability adjusted life year (DALY) and health-adjusted life expectancy (HALE) based on the opinion of medical professional experts. Furthermore, the study also aimed to compare and assess the size of DW according to two analytical methods and estimate the most valid DW from the perspective of years lost due to disability and HALE estimation. METHODS A self-administered web-based survey was conducted ranking five causes of disease. A total of 901 participants started the survey and response data of 806 participants were used in the analyses. In the process of rescaling predicted probability to DW on a scale from 0 to 1, two models were used for two groups: Group 1 (physicians and medical students) and Group 2 (nurses and oriental medical doctors). In Model 1, predicted probabilities were rescaled according to the normal distribution of DWs. In Model 2, the natural logarithms of predicted probabilities were rescaled according to the asymmetric distribution of DWs. RESULTS We estimated DWs for a total of 313 causes of disease in each model and group. The mean of DWs according to the models in each group was 0.490 (Model 1 in Group 1), 0.378 (Model 2 in Group 1), 0.506 (Model 1 in Group 2), and 0.459 (Model 2 in Group 2), respectively. About two-thirds of the causes of disease had DWs of 0.2 to 0.4 in Model 2 in Group 1. In Group 2, but not in Group 1, there were some cases where the DWs had a reversed order of severity. CONCLUSION We attempted to calculate DWs of 313 causes of disease based on the opinions of various types of medical professionals using the previous analysis methods as well as the revised analysis method. The DWs from this study can be used to accurately estimate DALY and health life expectancy, such as HALE, in the Korean population.
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Affiliation(s)
- Young Eun Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Big Data Department, National Health Insurance Service, Wonju, Korea
| | - Min Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - In Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seok Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jeehee Pyo
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Minsu Ock
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
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Spronk I, Haagsma JA, Edgar DW, van Baar ME, Polinder S, Wood FM. Comparison of three different methods to estimate the burden of disease of burn injuries in Western Australia in 2011-2018. Burns 2020; 46:1424-1431. [PMID: 32593481 DOI: 10.1016/j.burns.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/25/2019] [Accepted: 12/03/2019] [Indexed: 10/24/2022]
Abstract
BACKGROUND Priority setting and resource allocation in health care, surveillance and interventions is based increasingly on burden of disease. Several methods exist to calculate the non-fatal burden of disease of burns expressed in years lived with disability (YLDs). The aim of this study was to assess the burden of disease due to burns in Western Australia 2011-2018 and compare YLD outcomes between three existing methods. METHODS Data from the Burns Service of Western Australia was used. Three existing methods to assess YLDs were compared: the Global Burden of Disease (GBD) method, a method dedicated to assess injury YLDs (Injury-VIBES), and a method dedicated to assess burns YLDs (INTEGRIS-burns). RESULTS Incidence data from 2,866 burn patients were used. Non-fatal burden of disease estimates differed substantially between the different methods. Estimates for 2011-2018 ranged between 610 and 1,085 YLDs per 100.000 based on the Injury-VIBES method; between 209 and 324 YLDs based on the INTEGRIS-burns method; and between 89 and 120 YLDs based on the GBD method. YLDs per case were three to nine times higher when the Injury-VIBES method was applied compared to the other methods. Also trends in time differed widely through application of the different methods. There was a strong increase in YLDs over the years when the Injury-VIBES method was applied, a slight increase when the INTEGRIS-burns method was applied and a stable pattern when the GBD method was applied. CONCLUSION This study showed that the choice for a specific method heavily influences the non-fatal burden of disease expressed in YLDs, both in terms of annual estimates as well as in trends over time. By addressing the methodological limitations evident in previously published calculations of the non-fatal burden of disease, the INTEGRIS-burns seems to present a method to provide the most robust estimates to date, as it is the only method adapted to the nature of burn injuries and their recovery.
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Affiliation(s)
- Inge Spronk
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The Netherlands; Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
| | - Juanita A Haagsma
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The Netherlands
| | - Dale W Edgar
- State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Burn Injury Research Node, The University of Notre Dame, Western Australia, Australia; Fiona Wood Foundation, Murdoch, Western Australia, Australia.
| | - Margriet E van Baar
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The Netherlands; Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, The Netherlands
| | - Suzanne Polinder
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The Netherlands
| | - Fiona M Wood
- State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Fiona Wood Foundation, Murdoch, Western Australia, Australia
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Seuc AH, Fernandez-Gonzalez L, Mirabal M. Comparative Disease Assessment: a multi-causal approach for estimating the burden of mortality. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-020-01340-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract
Background
The Comparative Risk Assessment (CRA) framework comprehensively evaluates the impact of exposure to risk factors on health populations using the counterfactual causal approach.
Methods
We propose a framework, Comparative Disease Assessment (CDA), for assessing the impact of exposure to morbidity from some diseases on health outcomes, particularly death from other (relevant) diseases. This framework has been developed following the ideas of the CRA framework and using the widely accepted concept that exposure to morbidity is usually a risk factor for health outcomes (morbidity/mortality) related to other diseases. Our framework uses a counterfactual and not a categorical approach when attributing the burden of health outcomes to potential causes.
Results
This paper describes the different steps and assumptions required to implement the CDA framework, and an illustrative example is used considering diabetes mellitus morbidity as a risk factor for death from heart diseases.
Conclusions
One advantage of the CDA framework is that it can be applied using multi-causal death registries. Some assumptions are needed to implement it in order to avoid biases, but at least it can provide preliminary estimations of the impact of exposure to diseases as risk factors for deaths from other diseases. Another main advantage is that the burden of deaths is no longer attributed to a single cause, the underlying cause, as it is almost always done. Finally, this framework provides information on the pattern of comorbidity in a (sub)population of subjects who is about to die. These patterns can be used as a reference for alternative patterns of the general population or patterns of other specific subpopulations.
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Nontarak J, Assanangkornchai S, Callinan S. Patients' Self-Reported Disability Weights of Top-Ranking Diseases in Thailand: Do They Differ by Socio-Demographic and Illness Characteristics? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051595. [PMID: 32121635 PMCID: PMC7084387 DOI: 10.3390/ijerph17051595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/22/2020] [Accepted: 02/28/2020] [Indexed: 01/29/2023]
Abstract
Little is known about the impact of methodological decisions on estimating disability weights among patients with mental and physical disorders, and the effects of socio-demographic status on the estimation of these weights. A cross-sectional study was conducted in three hospitals in southern Thailand to describe the disability weights based on different valuation methods. Altogether, 150 patients with major depressive disorder, 150 with alcohol use disorder, and 150 with osteoarthritis with varying levels of severity were recruited. Using a face-to-face interview, all patients completed a visual analogue scale (VAS) and were randomly assigned to complete either the European Quality of Life-5 Dimensions (EQ-5D) or Time-trade-off (TTO) instrument to estimate their current utility score, which was consequently transformed to a disability weight. Significant differences were found between disability weights derived from the three instruments for the same disease, with the VAS providing the highest and EQ-5D the lowest weights. Patients with major depressive disorder had the highest disability weight while those with osteoarthritis had lowest by most methods. Patients’ socio-demographics do not affect how they perceive their disability or health condition. Our findings highlight the importance of carefully selecting methods of valuing disability weights, which can rely on disease specific conditions.
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Affiliation(s)
- Jiraluck Nontarak
- Health Systems Research Institute, Nonthaburi 11000, Thailand
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Sawitri Assanangkornchai
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
- Correspondence: ; Tel.: +66 74 451 165
| | - Sarah Callinan
- Centre for Alcohol Policy Research, Latrobe University, Victoria 3086, Australia
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Spronk I, Edgar DW, van Baar ME, Wood FM, Van Loey NEE, Middelkoop E, Renneberg B, Öster C, Orwelius L, Moi AL, Nieuwenhuis M, van der Vlies CH, Polinder S, Haagsma JA. Improved and standardized method for assessing years lived with disability after burns and its application to estimate the non-fatal burden of disease of burn injuries in Australia, New Zealand and the Netherlands. BMC Public Health 2020; 20:121. [PMID: 31996206 PMCID: PMC6988230 DOI: 10.1186/s12889-020-8233-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/16/2020] [Indexed: 12/16/2022] Open
Abstract
Background Burden of disease estimates are an important resource in public health. Currently, robust estimates are not available for the burn population. Our objectives are to adapt a refined methodology (INTEGRIS method) to burns and to apply this new INTEGRIS-burns method to estimate, and compare, the burden of disease of burn injuries in Australia, New Zealand and the Netherlands. Methods Existing European and Western-Australian health-related quality of life (HRQL) datasets were combined to derive disability weights for three homogenous burn injury groups based on percentage total body surface area (%TBSA) burned. Subsequently, incidence data from Australia, New Zealand, and the Netherlands from 2010 to 2017 were used to compute annual non-fatal burden of disease estimates for each of these three countries. Non-fatal burden of disease was measured by years lived with disability (YLD). Results The combined dataset included 7159 HRQL (EQ-5D-3 L) outcomes from 3401 patients. Disability weights ranged from 0.046 (subgroup < 5% TBSA burned > 24 months post-burn) to 0.497 (subgroup > 20% TBSA burned 0–1 months post-burn). In 2017 the non-fatal burden of disease of burns for the three countries (YLDs/100,000 inhabitants) was 281 for Australia, 279 for New Zealand and 133 for the Netherlands. Conclusions This project established a method for more precise estimates of the YLDs of burns, as it is the only method adapted to the nature of burn injuries and their recovery. Compared to previous used methods, the INTEGRIS-burns method includes improved disability weights based on severity categorization of burn patients; a better substantiated proportion of patients with lifelong disability based; and, the application of burn specific recovery timeframes. Information derived from the adapted method can be used as input for health decision making at both the national and international level. Future studies should investigate whether the application is valid in low- and middle- income countries.
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Affiliation(s)
- Inge Spronk
- Erasmus MC, Department of Public Health, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands. .,Amsterdam UMC, Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
| | - Dale W Edgar
- State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.,Burn Injury Research Node, The University of Notre Dame, Fremantle, Western Australia, Australia.,Fiona Wood Foundation, Murdoch, Western Australia, Australia
| | - Margriet E van Baar
- Erasmus MC, Department of Public Health, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.,Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands
| | - Fiona M Wood
- State Adult Burn Unit, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.,Fiona Wood Foundation, Murdoch, Western Australia, Australia
| | - Nancy E E Van Loey
- Association of Dutch Burn Centres, Department Behavioural Research, Beverwijk, the Netherlands.,Department Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | - Esther Middelkoop
- Amsterdam UMC, Department of Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, the Netherlands
| | - Babette Renneberg
- Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
| | - Caisa Öster
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Lotti Orwelius
- Department of Anaesthesiology and Intensive Care, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Asgjerd L Moi
- Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Plastic, Hand and Reconstructive Surgery, National Burn Centre, Haukeland University Hospital, Bergen, Norway
| | - Marianne Nieuwenhuis
- Association of Dutch Burn Centres, Martini Hospital, Groningen, the Netherlands.,Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Cornelis H van der Vlies
- Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands.,Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Suzanne Polinder
- Erasmus MC, Department of Public Health, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Erasmus MC, Department of Public Health, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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Lobo E, Nanda L, Akhouri SS, Shrivastava C, Ronghang R, Menon GR, Dutta A. Describing the Development of a Health State Valuation Protocol to Obtain Community-Derived Disability Weights. Front Public Health 2019; 7:276. [PMID: 31681720 PMCID: PMC6798035 DOI: 10.3389/fpubh.2019.00276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 09/12/2019] [Indexed: 11/17/2022] Open
Abstract
For the prioritization of the allocation of national resources, estimating the burden of disease studies play a critical role. Hence the first Global Burden of Disease study conducted in the 1990s was done for this particular estimation. By the means of introducing disability-adjusted life year (DALY) metric, the burden of various diseases was calculated using disability weights (DWs)—a component of DALY. DWs are values that capture individuals' perception regarding the severity of diseases that involve valuation tools and health state descriptions. Various studies have been conducted over the past few decades to evaluate health states and derive disease-specific disability weights using Person-Trade off, Time-trade off, etc. However, use of these complex and cognitively demanding methods has been carried out in developed countries where the bulk of the populace is more educated. Few attempts have been made in low- and middle-income countries such as India, where not only the majority is less educated but also the social construction of diseases and health conditions are diverse. Therefore, due to the absence of methodological protocols of health state valuations for application at the community-level in the developing world, we attempted to systematically describe the procedure that can be used universally and cross-culturally for various health states. We began with the tentative selection of health states and health states valuation methods by conducting a meticulous literature review, followed by community exploration and medical consultations. This led to developing vignettes (clinical description) and 6D5L pictorial narrations (functional status description). Two field tests for checking the usability and refinement of the tools was done. Final consultation by an expert panel comprising of medical and non-medical professionals was held/conducted to finalize the health state labels and functional status profiles of each health state. The methodical approach provides a robust and thorough procedure for guiding researchers to implement health state valuation studies at community level.
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Affiliation(s)
- Eunice Lobo
- Indian Institute of Public Health- Bhubaneswar, Public Health Foundation of India, Bhubaneswar, India
| | - Lipika Nanda
- Indian Institute of Public Health- Bhubaneswar, Public Health Foundation of India, Bhubaneswar, India
| | - Shuchi Sree Akhouri
- Indian Institute of Public Health- Bhubaneswar, Public Health Foundation of India, Bhubaneswar, India
| | - Chandni Shrivastava
- Indian Institute of Public Health- Bhubaneswar, Public Health Foundation of India, Bhubaneswar, India
| | - Roshan Ronghang
- Indian Institute of Public Health- Bhubaneswar, Public Health Foundation of India, Bhubaneswar, India
| | - Geetha R Menon
- National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Ambarish Dutta
- Indian Institute of Public Health- Bhubaneswar, Public Health Foundation of India, Bhubaneswar, India
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Cassini A, Colzani E, Pini A, Mangen MJJ, Plass D, McDonald SA, Maringhini G, van Lier A, Haagsma JA, Havelaar AH, Kramarz P, Kretzschmar ME, On Behalf Of The BCoDE Consortium. Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): results from the Burden of Communicable Diseases in Europe study, European Union and European Economic Area countries, 2009 to 2013. ACTA ACUST UNITED AC 2019; 23. [PMID: 29692315 PMCID: PMC5915974 DOI: 10.2807/1560-7917.es.2018.23.16.17-00454] [Citation(s) in RCA: 180] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The Burden of Communicable Diseases in Europe (BCoDE) study aimed to calculate disability-adjusted life years (DALYs) for 31 selected diseases in the European Union (EU) and European Economic Area (EEA). Methods: DALYs were estimated using an incidence-based and pathogen-based approach. Incidence was estimated through assessment of data availability and quality, and a correction was applied for under-estimation. Calculation of DALYs was performed with the BCoDE software toolkit without applying time discounting and age-weighting. Results: We estimated that one in 14 inhabitants experienced an infectious disease episode for a total burden of 1.38 million DALYs (95% uncertainty interval (UI): 1.25–1.5) between 2009 and 2013; 76% of which was related to the acute phase of the infection and its short-term complications. Influenza had the highest burden (30% of the total burden), followed by tuberculosis, human immunodeficiency virus (HIV) infection/AIDS and invasive pneumococcal disease (IPD). Men had the highest burden measured in DALYs (60% of the total), adults 65 years of age and over had 24% and children less than 5 years of age had 11%. Age group-specific burden showed that infants (less than 1 year of age) and elderly people (80 years of age and over) experienced the highest burden. Conclusions: These results provide baseline estimates for evaluating infectious disease prevention and control strategies. The study promotes an evidence-based approach to describing population health and assessing surveillance data availability and quality, and provides information for the planning and prioritisation of limited resources in infectious disease prevention and control.
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Affiliation(s)
- Alessandro Cassini
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.,European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Edoardo Colzani
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Alessandro Pini
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Marie-Josee J Mangen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Dietrich Plass
- Section Exposure Assessment and Environmental Health Indicators, German Environment Agency, Berlin, Germany
| | - Scott A McDonald
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Guido Maringhini
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Alies van Lier
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Arie H Havelaar
- University of Florida, Gainesville, Florida, United States.,Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Piotr Kramarz
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Mirjam E Kretzschmar
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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O'Donovan MR, Gapp C, Stein C. Burden of disease studies in the WHO European Region-a mapping exercise. Eur J Public Health 2019; 28:773-778. [PMID: 29697771 PMCID: PMC6093319 DOI: 10.1093/eurpub/cky060] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background The World Health Organization (WHO) and the Institute for Health Metrics and Evaluation (IHME) have produced numerous global burden of disease (GBD) estimates since the 1990s, using disability-adjusted life-years (DALYs). Here we attempt to identify studies that have either independent DALY estimates or build on the work of WHO and IHME, for the WHO European Region, categorize them by scope of disease analysis and geographic coverage, and briefly compare their methodology (age weighting, discounting and disability weights). Methods Google and Google Scholar were used with the search terms ‘DALY’, ‘national burden of disease’, Member State names and researcher’s names, covering all years. Studies were categorized as: ‘specific’ (fewer than five disease categories or just risk factors for a single country), ‘specific, multicountry’ (fewer than five disease categories or just risk factors for more than one country), ‘extensive’ (covering five or more but not all disease categories for one country), ‘full, sub country’ (covering all relevant disease categories for part of one country) and ‘full, country’ (covering all relevant disease categories for one country). Results A total of 198 studies were identified: 143 ‘specific’, 26 ‘specific, multicountry’, 7 ‘extensive’, 10 ‘full, sub country’ and 12 ‘full, country’ [England (1), Estonia (2), France (1), Romania (1), Serbia (1), Spain (3), Sweden (2) and Turkey (1)]. About 5 (20%) of the 25 examinable ‘extensive’, ‘full, sub country’ and ‘full, country’ studies calculated DALYs using GBD 2010 methodology. Conclusions Independent burden of diseases studies in Europe have been located, and categorized by scope of disease analysis and geographic coverage. Methodological choices varied between independent ‘full, country’ studies.
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Affiliation(s)
| | - Christian Gapp
- Division of Information, Evidence, Research, and Innovation, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Claudia Stein
- Division of Information, Evidence, Research, and Innovation, WHO Regional Office for Europe, Copenhagen, Denmark
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Ock M, Park B, Park H, Oh IH, Yoon SJ, Cho B, Jo MW. Disability Weights Measurement for 289 Causes of Disease Considering Disease Severity in Korea. J Korean Med Sci 2019; 34:e60. [PMID: 30923484 PMCID: PMC6434154 DOI: 10.3346/jkms.2019.34.e60] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/07/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND For the Korean Burden of Disease (KBD) 2015 study, we have amended disability weights for causes of disease adapting the methodology of the KBD disability weight 2012 study. METHODS We conducted a self-administered web-based survey in Korea using ranking five causes of disease. A total of 605 physicians and medical college students who were attending in third or fourth grade of a regular course performed the survey. We converted the ranked data into paired comparison data and ran a probit regression. The predicted probabilities for each cause of disease were calculated from the coefficient estimates of the probit regression. 'Being dead (1)' and 'Full health (0)' were utilized as anchor points to rescale the predicted probability on a scale from 0 to 1. RESULTS As a result, disability weights for a total of 289 causes of disease were estimated. In particular, we calculated the disability weights of 60 causes of disease considering severity level. These results show that prejudice about the severity of cause of disease itself can affect the estimation of disability weight, when estimating the disability weight for causes of disease without consideration of severity. Furthermore, we have shown that disability weights can be estimated based on a ranking method which can maximize efficiency of data collection. CONCLUSION Disability weights from this study can be used to estimate disability adjusted life year and healthy life expectancy. Furthermore, we expected that the use of the ranking method will increase gradually in disability weight studies.
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Affiliation(s)
- Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Bomi Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Bogeum Cho
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
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Maertens de Noordhout C, Devleesschauwer B, Salomon JA, Turner H, Cassini A, Colzani E, Speybroeck N, Polinder S, Kretzschmar ME, Havelaar AH, Haagsma JA. Disability weights for infectious diseases in four European countries: comparison between countries and across respondent characteristics. Eur J Public Health 2019; 28:124-133. [PMID: 29020343 PMCID: PMC5881674 DOI: 10.1093/eurpub/ckx090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background In 2015, new disability weights (DWs) for infectious diseases were constructed based on data from four European countries. In this paper, we evaluated if country, age, sex, disease experience status, income and educational levels have an impact on these DWs. Methods We analyzed paired comparison responses of the European DW study by participants’ characteristics with separate probit regression models. To evaluate the effect of participants’ characteristics, we performed correlation analyses between countries and within country by respondent characteristics and constructed seven probit regression models, including a null model and six models containing participants’ characteristics. We compared these seven models using Akaike Information Criterion (AIC). Results According to AIC, the probit model including country as covariate was the best model. We found a lower correlation of the probit coefficients between countries and income levels (range rs: 0.97–0.99, P < 0.01) than between age groups (range rs: 0.98–0.99, P < 0.01), educational level (range rs: 0.98–0.99, P < 0.01), sex (rs = 0.99, P < 0.01) and disease status (rs = 0.99, P < 0.01). Within country the lowest correlations of the probit coefficients were between low and high income level (range rs = 0.89–0.94, P < 0.01). Conclusions We observed variations in health valuation across countries and within country between income levels. These observations should be further explored in a systematic way, also in non-European countries. We recommend future researches studying the effect of other characteristics of respondents on health assessment.
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Affiliation(s)
| | - Brecht Devleesschauwer
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium
| | - Joshua A Salomon
- Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA
| | - Heather Turner
- Department of Statistics, University of Warwick, Coventry, UK
| | - Alessandro Cassini
- European Centre for Disease Prevention and Control, Stockholm, Sweden.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Edoardo Colzani
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Niko Speybroeck
- Institute of Health and Society, Université catholique de Louvain (Clos Chapelle-aux-Champs, 30) Brussels, Belgium
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Mirjam E Kretzschmar
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Arie H Havelaar
- Department of Animal Health and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.,Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Juanita A Haagsma
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Institute for Health Metrics and Evaluation, Seattle, WA, USA
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Disability Weights for Pediatric Surgical Procedures: A Systematic Review and Analysis. World J Surg 2018; 42:3021-3034. [PMID: 29441407 DOI: 10.1007/s00268-018-4537-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Metrics to measure the burden of surgical conditions, such as disability weights (DWs), are poorly defined, particularly for pediatric conditions. To summarize the literature on DWs of children's surgical conditions, we performed a systematic review of disability weights of pediatric surgical conditions in low- and middle-income countries (LMICs). METHOD For this systematic review, we searched MEDLINE for pediatric surgery cost-effectiveness studies in LMICs, published between January 1, 1996, and April 1, 2017. We also included DWs found in the Global Burden of Disease studies, bibliographies of studies identified in PubMed, or through expert opinion of authors (ES and HR). RESULTS Out of 1427 publications, 199 were selected for full-text analysis, and 30 met all eligibility criteria. We identified 194 discrete DWs published for 66 different pediatric surgical conditions. The DWs were primarily derived from the Global Burden of Disease studies (72%). Of the 194 conditions with reported DWs, only 12 reflected pre-surgical severity, and 12 included postsurgical severity. The methodological quality of included studies and DWs for specific conditions varied greatly. INTERPRETATION It is essential to accurately measure the burden, cost-effectiveness, and impact of pediatric surgical disease in order to make informed policy decisions. Our results indicate that the existing DWs are inadequate to accurately quantify the burden of pediatric surgical conditions. A wider set of DWs for pediatric surgical conditions needs to be developed, taking into account factors specific to the range and severity of surgical conditions.
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Sunyoto T, Verdonck K, el Safi S, Potet J, Picado A, Boelaert M. Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa-A systematic review. PLoS Negl Trop Dis 2018; 12:e0006914. [PMID: 30359376 PMCID: PMC6219817 DOI: 10.1371/journal.pntd.0006914] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/06/2018] [Accepted: 10/11/2018] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Cutaneous leishmaniasis (CL) is the most frequent form of leishmaniasis, with 0.7 to 1.2 million cases per year globally. However, the burden of CL is poorly documented in some regions. We carried out this review to synthesize knowledge on the epidemiological burden of CL in sub-Saharan Africa. METHODS We systematically searched PubMed, CABI Global health, Africa Index Medicus databases for publications on CL and its burden. There were no restrictions on language/publication date. Case series with less than ten patients, species identification studies, reviews, non-human, and non-CL focused studies were excluded. Findings were extracted and described. The review was conducted following PRISMA guidelines; the protocol was registered in PROSPERO (42016036272). RESULTS From 289 identified records, 54 met eligibility criteria and were included in the synthesis. CL was reported from 13 of the 48 sub-Saharan African countries (3 eastern, nine western and one from southern Africa). More than half of the records (30/54; 56%) were from western Africa, notably Senegal, Burkina Faso and Mali. All studies were observational: 29 were descriptive case series (total 13,257 cases), and 24 followed a cross-sectional design. The majority (78%) of the studies were carried out before the year 2000. Forty-two studies mentioned the parasite species, but was either assumed or attributed on the historical account. Regional differences in clinical manifestations were reported. We found high variability across methodologies, leading to difficulties to compare or combine data. The prevalence in hospital settings among suspected cases ranged between 0.1 and 14.2%. At the community level, CL prevalence varied widely between studies. Outbreaks of thousands of cases occurred in Ethiopia, Ghana, and Sudan. Polymorphism of CL in HIV-infected people is a concern. Key information gaps in CL burden here include population-based CL prevalence/incidence, risk factors, and its socio-economic burden. CONCLUSION The evidence on CL epidemiology in sub-Saharan Africa is scanty. The CL frequency and severity are poorly identified. There is a need for population-based studies to define the CL burden better. Endemic countries should consider research and action to improve burden estimation and essential control measures including diagnosis and treatment capacity.
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Affiliation(s)
- Temmy Sunyoto
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Policy Department, Médecins Sans Frontières - Campaign for Access to Medicines, Geneva, Switzerland
| | - Kristien Verdonck
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sayda el Safi
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Julien Potet
- Policy Department, Médecins Sans Frontières - Campaign for Access to Medicines, Geneva, Switzerland
| | - Albert Picado
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - Marleen Boelaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Teng KTY, Devleesschauwer B, Maertens De Noordhout C, Bennett P, McGreevy PD, Chiu PY, Toribio JALML, Dhand NK. Welfare-Adjusted Life Years (WALY): A novel metric of animal welfare that combines the impacts of impaired welfare and abbreviated lifespan. PLoS One 2018; 13:e0202580. [PMID: 30208045 PMCID: PMC6135394 DOI: 10.1371/journal.pone.0202580] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 08/05/2018] [Indexed: 11/30/2022] Open
Abstract
Currently, separate measures are used to estimate the impact of animal diseases on mortality and animal welfare. This article introduces a novel metric, the Welfare-Adjusted Life Year (WALY), to estimate disease impact by combining welfare compromise and premature death components. Adapting the Disability-Adjusted Life Year approach used in human health audits, we propose WALY as the sum of a) the years lived with impaired welfare due to a particular cause and b) the years of life lost due to the premature death from the same cause. The years lived with impaired welfare are the product of the average duration of each welfare impediment, reflecting the actual condition that compromises animal welfare, the probability of an incident case developing and impaired welfare weights, representing the degree of impaired welfare. The years of life lost are calculated using the standard expected lifespan at the time of premature death. To demonstrate the concept, we estimated WALYs for 10 common canine diseases, namely mitral valve disease, dilated cardiomyopathy, chronic kidney disease, diabetes mellitus, atopic dermatitis, splenic haemangiosarcoma, appendicular osteosarcoma, cranial cruciate ligament disease, thoracolumbar intervertebral disc disease and cervical spondylomyelopathy. A survey of veterinarians (n = 61) was conducted to elicit impaired welfare weights for 35 welfare impediments. Paired comparison was the primary method to elicit weights, whereas visual analogue scale and time trade-off approaches rescaled these weights onto the desired scale, from 0 (the optimal welfare imaginable) to 1 (the worst welfare imaginable). WALYs for the 10 diseases were then estimated using the impaired welfare weights and published epidemiological data on disease impacts. Welfare impediment “amputation: one limb” and “respiratory distress” had the lowest and highest impaired welfare weights at 0.134 and 0.796, rescaled with a visual analogue scale, and 0.117 and 0.857, rescaled with time trade-off. Among the 10 diseases, thoracolumbar intervertebral disc disease and atopic dermatitis had the smallest and greatest adverse impact on dogs with WALYs at 2.83 (95% UI: 1.54–3.94) and 9.73 (95% uncertainty interval [UI]: 7.17–11.8), respectively. This study developed the WALY metric and demonstrated that it summarises welfare compromise as perceived by humans and total impact of diseases in individual animals. The WALY can potentially be used for prioritisation of disease eradication and control programs, quantification of population welfare and longitudinal surveillance of animal welfare in companion animals and may possibly be extended to production animals.
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Affiliation(s)
- Kendy Tzu-Yun Teng
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, NSW, Australia
- * E-mail:
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Peter Bennett
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, NSW, Australia
| | - Paul D. McGreevy
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, NSW, Australia
| | - Po-Yu Chiu
- National Taiwan University Veterinary Hospital, Taipei, Taiwan
| | - Jenny-Ann L. M. L. Toribio
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, NSW, Australia
| | - Navneet K. Dhand
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, NSW, Australia
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Gabbe BJ, Dipnall JF, Lynch JW, Rivara FP, Lyons RA, Ameratunga S, Brussoni M, Lecky FE, Bradley C, Simpson PM, Beck B, Demmler JC, Lyons J, Schneeberg A, Harrison JE. Validating injury burden estimates using population birth cohorts and longitudinal cohort studies of injury outcomes: the VIBES-Junior study protocol. BMJ Open 2018; 8:e024755. [PMID: 30082368 PMCID: PMC6078268 DOI: 10.1136/bmjopen-2018-024755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Traumatic injury is a leading contributor to the global disease burden in children and adolescents, but methods used to estimate burden do not account for differences in patterns of injury and recovery between children and adults. A lack of empirical data on postinjury disability in children has limited capacity to derive valid disability weights and describe the long-term individual and societal impacts of injury in the early part of life. The aim of this study is to establish valid estimates of the burden of non-fatal injury in children and adolescents. METHODS AND ANALYSIS Five longitudinal studies of paediatric injury survivors <18 years at the time of injury (Australia, Canada, UK and USA) and two whole-of-population linked administrative data paediatric studies (Australia and Wales) will be analysed over a 3-year period commencing 2018. Meta-analysis of deidentified patient-level data (n≈2,600) from five injury-specific longitudinal studies (Victorian State Trauma Registry; Victorian Orthopaedic Trauma Outcomes Registry; UK Burden of Injury; British Columbia Children's Hospital Longitudinal Injury Outcomes; Children's Health After Injury) and >1 million children from two whole-of-population cohorts (South Australian Early Childhood Data Project and Wales Electronic Cohort for Children). Systematic analysis of pooled injury-specific cohort data using a variety of statistical techniques, and parallel analysis of whole-of-population cohorts, will be used to develop estimated disability weights for years lost due to disability, establish appropriate injury classifications and explore factors influencing recovery. ETHICS AND DISSEMINATION The project was approved by the Monash University Human Research Ethics Committee project number 12 311. Results of this study will be submitted for publication in internationally peer-reviewed journals. The findings from this project have the capacity to improve the validity of paediatric injury burden measurements in future local and global burden of disease studies.
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Affiliation(s)
- Belinda J Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Health Data Research UK, Swansea University, Swansea, UK
- National Centre for Population Health and Wellbeing Research, Swansea University, Swansea, UK
| | - Joanna F Dipnall
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - John W Lynch
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
- School of Population Health Sciences, University of Bristol, Bristol, UK
| | - Frederick P Rivara
- Departments of Pediatrics and Epidemiology, and the Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
| | - Ronan A Lyons
- Health Data Research UK, Swansea University, Swansea, UK
- National Centre for Population Health and Wellbeing Research, Swansea University, Swansea, UK
| | - Shanthi Ameratunga
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Mariana Brussoni
- Department of Pediatrics, School of Population and Public Health, University of British Columbia, Vancouver, Canada
- British Columbia Injury Research and Prevention Unit, Children's Hospital Research Institute, Vancouver, Canada
| | - Fiona E Lecky
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Clare Bradley
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Pam M Simpson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Jane Lyons
- Health Data Research UK, Swansea University, Swansea, UK
| | - Amy Schneeberg
- British Columbia Injury Research and Prevention Unit, Children's Hospital Research Institute, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - James E Harrison
- Research Centre for Injury Studies, Flinders University, Adelaide, South Australia, Australia
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Torgerson PR, Rüegg S, Devleesschauwer B, Abela-Ridder B, Havelaar AH, Shaw AP, Rushton J, Speybroeck N. zDALY: An adjusted indicator to estimate the burden of zoonotic diseases. One Health 2018; 5:40-45. [PMID: 29911164 PMCID: PMC6000816 DOI: 10.1016/j.onehlt.2017.11.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/27/2017] [Accepted: 11/27/2017] [Indexed: 12/17/2022] Open
Abstract
The burden of human diseases in populations, or for an individual, is frequently estimated in terms of one of a number of Health Adjusted Life Years (HALYs). The Disability Adjusted Life Year (DALY) is a widely accepted HALY metric and is used by the World Health Organization and the Global Burden of Disease studies. Many human diseases are of animal origin and often cause ill health and production losses in domestic animals. The economic losses due to disease in animals are usually estimated in monetary terms. The monetary impact on animal health is not compatible with HALY approaches used to measure the impact on human health. To estimate the societal burden of zoonotic diseases that have substantial human and animal disease burden we propose methodology which can be accommodated within the DALY framework. Monetary losses due to the animal disease component of a zoonotic disease can be converted to an equivalent metric using a local gross national income per capita deflator. This essentially gives animal production losses a time trade-off for human life years. This is the time required to earn the income needed to replace that financial loss. This can then be assigned a DALY equivalent, termed animal loss equivalents (ALE), and added to the DALY associated with human ill health to give a modified DALY. This is referred to as the "zDALY". ALEs could also be estimated using willingness-to-pay for animal health or survey tools to estimate the replacement time value for animals with high societal or emotional value (for example pets) that cannot be calculated directly using monetary worth. Thus the zDALY estimates the impact of a zoonotic disease to animal and human health. The losses due to the animal disease component of the modified DALY are straightforward to calculate. A number of worked examples such as echinococcosis, brucellosis, Q fever and cysticercosis from a diverse spectrum of countries with different levels of economic development illustrate the use of the zDALY indicator.
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Affiliation(s)
- Paul R. Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 270, CH-8057 Zurich, Switzerland
| | - Simon Rüegg
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 270, CH-8057 Zurich, Switzerland
| | - Brecht Devleesschauwer
- Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle aux champs, 30, 1200 Bruxelles, Belgium
- Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium
| | - Bernadette Abela-Ridder
- Department of Food Safety and Zoonoses (FOS), World Health Organization, Avenue Appia 20, CH-1211 Geneva 27, Switzerland
| | - Arie H. Havelaar
- Institute for Sustainable Food Systems, Emerging Pathogens Institute and Animal Sciences Department, University of Florida, Gainesville, FL, USA
- Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Alexandra P.M. Shaw
- Division of Infection and Pathway Medicine, Edinburgh Medical School: Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, UK
- A P Consultants, 22 Walworth Enterprise Centre, Duke Close, Andover SP10 5AP, UK
| | - Jonathan Rushton
- Institute of Infection and Global Health, University of Liverpool, UK
| | - Niko Speybroeck
- Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle aux champs, 30, 1200 Bruxelles, Belgium
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A tale of two countries: comparing disability weights for gambling problems in New Zealand and Australia. Qual Life Res 2018; 27:2361-2371. [PMID: 29777460 DOI: 10.1007/s11136-018-1882-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE This study aimed to assess the impact of gambling problems on quality of life. Specifically, we generated disability weight estimates for gambling problems in New Zealand, and compared these results with (i) Australian figures (J Gambl Issues, 10.4309/jgi.v0i36.3978, 2017) and (ii) other health states (Lancet, 10.1016/S0140-6736(12)61680-8, 2013); such as anxiety and alcohol use disorders. METHOD The 324 participants (48 experts and 276 general population members) evaluated a series of gambling harm vignettes. The participants rated the decrement to one's quality of life using Visual Analogue Scale and Time Trade-Off protocols (Br Med Bull, 10.1093/bmb/ldq033, 2010). These evaluations enabled the calculation of disability weights for three categories of gamblers (low-risk, moderate-risk, and problem gamblers). RESULTS Disability weight estimates for low-risk, moderate-risk, and problem gamblers in NZ were consistently higher than the Australian weights: low (0.18 vs. 0.13), moderate (0.37 vs. 0.29), and problem (0.54 vs. 0.44). The quality of life impact for problem gambling in NZ (0.54) was comparable to that experienced in severe alcohol use disorder (0.55) (Lancet, 10.1016/S0140-6736(12)61680-8, 2013). CONCLUSIONS This study represents one of the first attempts to assess gambling-related harm through a public health perspective. The results of this study are informative for policy-making, resource allocation, and service planning. These estimates now allow for the population-level impact of gambling in NZ to be calculated and tracked over time, which is essential for informing harm-minimisation initiatives.
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Steckling N, Tobollik M, Plass D, Hornberg C, Ericson B, Fuller R, Bose-O'Reilly S. Global Burden of Disease of Mercury Used in Artisanal Small-Scale Gold Mining. Ann Glob Health 2018; 83:234-247. [PMID: 28619398 DOI: 10.1016/j.aogh.2016.12.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Artisanal small-scale gold mining (ASGM) is the world's largest anthropogenic source of mercury emission. Gold miners are highly exposed to metallic mercury and suffer occupational mercury intoxication. The global disease burden as a result of this exposure is largely unknown because the informal character of ASGM restricts the availability of reliable data. OBJECTIVE To estimate the prevalence of occupational mercury intoxication and the disability-adjusted life years (DALYs) attributable to chronic metallic mercury vapor intoxication (CMMVI) among ASGM gold miners globally and in selected countries. METHODS Estimates of the number of artisanal small-scale gold (ASG) miners were extracted from reviews supplemented by a literature search. Prevalence of moderate CMMVI among miners was determined by compiling a dataset of available studies that assessed frequency of intoxication in gold miners using a standardized diagnostic tool and biomonitoring data on mercury in urine. Severe cases of CMMVI were not included because it was assumed that these persons can no longer be employed as miners. Cases in workers' families and communities were not considered. Years lived with disability as a result of CMMVI among ASG miners were quantified by multiplying the number of prevalent cases of CMMVI by the appropriate disability weight. No deaths are expected to result from CMMVI and therefore years of life lost were not calculated. Disease burden was calculated by multiplying the prevalence rate with the number of miners for each country and the disability weight. Sensitivity analyses were performed using different assumptions on the number of miners and the intoxication prevalence rate. FINDINGS Globally, 14-19 million workers are employed as ASG miners. Based on human biomonitoring data, between 25% and 33% of these miners-3.3-6.5 million miners globally-suffer from moderate CMMVI. The resulting global burden of disease is estimated to range from 1.22 (uncertainty interval [UI] 0.87-1.61) to 2.39 (UI 1.69-3.14) million DALYs. CONCLUSIONS This study presents the first global and country-based estimates of disease burden caused by mercury intoxication in ASGM. Data availability and quality limit the results, and the total disease burden is likely undercounted. Despite these limitations, the data clearly indicate that mercury intoxication in ASG miners is a major, largely neglected global health problem.
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Affiliation(s)
- Nadine Steckling
- Bielefeld University, School of Public Health, Department Environment & Health, Bielefeld, Germany; University Hospital Munich, WHO Collaborating Centre for Occupational Health, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Unit Paediatric Environmental Epidemiology, Munich, Germany; Department of Public Health and Health Technology Assessment, University for Health Sciences, Medical Computer Science and Technology, Hall in Tirol, Austria.
| | - Myriam Tobollik
- Bielefeld University, School of Public Health, Department Environment & Health, Bielefeld, Germany; German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Berlin, Germany
| | - Dietrich Plass
- German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Berlin, Germany
| | - Claudia Hornberg
- Bielefeld University, School of Public Health, Department Environment & Health, Bielefeld, Germany
| | - Bret Ericson
- Pure Earth, formerly Blacksmith Institute, New York, NY
| | | | - Stephan Bose-O'Reilly
- University Hospital Munich, WHO Collaborating Centre for Occupational Health, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Unit Paediatric Environmental Epidemiology, Munich, Germany; Department of Public Health and Health Technology Assessment, University for Health Sciences, Medical Computer Science and Technology, Hall in Tirol, Austria
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Braithwaite T, Taylor H, Bourne R, Keeffe J, Pesudovs K. Does blindness count? Disability weights for vision loss. Clin Exp Ophthalmol 2017; 45:217-220. [PMID: 27862844 DOI: 10.1111/ceo.12874] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/29/2016] [Accepted: 11/06/2016] [Indexed: 11/30/2022]
Affiliation(s)
| | - Hugh Taylor
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Rupert Bourne
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
| | | | - Konrad Pesudovs
- NHMRC Centre for Clinical Eye Research, Flinders University, Adelaide, South Australia, Australia
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Martenies SE, Milando CW, Williams GO, Batterman SA. Disease and Health Inequalities Attributable to Air Pollutant Exposure in Detroit, Michigan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101243. [PMID: 29048385 PMCID: PMC5664744 DOI: 10.3390/ijerph14101243] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 10/10/2017] [Accepted: 10/15/2017] [Indexed: 01/21/2023]
Abstract
The environmental burden of disease is the mortality and morbidity attributable to exposures of air pollution and other stressors. The inequality metrics used in cumulative impact and environmental justice studies can be incorporated into environmental burden studies to better understand the health disparities of ambient air pollutant exposures. This study examines the diseases and health disparities attributable to air pollutants for the Detroit urban area. We apportion this burden to various groups of emission sources and pollutants, and show how the burden is distributed among demographic and socioeconomic subgroups. The analysis uses spatially-resolved estimates of exposures, baseline health rates, age-stratified populations, and demographic characteristics that serve as proxies for increased vulnerability, e.g., race/ethnicity and income. Based on current levels, exposures to fine particulate matter (PM2.5), ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2) are responsible for more than 10,000 disability-adjusted life years (DALYs) per year, causing an annual monetized health impact of $6.5 billion. This burden is mainly driven by PM2.5 and O3 exposures, which cause 660 premature deaths each year among the 945,000 individuals in the study area. NO2 exposures, largely from traffic, are important for respiratory outcomes among older adults and children with asthma, e.g., 46% of air-pollution related asthma hospitalizations are due to NO2 exposures. Based on quantitative inequality metrics, the greatest inequality of health burdens results from industrial and traffic emissions. These metrics also show disproportionate burdens among Hispanic/Latino populations due to industrial emissions, and among low income populations due to traffic emissions. Attributable health burdens are a function of exposures, susceptibility and vulnerability (e.g., baseline incidence rates), and population density. Because of these dependencies, inequality metrics should be calculated using the attributable health burden when feasible to avoid potentially underestimating inequality. Quantitative health impact and inequality analyses can inform health and environmental justice evaluations, providing important information to decision makers for prioritizing strategies to address exposures at the local level.
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Affiliation(s)
- Sheena E Martenies
- Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Chad W Milando
- Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Guy O Williams
- Detroiters Working for Environmental Justice, 4750 Woodward Ave., Suite 415, Detroit, MI 48201, USA.
| | - Stuart A Batterman
- Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
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Campolina AG, Rozman LM, Decimoni TC, Leandro R, Novaes HMD, De Soárez PC. Many Miles to Go: A Systematic Review of the State of Cost-Utility Analyses in Brazil. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2017; 15:163-172. [PMID: 27798797 DOI: 10.1007/s40258-016-0290-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Little is known about the quality and quantity of cost-utility analyses (CUAs) in Brazil. OBJECTIVE The objective of this study was to provide a systematic review of published CUAs of healthcare technologies in Brazil. METHODS We performed a systematic review of economic evaluations studies published in MEDLINE, EMBASE, LILACS (Latin American and Caribbean Health Sciences Literature), SciELO (Scientific Electronic Library Online), NHS EED (National Health Service Economic Evaluation Database), HTA (Health Technology Assessment) Database, Web of Science, Scopus, Bireme (Biblioteca Regional de Medicina), BVS ECOS (Health Economics database of the Brazilian Virtual Library of Health), and SISREBRATS (Sistema de Informação da Rede Brasileira de Avaliação de Tecnologias em Saúde [Brazilian Network for the Evaluation of Health Technologies]) from 1980 to 2013. Articles were included if they were CUAs according to the classification devised by Drummond et al. Two independent reviewers screened articles for relevance and carried out data extraction. Disagreements were resolved through discussion or through consultation with a third reviewer. We performed a qualitative narrative synthesis. RESULTS Of the 535 health economic evaluations (HEEs) relating to Brazil, only 40 were CUAs and therefore included in the analysis. Most studies adhered to methodological guidelines for quality of reporting and 77.5% used quality-adjusted life-years (QALYs) as the health outcome. Of these studies, 51.6% did not report the population used to elicit preferences for outcomes and 45.2% used a specific population such as expert opinion. The preference elicitation method was not reported in 58.1% of these studies. The majority (80.6%) of studies did not report the instrument used to derive health state valuations and no publication reported whether tariffs (or preference weights) were national or international. No study mentioned the methodology used to estimate QALYs. CONCLUSIONS Many published Brazilian cost-utility studies adhere to key recommended general methods for HEE; however, the use of QALY calculations is far from being the current international standard. Development of health preferences research can contribute to quality improvement of health technology assessment reports in Brazil.
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Affiliation(s)
- Alessandro G Campolina
- Center for Translational Research in Oncology, Cancer Institute of Sao Paulo (ICESP), University of São Paulo School of Medicine, Av. Dr. Arnaldo 251, 8 andar, São Paulo, SP, 01246-000, Brazil
- National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, Rio Grande do Sul, Brazil
| | - Luciana M Rozman
- Department of Preventive Medicine, University of São Paulo School of Medicine, Av. Dr. Arnaldo 455, 2 andar sala 2228, São Paulo, SP, 01246-903, Brazil
| | - Tassia C Decimoni
- Department of Preventive Medicine, University of São Paulo School of Medicine, Av. Dr. Arnaldo 455, 2 andar sala 2228, São Paulo, SP, 01246-903, Brazil
| | - Roseli Leandro
- Department of Preventive Medicine, University of São Paulo School of Medicine, Av. Dr. Arnaldo 455, 2 andar sala 2228, São Paulo, SP, 01246-903, Brazil
| | - Hillegonda M D Novaes
- Department of Preventive Medicine, University of São Paulo School of Medicine, Av. Dr. Arnaldo 455, 2 andar sala 2228, São Paulo, SP, 01246-903, Brazil
- National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, Rio Grande do Sul, Brazil
| | - Patrícia Coelho De Soárez
- Department of Preventive Medicine, University of São Paulo School of Medicine, Av. Dr. Arnaldo 455, 2 andar sala 2228, São Paulo, SP, 01246-903, Brazil.
- National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, Rio Grande do Sul, Brazil.
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Poenaru D, Pemberton J, Frankfurter C, Cameron BH, Stolk E. Establishing disability weights for congenital pediatric surgical conditions: a multi-modal approach. Popul Health Metr 2017; 15:8. [PMID: 28259148 PMCID: PMC5336647 DOI: 10.1186/s12963-017-0125-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 02/16/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Burden of disease (BoD) as measured by Disability-Adjusted Life Years (DALYs) is one of the criteria for priority-setting in health care resource allocation. DALYs incorporate disability weights (DWs), which are currently expert-derived estimates or non-existent for most pediatric surgical conditions. The objective of this study is to establish DWs for a subset of key pediatric congenital anomalies using a range of health valuation metrics with caregivers in both high- and low-resource settings. METHOD We described 15 health states to health professionals (physicians, nurses, social workers, and therapists) and community caregivers in Kenya and Canada. The health states summaries were expert- and community-derived, consisting of a narrated description of the disease and a functional profile described in EQ-5D-5 L style. DWs for each health state were elicited using four health valuation exercises (preference ranking, visual analogue scale (VAS), paired comparison (PC), and time trade-off (TTO)). The PC data were anchored internally to the TTO and externally to existing data to yield DWs for each health state on a scale from 0 (health) to 1 (dead). Any differences in DWs between the two countries were analyzed. RESULTS In total, 154 participants, matched by profession, were recruited from Kijabe, Kenya (n = 78) and Hamilton, Canada (n = 76). Overall calculated DWs for 15 health states ranged from 0.13 to 0.77, with little difference between countries (intra-class coefficient 0.97). However, DWs generated in Kenya for severe hypospadias and undescended testes were higher than Canadian-derived DWs (p = 0.04 and p < 0.003, respectively). CONCLUSIONS We have derived country-specific DWs for pediatric congenital anomalies using several low-cost methods and inter-professional and community caregivers. The TTO-anchored PC method appears best suited for future use. The majority of DWs do not appear to differ significantly between the two cultural contexts and could be used to inform further work of estimating the burden of global pediatric surgical disease. Care should be taken in comparing the DWs obtained in the current study to the existent list of DWs because methodological differences may impact on their compatibility.
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Affiliation(s)
- D. Poenaru
- McMaster Pediatric Surgery Research Collaborative, Dept. of Surgery, McMaster University, Hamilton, Canada
- MyungSung Medical College, Addis Ababa, Ethiopia
- Department of Surgery, Montreal Children’s Hospital, McGill University, 16-4200 Sherbrooke West, Westmount QC H3Z 1C4, Montreal, Canada
| | - J. Pemberton
- McMaster Pediatric Surgery Research Collaborative, Dept. of Surgery, McMaster University, Hamilton, Canada
- Dept. of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - C. Frankfurter
- McMaster Pediatric Surgery Research Collaborative, Dept. of Surgery, McMaster University, Hamilton, Canada
| | - B. H. Cameron
- McMaster Pediatric Surgery Research Collaborative, Dept. of Surgery, McMaster University, Hamilton, Canada
- Dept. of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - E. Stolk
- Institute for Medical Technology Assessment, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
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Estimation of years lived with disability due to noncommunicable diseases and injuries using a population-representative survey. PLoS One 2017; 12:e0172001. [PMID: 28196151 PMCID: PMC5308848 DOI: 10.1371/journal.pone.0172001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 01/30/2017] [Indexed: 01/22/2023] Open
Abstract
The Global Burden of Disease 2010 and the WHO Global Health Estimates of years lived with disability (YLDs) uses disability-weights obtained from lay health-state descriptions, which cannot fully reflect different disease manifestations, according to severity, treatment, and environment. The aim of this study was to provide population-representative YLDs of noncommunicable diseases and injuries using a prevalence-based approach, with the disability weight measured in subjects with specific diseases or injuries. We included a total of 44969 adults, who completed the EQ-5D questionnaire as participation in the Korea National Health and Nutrition Examination Survey 2007–2014. We estimated the prevalence of each of 40 conditions identified from the noncommunicable diseases and injuries in the WHO list. Modified condition-specific disability-weight was determined from the adjusted mean difference of the EQ-5D index between the condition and reference groups. Condition-specific YLDs were calculated as the condition’s prevalence multiplied by the condition’s disability-weight. All-cause YLDs, estimated as “number of population × (1 − mean score of EQ-5D)” were 2165 thousands in 39044 thousand adults aged ≥20. The combined YLDs for all 40 conditions accounted for 67.6% of all-cause YLDs, and were 1604, 2126, 8749, and 12847 per 100000 young (age 20−59) males, young females, old (age ≥60) males, and old females, respectively. Back pain/osteoarthritis YLDs were exceptionally large (442/40, 864/146, 2037/836, and 4644/3039 per 100000 young males, young females, old males, and old females, respectively). Back pain, osteoarthritis, depression, diabetes, periodontitis, and stroke accounted for 22.3%, 9.1%, 4.6%, 3.3%, 3.2%, and 2.9% of all-cause YLDs, respectively. In conclusion, this estimation of YLDs using prevalence rates and disability-weights measured in a population-representative survey may form the basis for population-level strategies to prevent age-related worsening of disability.
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A Software Tool for Estimation of Burden of Infectious Diseases in Europe Using Incidence-Based Disability Adjusted Life Years. PLoS One 2017; 12:e0170662. [PMID: 28107447 PMCID: PMC5249178 DOI: 10.1371/journal.pone.0170662] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 01/09/2017] [Indexed: 12/30/2022] Open
Abstract
The burden of disease framework facilitates the assessment of the health impact of diseases through the use of summary measures of population health such as Disability-Adjusted Life Years (DALYs). However, calculating, interpreting and communicating the results of studies using this methodology poses a challenge. The aim of the Burden of Communicable Disease in Europe (BCoDE) project is to summarize the impact of communicable disease in the European Union and European Economic Area Member States (EU/EEA MS). To meet this goal, a user-friendly software tool (BCoDE toolkit), was developed. This stand-alone application, written in C++, is open-access and freely available for download from the website of the European Centre for Disease Prevention and Control (ECDC). With the BCoDE toolkit, one can calculate DALYs by simply entering the age group- and sex-specific number of cases for one or more of selected sets of 32 communicable diseases (CDs) and 6 healthcare associated infections (HAIs). Disease progression models (i.e., outcome trees) for these communicable diseases were created following a thorough literature review of their disease progression pathway. The BCoDE toolkit runs Monte Carlo simulations of the input parameters and provides disease-specific results, including 95% uncertainty intervals, and permits comparisons between the different disease models entered. Results can be displayed as mean and median overall DALYs, DALYs per 100,000 population, and DALYs related to mortality vs. disability. Visualization options summarize complex epidemiological data, with the goal of improving communication and knowledge transfer for decision-making.
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