scholarly journals Adherence to the iDSI reference case among published cost-per-DALY averted studies

2018 ◽  
Author(s):  
Joanna Emerson ◽  
Ari Panzer ◽  
Joshua T. Cohen ◽  
Kalipso Chalkidou ◽  
Yot Teerawattananon ◽  
...  
Keyword(s):  
Global Health ◽  
Medical Center ◽  
Sensitivity Analyses ◽  
Reporting Standards ◽  
Disability Adjusted Life Years ◽  
Reference Case ◽  
Policy Makers ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Full Adherence

AbstractBackgroundThe iDSI reference case, originally published in 2014, aims to improve the quality and comparability of cost-effectiveness analyses (CEAs). This study assesses whether the development of the guideline has improved the reporting and methodology for CEAs using disability-adjusted life-years (DALYs).MethodsWe analyzed the Tufts Medical Center Global Health CEA Registry to identify cost-per-DALY averted studies published from 2011 to 2017. Among each of 11 principles in the iDSI reference case, we translated all reporting standards and methodological specifications into quantifiable yes/no questions and awarded articles one point for each item satisfied. We then separately calculated reporting and methods scores, measured as percent adherence (0%=no adherence, 100%=full adherence). Using the year 2014 as the dissemination period, we conducted a pre-post analysis. Additionally, we conducted an analysis stratified by the 11 principles and examined different scoring strategies and dissemination periods in sensitivity analyses.ResultsArticles averaged 74% adherence to reporting standards and 60% adherence to methodological specifications. Adherence to reporting standards increased slightly over time (72% pre-2014 vs. 75% post-2014, p<0.01), but methodological adherence did not significantly improve (59% pre-2014 vs. 60% post-2014, p=0.53). Overall, reporting adherence scores exceeded methodology adherence scores (74% vs. 60%, p<0.001). Articles seldom addressed budget impact (9% reporting, 10% methodology) or equity (7% reporting, 7% methodology).ConclusionsThe iDSI reference case has substantial potential to serve as a useful resource for researchers and policy-makers in global health settings, but greater effort to promote adherence and awareness is needed to achieve its potential.

scholarly journals Estimation of Burden of Cystic Echinococcosis in Iran Using Disability Adjusted Life Years (DALYs) in 2018

2021 ◽  
Author(s):  
Fateme Parandin ◽  
Fatemeh Heydarpour ◽  
Mehdi Mohebali ◽  
Ahmad Ali Hanafi-Bojd ◽  
Ali Akbari Sari ◽  
...  
Keyword(s):  
Premature Death ◽  
Years Of Life Lost ◽  
Disability Adjusted Life Years ◽  
Public Concern ◽  
Policy Makers ◽  
Control Programs ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Standard Life ◽  
And Control

Background: Human hydatidosis as a public concern has increased in a number of countries that have reduced control programs for the disease due to lack of resources or policies. We aimed to estimate Disability-Adjusted Life Years (DALYs) for human hydatidosis in Iran in 2018. Methods: Data were collected from the Center of Communicable Diseases Control, Ministry of Health &Medical Education, Tehran, Iran in 2018. To calculate DALYs, years of life lost due to premature death (YLL) with years of life with disability (YLD) were calculated according to the formula as DALY = YLL + YLD. The standard life expectancy lost method (SEYLL) was used to calculate the years lost due to premature death. Results: DALYs for human hydatidosis was calculated as 1210.12 years (YLD equals to 177.12 and YLL equals to 1033) in Iran for the year 2018. It was estimated to be 700.2 years for men and 509.8 years for women.  DALYs in men were significantly different from women (P= 0.001) so DALYs were more in men than women were. YLD was calculated at 78.228 years in men and 98.892 years in women and in both men and women at 177.12 years. YLD was significantly different in women compared to men (P=0.001), so YLD in women was more than in men. Conclusion: We reached considerable indices for hydatidosis in our study. Therefore, disease prevention and control programs in Iran seem necessary by the policy makers.

Life Years at Stake

2019 ◽  
pp. 48-60
Author(s):  
Andreas Mogensen
Keyword(s):  
Life Expectancy ◽  
Global Health ◽  
Burden Of Disease ◽  
Global Burden ◽  
Years Of Life Lost ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Ethical Basis

In quantifying the global burden of disease in terms of Disability-Adjusted Life Years (DALYs), we must determine both Years of Life Lost (YLLs) and Years Lost to Disability (YLDs). In setting priorities for global health, many have felt that YLLs should not always simply equal life expectancy at death. To this end, Dean Jamison and colleagues recommend the use of a DALY metric that incorporates Acquisition of Life Potential (ALP). When an individual dies, the YLLs that we would otherwise count are multiplied by the value of the ALP function, which rises gradually from 0 to 1 during the first stages of an individual’s life. Jamison et al. do not provide a detailed philosophical justification for the use of gradual ALP. In this chapter I explain why I believe the Time-Relative Interest Account represents the most plausible ethical basis for the ALP approach and describe how we might model ALP in light of this account.

scholarly journals Using QALYs versus DALYs to measure cost-effectiveness: How much does it matter?

2020 ◽  
Vol 36 (2) ◽  
pp. 96-103 ◽  
Author(s):  
Xue Feng ◽  
David D. Kim ◽  
Joshua T. Cohen ◽  
Peter J. Neumann ◽  
Daniel A. Ollendorf
Keyword(s):  
Cost Effectiveness ◽  
Medical Center ◽  
Disability Adjusted Life Years ◽  
Quality Adjusted Life Years ◽  
Effectiveness Analysis ◽  
Disability Weights ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Relative Differences ◽  
Quality Adjusted Life

ObjectivesQuality-adjusted life-years (QALYs) and disability-adjusted life-years (DALYs) are commonly used in cost-effectiveness analysis (CEA) to measure health benefits. We sought to quantify and explain differences between QALY- and DALY-based cost-effectiveness ratios, and explore whether using one versus the other would materially affect conclusions about an intervention's cost-effectiveness.MethodsWe identified CEAs using both QALYs and DALYs from the Tufts Medical Center CEA Registry and Global Health CEA Registry, with a supplemental search to ensure comprehensive literature coverage. We calculated absolute and relative differences between the QALY- and DALY-based ratios, and compared ratios to common benchmarks (e.g., 1× gross domestic product per capita). We converted reported costs into US dollars.ResultsAmong eleven published CEAs reporting both QALYs and DALYs, seven focused on pharmaceuticals and infectious disease, and five were conducted in high-income countries. Four studies concluded that the intervention was “dominant” (cost-saving). Among the QALY- and DALY-based ratios reported from the remaining seven studies, absolute differences ranged from approximately $2 to $15,000 per unit of benefit, and relative differences from 6–120 percent, but most differences were modest in comparison with the ratio value itself. The values assigned to utility and disability weights explained most observed differences. In comparison with cost-effectiveness thresholds, conclusions were consistent regardless of the ratio type in ten of eleven cases.ConclusionsOur results suggest that although QALY- and DALY-based ratios for the same intervention can differ, differences tend to be modest and do not materially affect comparisons to common cost-effectiveness thresholds.

scholarly journals The Monetary Value of Disability-Adjusted Life Years in Kenya in 2017

SAGE Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 215824402097055
Author(s):  
Rose Nabi Deborah Karimi Muthuri ◽  
Joses Muthuri Kirigia
Keyword(s):  
Analytical Framework ◽  
Noncommunicable Diseases ◽  
Disability Adjusted Life Years ◽  
Public And Private ◽  
Policy Makers ◽  
Monetary Value ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Socioeconomic Burden ◽  
All Diseases

All diseases and injuries exert a heavy epidemiological and socioeconomic burden on Kenya. The specific objectives of this study were (a) to estimate the monetary value of disability-adjusted life years (DALYs) from all causes in 2017 with the ongoing implementation of United Nations sustainable development goal (SDG) 3 and (b) to estimate the reductions in the monetary value of DALYs in Kenya, assuming diseases and injuries related to SDG3 targets are achieved by 2030. A variant of human capital (or net output) analytical framework was applied to value DALYs from 162 diseases and injuries into their monetary equivalents. The 17.9 million DALYs from 162 causes in Kenya in 2017 had a total monetary value of Int$ 67,012,790,388. Approximately 57% of the monetary value of DALYs emanated from communicable, maternal, neonatal, and nutritional diseases; 36% from noncommunicable diseases; and 7% from injuries. We estimate that attainment of the five SDG3 targets would lead to an Int$ 21.5 billion (45%) decrease in the SDG3-related monetary value of DALYs by 2030. There is an urgent need for health policy-makers to use this kind of evidence when advocating among public and private sectors for increased spending on health development.

Epicurean Challenges to the Disvalue of Death

2019 ◽  
pp. 91-104 ◽  
Author(s):  
Carl Tollef Solberg
Keyword(s):  
Global Health ◽  
Priority Setting ◽  
Years Of Life Lost ◽  
Mortality Reduction ◽  
Disability Adjusted Life Years ◽  
Trade Off ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Before And After ◽  
Time Argument

In global health, several practices rely on the assumption that death has a disvalue for those who die. This includes the fact that we prioritize extending human lives rather than creating new ones, the combination Years Lived with Disability (YLD) and Years of Life Lost (YLL) into Disability-Adjusted Life Years (DALYs), as well as managing the trade-off between morbidity and mortality reduction in a health priority setting. According to Epicureanism, however, death cannot have any disvalue for those who die. Three main arguments are offered on behalf of Epicureanism: the view that we cannot experience death (the experience argument), the view that there is no time where death harms us (the time argument), and the view that there is a symmetry between the nonexistence before and after our lives (the symmetry argument). I show that all three arguments fail to convince.

scholarly journals Estimated population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling study

BMJ ◽  
2020 ◽  
pp. m824 ◽  
Author(s):  
Matti Marklund ◽  
Gitanjali Singh ◽  
Raquel Greer ◽  
Frederick Cudhea ◽  
Kunihiro Matsushita ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Adult Population ◽  
Sensitivity Analyses ◽  
Disability Adjusted Life Years ◽  
Net Benefit ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Modelling Study

AbstractObjectivesTo estimate the effects of nationwide replacement of discretionary salt (used at table or during cooking) with potassium enriched salt substitute on morbidity and death from cardiovascular disease in China.DesignModelling study.SettingChina.PopulationAdult population in China, and specifically individuals with chronic kidney disease (about 17 million people).InterventionsComparative risk assessment models were used to estimate the effects of a nationwide intervention to replace discretionary dietary salt with potassium enriched salt substitutes (20-30% potassium chloride). The models incorporated existing data and corresponding uncertainties from randomised trials, the China National Survey of Chronic Kidney Disease, the Global Burden of Disease Study, and the Chronic Kidney Disease Prognosis Consortium.Main outcome measuresAverted deaths from cardiovascular disease, non-fatal events, and disability adjusted life years from a reduction in blood pressure were estimated after implementation of potassium enriched salt substitution. In individuals with chronic kidney disease, additional deaths from cardiovascular disease related to hyperkalaemia from increased intake of potassium were calculated. The net effects on deaths from cardiovascular disease were estimated as the difference and ratio of averted and additional deaths from cardiovascular disease.ResultsNationwide implementation of potassium enriched salt substitution could prevent about 461 000 (95% uncertainty interval 196 339 to 704 438) deaths annually from cardiovascular disease, corresponding to 11.0% (4.7% to 16.8%) of annual deaths from cardiovascular disease in China; 743 000 (305 803 to 1 273 098) non-fatal cardiovascular events annually; and 7.9 (3.3 to 12.9) million disability adjusted life years related to cardiovascular disease annually. The intervention could potentially produce an estimated 11 000 (6422 to 16 562) additional deaths related to hyperkalaemia in individuals with chronic kidney disease. The net effect would be about 450 000 (183 699 to 697 084) fewer deaths annually from cardiovascular disease in the overall population and 21 000 (1928 to 42 926) fewer deaths in individuals with chronic kidney disease. In deterministic sensitivity analyses, with changes to key model inputs and assumptions, net benefits were consistent in the total population and in individuals with chronic kidney disease, with averted deaths outweighing additional deaths.ConclusionsNationwide potassium enriched salt substitution in China was estimated to result in a substantial net benefit, preventing around one in nine deaths from cardiovascular disease overall. Taking account of the risks of hyperkalaemia, a substantial net benefit was also estimated for individuals with chronic kidney disease.

scholarly journals Cancer statistics: a comparison between World Health Organization (WHO) and Global Burden of Disease (GBD)

2019 ◽  
Vol 30 (5) ◽  
pp. 1026-1027 ◽  
Author(s):  
Camilla Mattiuzzi ◽  
Giuseppe Lippi
Keyword(s):  
Global Health ◽  
Cancer Mortality ◽  
Data Exchange ◽  
World Health ◽  
Disability Adjusted Life Years ◽  
Excellent Correlation ◽  
Cancer Statistics ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Health Organization

Abstract This study aims to define comparability of 2016 statistics between Global Health Estimates (GHE) and Global Health Data Exchange (GHDx) registries for disability-adjusted life years (DALYs) and mortality of the 25 most frequent worldwide malignancies. An excellent correlation can be found between the two registries for both cancer DALYs (r = 0.988) and mortality (r = 0.993). Cancer-related DALYs are substantially equivalent (mean bias, −1.9%; P = 0.603), while cancer mortality is modestly but significantly overestimated in GDHx (mean bias, 9.1%; P = 0.004). These results suggest that cancer DALYs estimate appear almost overlapping between GHE and GHDx registries, while cancer mortality is slightly overestimated in GDHx.

scholarly journals Estimating the direct Covid-19 disability-adjusted life years impact on the Malta population for the first full year

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Cuschieri ◽  
Neville Calleja ◽  
Brecht Devleesschauwer ◽  
Grant M. A. Wyper
Keyword(s):  
Multidisciplinary Care ◽  
Population Level ◽  
Sensitivity Analyses ◽  
Disability Adjusted Life Years ◽  
Admission Data ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Causes Of Disease ◽  
The Impact ◽  
Roll Out

Abstract Background Disability-adjusted life years (DALYs) combine the impact of morbidity and mortality, allowing for comprehensive comparisons of the population. The aim was to estimate the DALYs due to Covid-19 in Malta (March 2020–21) and investigate its impact in relation to other causes of disease at a population level. Methods Mortality and weekly hospital admission data were used to calculate DALYs, based on the European Burden of Disease Network consensus Covid-19 model. Covid-19 infection duration of 14 days was considered. Sensitivity analyses for different morbidity scenarios, including post-acute consequences were presented. Results An estimated 70,421 people were infected (with and without symptoms) by Covid-19 in Malta (March 2020–1), out of which 1636 required hospitalisation and 331 deaths, contributing to 5478 DALYs. These DALYs positioned Covid-19 as the fourth leading cause of disease in Malta. Mortality contributed to 95% of DALYs, while post-acute consequences contributed to 60% of morbidity. Conclusions Covid-19 over 1 year has impacted substantially the population health in Malta. Post-acute consequences are the leading morbidity factors that require urgent targeted action to ensure timely multidisciplinary care. It is recommended that DALY estimations in 2021 and beyond are calculated to assess the impact of vaccine roll-out and emergence of new variants.

Identifying Public Health Problems

2018 ◽  
Author(s):  
Scott Burris ◽  
Micah L. Berman ◽  
Matthew Penn, and ◽  
Tara Ramanathan Holiday
Keyword(s):  
Public Health ◽  
Health Problems ◽  
Health Priorities ◽  
Disability Adjusted Life Years ◽  
Quality Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Study Designs ◽  
Quality Adjusted Life

Chapter 5 discusses the use of epidemiology to identify the source of public health problems and inform policymaking. It uses a case study to illustrate how researchers, policymakers, and practitioners detect diseases, identify their sources, determine the extent of an outbreak, and prevent new infections. The chapter also defines key measures in epidemiology that can indicate public health priorities, including morbidity and mortality, years of potential life lost, and measures of lifetime impacts, including disability-adjusted life years and quality-adjusted life years. Finally, the chapter reviews epidemiological study designs, differentiating between experimental and observational studies, to show how to interpret data and identify limitations.

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