Abstract 310: National Institutes of Health Research Investment for the Leading Causes of Disability-Adjusted Life Years in the United States

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Ryan A Coute ◽  
Brian Nathanson ◽  
Michael C Kurz ◽  
Nathan L Haas ◽  
Bryan McNally ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Research Funding ◽  
The United States ◽  
National Institutes Of Health ◽  
Disability Adjusted Life Years ◽  
Inclusion Criteria ◽  
Research Investment ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The U.S

Background: Cardiac arrest (CA) is a leading cause of disability-adjusted life years (DALY) in the United States (U.S.). The National Institutes of Health (NIH) does not report annual research funding for CA. Our objective was to calculate and compare the NIH research investment for CA to other leading causes of DALY in the U.S. Methods: A search within NIH RePORTER for the year 2016 was performed using the following terms: cardiac arrest, cardiopulmonary resuscitation, heart arrest, circulatory arrest, pulseless electrical activity, ventricular fibrillation, or resuscitation. Grants were individually reviewed and categorized as CA research (yes/no) using predefined criteria and the sum of funding for grants meeting inclusion criteria were tabulated. DALY were calculated as the sum of years of life lost (YLL) and years lived with disability (YLD) using all adult non-traumatic EMS-treated out-of-hospital CA (OHCA) from the CARES database for 2016. Total DALY for the study population were extrapolated to a national level. The leading causes of DALY were obtained from the Global Burden of Disease study. Funding data were extracted from the 2016 NIH Categorical Spending Report. Research funding were compared using U.S. dollars invested per DALY as the outcome measure. Results: The search yielded 285 NIH-funded grants, of which 65 (22.8%) were classified as CA research. Total NIH funding for CA research in 2016 was $28.5M. A total of 59,752 cases from CARES met study inclusion criteria for the DALY analysis. The total DALY following adult OHCA in the U.S. were 4,354,192 (YLL 4,350,825; YLD 3,365). Per annual DALY, the NIH invested $284 for diabetes, $89 for stroke, $53 for ischemic heart disease, and $7 for CA research in 2016 (FIGURE). Conclusion: The NIH investment into CA research is less than other leading causes of death and disability in the U.S. These results should help inform the debate regarding how to best utilize limited resources to improve public health.

The Burden of Traumatic Spinal Cord Injury in the United States: Disability-Adjusted Life Years

2019 ◽  
Vol 100 (1) ◽  
pp. 95-100 ◽  
Author(s):  
O. Trent Hall ◽  
Ryan P. McGrath ◽  
Mark D. Peterson ◽  
Edmund H. Chadd ◽  
Michael J. DeVivo ◽  
...  
Keyword(s):  
United States ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
The United States ◽  
Traumatic Spinal Cord Injury ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Cord Injury

Abstract 283: Estimating the Impact of Bystander Interventions on Disability-Adjusted Life Years Following Adult Out-of-Hospital Cardiac Arrest in the United States

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Ryan A Coute ◽  
Brian Nathanson ◽  
Ashish Panchal ◽  
Michael Kurz ◽  
Nathan Haas ◽  
...  
Keyword(s):  
Cumulative Effect ◽  
The United States ◽  
Disability Adjusted Life Years ◽  
Healthy Life ◽  
Healthy Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Bystander Cpr ◽  
The Impact ◽  
Hospital Cardiac Arrest

Background: Disability-adjusted life years (DALY) are a common public health metric used to consistently estimate and compare disease burden. The impact of bystander interventions on DALY following out-of-hospital cardiac arrest (OHCA) is unknown. Our objective was to estimate the effect of bystander CPR (B-CPR) and bystander AED (B-AED) application on DALY following OHCA in the United States (U.S.). Methods: DALY were calculated as the sum of years of life lost (YLL) and years lived with disability (YLD) using all adult non-traumatic EMS-treated OHCA from the national CARES database for 2016. A multivariable linear regression model was constructed for effect estimation with DALY values as the outcome and standard Utstein variables as independent variables. Marginal effect estimates for B-CPR and B-AED were derived in models that used all independent variables as main effects. A sensitivity analysis included interaction terms. The analysis for B-CPR was limited to bystander witnessed events. The B-AED analysis was limited to public OHCA events. The marginal effects on DALY were used to derive national estimates of life years saved. Results: A total of 19,324 OHCA cases met study inclusion criteria. The provision of B-CPR was associated with an absolute mean decrease of -0.36 DALY; 95% CI (-0.44, -0.27) per OHCA, when compared to cases without B-CPR (p<0.001). When extrapolated to a national level, the cumulative effect of B-CPR resulted in an estimated 25,317 healthy life years saved; 95% CI (19,342, 31,292). Bystander AED application was associated with a mean reduction of -0.32 DALY; 95% CI (-0.41, -0.23) per OHCA (p<0.001). The cumulative effect of B-AED application was an estimated 22,755 healthy life years saved 95% CI (16292, 29218). From a regression model that incorporated interaction effects, B-CPR with defibrillation was associated with an estimated 74,758; 95% CI (58511, 91004) healthy life years saved. Conclusion: Bystander interventions are associated with a decrease in DALY following adult OHCA. These results highlight the importance of national bystander CPR and AED education and surveillance.

scholarly journals The Goal of Epilepsy Therapy: No Seizures, No Side Effects, as Soon as Possible

CNS Spectrums ◽  
2004 ◽  
Vol 9 (2) ◽  
pp. 95-97 ◽  
Author(s):  
Jerome Engel
Keyword(s):  
Side Effects ◽  
Epileptic Seizures ◽  
The United States ◽  
World Health ◽  
Global Burden ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Health Organization ◽  
The Cost

Epilepsy is a significant health problem. Ten percent of people living a normal lifespan will experience at least one epileptic seizure and one third will develop a chronic epileptic condition. At any given time, 0.5% to 1% of the world's population has active epilepsy, amounting to over 40 million people. A World Health Organization-sponsored study determined that epilepsy accounts for 1% of the global burden of disease, measured as disability-adjusted life years equivalent to the global burden of lung cancer in men and to breast cancer in women. Disability-adjusted life years measure years of productivity lost as a result of disability or death, which is relatively high for epilepsy because this condition often begins in childhood. The cost of epilepsy in the United States has been estimated at $12.5 billion/year, and 80% of this cost is borne by the 30% of patients whose seizures are not controlled.The cost of uncontrolled epileptic seizures to society, and to individuals with epilepsy and their families, is measured not only in economic terms, but also in terms of human suffering. In this month's first article, Michael R. Sperling, MD, who has authored seminal papers on consequences of epilepsy, provides evidence that epilepsy is not a benign disorder; that early control of epileptic seizures is important to avoid irreversible disability due to the development of psychological and social disturbances and progressive cerebral dysfunction, as well as epilepsy-related death. The burden imposed on society and on individuals by uncontrolled epileptic seizures is all the more tragic because many suffer needlessly. For a significant number of adults who have had recurrent seizures since infancy, childhood, or adolescence, more aggressive early intervention might have rescued them from a lifetime of disability. Consequently, the goal of therapy today should be no seizures and no side effects, as soon as possible.

scholarly journals Comparison of COVID-19 vaccine prioritization strategies in the United States

2021 ◽  
Author(s):  
Lloyd A C Chapman ◽  
Poojan Shukla ◽  
Isabel Rodríguez-Barraquer ◽  
Priya B. Shete ◽  
Tomás M. León ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
The United States ◽  
Older Individuals ◽  
Disability Adjusted Life Years ◽  
Single Risk Factor ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Comorbidity Status ◽  
The Impact

AbstractA critical question in the COVID-19 pandemic is how to optimally allocate the first available vaccinations to maximize health impact. We used a static simulation model with detailed demographic and risk factor stratification to compare the impact of different vaccine prioritization strategies in the United States on key health outcomes, using California as a case example. We calibrated the model to demographic and location data on 28,175 COVID-19 deaths in California up to December 30, 2020, and incorporated variation in risk by occupation and comorbidity status using published estimates. We predicted the proportion of COVID-19 clinical cases, deaths and disability-adjusted life years (DALYs) averted over 6 months relative to a scenario of no vaccination for five vaccination strategies that prioritized vaccination by a single risk factor: random allocation; targeting special populations (e.g. incarcerated individuals); targeting older individuals; targeting essential workers; and targeting individuals with comorbidities. Targeting older individuals averted the highest proportion of DALYs (40% for 5 million individuals vaccinated) and deaths (65%) but the lowest proportion of cases (12%). Targeting essential workers averted the lowest proportion of DALYs (25%) and deaths (33%). Allocating vaccinations simultaneously by age and location or by age, sex, race/ethnicity, location, occupation, and comorbidity status averted a significantly higher proportion of DALYs (48% and 56%) than any strategy prioritizing by a single risk factor. Our results corroborate findings of other studies that age targeting is the best single-risk-factor prioritization strategy for averting DALYs, and suggest that targeting by multiple risk factors would provide additional benefit.Significance statementCOVID-19 has caused a global pandemic, and a key public health question is who should get the first available vaccinations. Most vaccine prioritization analyses have only considered variation in risk of infection and death by age and occupation. We provide a more granular analysis with stratification by demographics, risk factors, and location. We predict the impact of different prioritization strategies on COVID-19 cases, deaths and disability-adjusted life years (DALYs). We find that age-based targeting averts the most deaths and DALYs of strategies targeting by a single risk factor, but that targeting by two or more risk factors simultaneously would avert significantly more deaths and DALYs. Our findings highlight the potential value of multiple-risk-factor targeting of vaccination when supply is limited.

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