scholarly journals 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

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Shuhei Nomura ◽  
Yoshiko Yamamoto ◽  
Daisuke Yoneoka ◽  
Juanita A. Haagsma ◽  
Joshua A. Salomon ◽  
...  
Keyword(s):  
Japanese Population ◽  
Vision Loss ◽  
Paired Comparison ◽  
Probit Regression ◽  
Health States ◽  
Uncertainty Interval ◽  
Mild Anemia ◽  
Disability Weights ◽  
Life Years ◽  
Cord Injury

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.

scholarly journals The burden of skin disease and eye disease due to onchocerciasis in countries formerly under the African Programme for Onchocerciasis Control mandate for 1990, 2020, and 2030

2021 ◽  
Vol 15 (7) ◽  
pp. e0009604
Author(s):  
Natalie V. S. Vinkeles Melchers ◽  
Wilma A. Stolk ◽  
Welmoed van Loon ◽  
Belén Pedrique ◽  
Roel Bakker ◽  
...  
Keyword(s):  
Total Population ◽  
Vision Loss ◽  
New Drugs ◽  
Eye Disease ◽  
River Blindness ◽  
Control Distribution ◽  
Disability Weights ◽  
Life Years ◽  
Disease Study ◽  
Onchocerciasis Control

Background Onchocerciasis (“river blindness”) can cause severe morbidity, including vision loss and various skin manifestations, and is targeted for elimination using ivermectin mass drug administration (MDA). We calculated the number of people with Onchocerca volvulus infection and onchocercal skin and eye disease as well as disability-adjusted life years (DALYs) lost from 1990 through to 2030 in areas formerly covered by the African Programme for Onchocerciasis Control. Methods Per MDA implementation unit, we collated data on the pre-control distribution of microfilariae (mf) prevalence and the history of control. Next, we predicted trends in infection and morbidity over time using the ONCHOSIM simulation model. DALY estimates were calculated using disability weights from the Global Burden of Disease Study. Results In 1990, prior to MDA implementation, the total population at risk was 79.8 million with 26.0 million (32.5%) mf-positive individuals, of whom 17.5 million (21.9%) had some form of onchocercal skin or eye disease (2.5 million DALYs lost). By 2030, the total population was predicted to increase to 236.1 million, while the number of mf-positive cases (about 6.8 million, 2.9%), people with skin or eye morbidity (4.2 million, 1.8%), and DALYs lost (0.7 million) were predicted to decline. Conclusions MDA has had a remarkable impact on the onchocerciasis burden in countries previously under the APOC mandate. In the few countries where we predict continued transmission between now and 2030, intensified MDA could be combined with local vector control efforts, or the introduction of new drugs for mopping up residual cases of infection and morbidity.

scholarly journals Valuation of the EQ-5D-3L in Russia

2021 ◽  
Author(s):  
Vitaly Omelyanovskiy ◽  
Nuriya Musina ◽  
Svetlana Ratushnyak ◽  
Tatiana Bezdenezhnykh ◽  
Vlada Fediaeva ◽  
...  
Keyword(s):  
Health Problems ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Computer Assisted ◽  
Health State ◽  
Primary Analysis ◽  
Health States ◽  
Value Set ◽  
Model Combining ◽  
Life Years

Abstract Purpose The most widely used generic questionnaire to estimate the quality of life for yielding quality-adjusted life years in economic evaluations is EQ-5D. Country-specific population value sets are required to use EQ-5D in economic evaluations. The aim of this study was to establish an EQ-5D-3L value set for Russia. Methods A representative sample aged 18+ years was recruited from the Russia`s general population. Computer-assisted face–to–face interviews were conducted based on the standardized valuation protocol using EQ-Portable Valuation Technology. Population preferences were elicited utilizing both composite time trade-off (cTTO) and discrete choice experiment (DCE) techniques. To estimate the value set, a hybrid regression model combining cTTO and DCE data was used. Results A total of 300 respondents who successfully completed the interview were included in the primary analysis. 120 (40.0%) respondents reported no health problems of any dimension, and 56 (18.7%) reported moderate health problems in one dimension of the EQ‐5D‐3L. Median self-rated health using EQ‐VAS was 80 with IQR 70–90. Comparing cTTO and DCE-predicted values for 243 health states resulted in a similar pattern. This supports the use of hybrid models. The predicted value based on the preferred model for the worst health state “33333” was −0.503. Mobility dimension had the most significant impact on the utility decrement, and anxiety/depression had the lowest decrement. Conclusion Determining a Russian national value set may be considered the first step towards promoting cost-utility analysis use to increase comparability among studies and improve the transferability of healthcare decision-making in Russia.

Data inputs and assumptions in calculating the non-fatal burden in burden of disease studies

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Haagsma ◽  
G Wyper ◽  
B Devleesschauwer
Keyword(s):  
Real Life ◽  
Disability Weight ◽  
Health States ◽  
Methodological Choices ◽  
Disability Weights ◽  
Disability Adjusted Life ◽  
Simple Step ◽  
Years Lived With Disability ◽  
Disability Adjusted Life Year

Abstract Years Lived with Disability (YLD) is a component of the Disability-Adjusted Life Year (DALY), and measures the healthy time that is lost because of living with a disease or disability. YLDs are calculated by multiplying the prevalence and/or incidence of a disorder by the short- or long-term loss of health associated with that disability (the disability weight) and disease severity (severity distribution). The process of calculating a YLD involves several components and in this presentation each step will be highlighted through a sequential walk through for each step in the YLD calculation, including counting disease occurrencethe relationship between disability weights, health states and severity distributionsadjusting for comorbiditiesdealing with uncertainty The aim of this presentation is to provide a simple step by step guide on the key components in the YLD calculation. Using the real-life example of cerebrovascular disease, the presentation will outline the key choices and assumptions that underline each data input in the YLD calculation. Participants in this session will also be provided with links to resources to help facilitate this decision-making process. The workshop will end with an interactive session where the presenters will discuss the implications of the different methodological choices with the audience.

scholarly journals Implications of Brexit on the effectiveness of the UK soft drinks industry levy upon CHD in England: a modelling study

2018 ◽  
Vol 21 (18) ◽  
pp. 3431-3439
Author(s):  
Paraskevi Seferidi ◽  
Anthony A Laverty ◽  
Jonathan Pearson-Stuttard ◽  
Maria Guzman-Castillo ◽  
Brendan Collins ◽  
...  
Keyword(s):  
Food Policy ◽  
Uncertainty Interval ◽  
Sugar Price ◽  
Policy Model ◽  
Sweetened Beverages ◽  
Life Years ◽  
Economic Circumstance ◽  
One Year ◽  
The Uk ◽  
The Eu

AbstractObjectiveAn industry levy on sugar-sweetened beverages (SSB) was implemented in the UK in 2018. One year later, Brexit is likely to change the UK trade regime with potential implications for sugar price. We modelled the effect of potential changes in sugar price due to Brexit on SSB levy impacts upon CHD mortality and inequalities.DesignWe modelled a baseline SSB levy scenario; an SSB levy under ‘soft’ Brexit, where the UK establishes a free trading agreement with the EU; and an SSB levy under ‘hard’ Brexit, in which World Trade Organization tariffs are applied. We used the previously validated IMPACT Food Policy model and probabilistic sensitivity analysis to estimate the effect of each scenario on CHD deaths prevented or postponed and life-years gained, stratified by age, sex and socio-economic circumstance, in 2021.SettingEngland.SubjectsAdults aged 25 years or older.ResultsThe SSB levy was associated with approximately 370 (95 % uncertainty interval 220, 560) fewer CHD deaths and 4490 (2690, 6710) life-years gained in 2021. Associated reductions in CHD mortality were 4 and 8 % greater under ‘soft’ and ‘hard’ Brexit scenarios, respectively. The SSB levy was associated with approximately 110 (50, 190) fewer CHD deaths in the most deprived quintile compared with 60 (20, 100) in the most affluent, under ‘hard’ Brexit.ConclusionsOur study found the SSB levy resilient to potential effects of Brexit upon sugar price. Even under ‘hard’ Brexit, the SSB levy would yield benefits for CHD mortality and inequalities. Brexit negotiations should deliver a fiscal and regulatory environment which promotes population health.

Restricting tobacco sales to only pharmacies combined with cessation advice: a modelling study of the future smoking prevalence, health and cost impacts

2018 ◽  
Vol 28 (6) ◽  
pp. 643-650 ◽  
Author(s):  
Frederieke S Petrović-van der Deen ◽  
Tony Blakely ◽  
Giorgi Kvizhinadze ◽  
Christine L Cleghorn ◽  
Linda J Cobiac ◽  
...  
Keyword(s):  
Population Health ◽  
Smoking Prevalence ◽  
Large Population ◽  
Simulation Models ◽  
Intervention Package ◽  
Future Health ◽  
Uncertainty Interval ◽  
Tobacco Sales ◽  
Life Years ◽  
Tobacco Endgame

ObjectiveRestricting tobacco sales to pharmacies only, including the provision of cessation advice, has been suggested as a potential measure to hasten progress towards the tobacco endgame. We aimed to quantify the impacts of this hypothetical intervention package on future smoking prevalence, population health and health system costs for a country with an endgame goal: New Zealand (NZ).MethodsWe used two peer-reviewed simulation models: 1) a dynamic population forecasting model for smoking prevalence and 2) a closed cohort multi-state life-table model for future health gains and costs by sex, age and ethnicity. Greater costs due to increased travel distances to purchase tobacco were treated as an increase in the price of tobacco. Annual cessation rates were multiplied with the effect size for brief opportunistic cessation advice on sustained smoking abstinence.ResultsThe intervention package was associated with a reduction in future smoking prevalence, such that by 2025 prevalence was 17.3%/6.8% for Māori (Indigenous)/non-Māori compared to 20.5%/8.1% projected under no intervention. The measure was furthermore estimated to accrue 41 700 discounted quality-adjusted life-years (QALYs) (95% uncertainty interval (UI): 33 500 to 51 600) over the remainder of the 2011 NZ population’s lives. Of these QALYs gained, 74% were due to the provision of cessation advice over and above the limiting of sales to pharmacies.ConclusionsThis work provides modelling-level evidence that the package of restricting tobacco sales to only pharmacies combined with cessation advice in these settings can accelerate progress towards the tobacco endgame, and achieve large population health benefits and cost-savings.

scholarly journals Slaying little dragons: the impact of the Guinea Worm Eradication Program on dracunculiasis disability averted from 1990 to 2016

2018 ◽  
Vol 2 ◽  
pp. 30 ◽  
Author(s):  
Elizabeth A. Cromwell ◽  
Sharon Roy ◽  
Dieudonne P. Sankara ◽  
Adam Weiss ◽  
Jeffrey Stanaway ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Case Reports ◽  
Annual Number ◽  
Infection Prevalence ◽  
Eradication Program ◽  
Guinea Worm ◽  
Disability Weights ◽  
Life Years ◽  
Disease Study ◽  
The Impact

Background:The objective of this study was to document the worldwide decline of dracunculiasis (Guinea worm disease, GWD) burden, expressed as disability-adjusted life years (DALYs), from 1990 to 2016, as estimated in the Global Burden of Disease study 2016 (GBD 2016). While the annual number of cases of GWD have been consistently reported by WHO since the 1990s, the burden of disability due to GWD has not previously been quantified in GBD.Methods:The incidence of GWD was modeled for each endemic country using annual national case reports. A literature search was conducted to characterize the presentation of GWD, translate the clinical symptoms into health sequelae, and then assign an average duration to the infection. Prevalence measures by sequelae were multiplied by disability weights to estimate DALYs.Results:The total DALYs attributed to GWD across all endemic countries (n=21) in 1990 was 50,725 (95% UI: 35,265–69,197) and decreased to 0.9 (95% UI: 0.5–1.4) in 2016. A cumulative total of 12,900 DALYs were attributable to GWD from 1990 to 2016.Conclusions:Using 1990 estimates of burden propagated forward, this analysis suggests that between 990,000 to 1.9 million DALYs have been averted as a result of the eradication program over the past 27 years.

scholarly journals Disease burden of varicella versus other vaccine-preventable diseases before introduction of vaccination into the national immunisation programme in the Netherlands

2019 ◽  
Vol 24 (18) ◽  
Author(s):  
Alies van Lier ◽  
Brechje de Gier ◽  
Scott A McDonald ◽  
Marie-Josée J. Mangen ◽  
Maarten van Wijhe ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
The Netherlands ◽  
Immunisation Programme ◽  
Current Approach ◽  
Published Data ◽  
Uncertainty Interval ◽  
National Immunisation Programme ◽  
Vaccine Preventable Diseases ◽  
National Immunisation ◽  
Life Years

Introduction Estimating burden of disease (BoD) is an essential first step in the decision-making process on introducing new vaccines into national immunisation programmes (NIPs). For varicella, a common vaccine-preventable disease, BoD in the Netherlands was unknown. Aim To assess national varicella BoD and compare it to BoD of other vaccine-preventable diseases before their introduction in the NIP. Methods In this health estimates reporting study, BoD was expressed in disability-adjusted life years (DALYs) using methodology from the Burden of Communicable Diseases in Europe (BCoDE)-project. As no parameters/disease model for varicella (including herpes zoster) were available in the BCoDE toolkit, incidence, disease progression model and parameters were derived from seroprevalence, healthcare registries and published data. For most other diseases, BoD was estimated with existing BCoDE-parameters, adapted to the Netherlands if needed. Results In 2017, the estimated BoD of varicella in the Netherlands was 1,800 (95% uncertainty interval (UI): 1,800–1,900) DALYs. Herpes zoster mainly contributed to this BoD (1,600 DALYs; 91%), which was generally lower than the BoD of most current NIP diseases in the year before their introduction into the NIP. However, BoD for varicella was higher than for rotavirus gastroenteritis (1,100; 95%UI: 440–2,200 DALYs) and meningococcal B disease (620; 95%UI: 490–770 DALYs), two other potential NIP candidates. Conclusions When considering the introduction of a new vaccine in the NIP, BoD is usually estimated in isolation. The current approach assesses BoD in relation to other vaccine-preventable diseases’ BoD, which may help national advisory committees on immunisation and policymakers to set vaccination priorities.

scholarly journals A Comparison of Disability Weights for Alcohol Use Disorders

2020 ◽  
Author(s):  
Jiraluck Nontarak ◽  
Sawitri Assanangkornchai ◽  
Sarah Callinan
Keyword(s):  
Alcohol Use ◽  
Family Income ◽  
Alcohol Use Disorders ◽  
Disability Weight ◽  
Control Group ◽  
Health States ◽  
Cross Sectional ◽  
Face To Face ◽  
Valuation Methods ◽  
Disability Weights

Objective: This study aims to determine and compare the disability weights of alcohol use disorders (AUD) based on responses from AUD patients and a non-patient population using three valuation methods. Material and Methods: Cross-sectional data were collected from three hospitals in southern Thailand. Two groups of participants were recruited: 150 patients diagnosed with AUD and a control group containing 150 persons without AUD. Both groups were asked to rate the AUD health states using a visual analogue scale (VAS), and again using either the European Quality of Life-5 Dimension (EQ-5D) instrument or the time trade-off (TTO) technique. Data were collected via face-to-face interviews. Results: The mean disability weights, based on the VAS, TTO and EQ-5D valuation methods obtained from AUD patients were: 0.485, 0.405, and 0.311, respectively, while those obtained from the control group were: 0.541, 0.330, and 0.237, respectively. Disability weights had a positive correlation with AUD severity levels. Employment status and family income were significantly associated with VAS disability weight among the control group. Conclusion: The use of three different instruments to calculate disability weights for people with AUD is feasible in Thailand. The disability weights differ depending on the valuation methods used and respondent groups.

Abstract 057: Estimating the Benefits of the Proposed FDA Sodium Reformulation Policy on Cardiovascular Disease, Disparities and Economic Costs

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Jonathan Pearson-Stuttard ◽  
Chris Kypridemos ◽  
Brendan Collins ◽  
Yue Huang ◽  
Piotr Bandosz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cost Savings ◽  
Sensitivity Analyses ◽  
Sodium Reduction ◽  
Uncertainty Interval ◽  
Population Total ◽  
Health Gains ◽  
Life Years ◽  
The Us ◽  
Hispanic White

Background: Sodium consumption is a leading modifiable risk factor for CVD mortality and morbidity in the US. In 2016, the US Food and Drug Administration (FDA), following recent effective examples in several other countries, proposed voluntary sodium targets for industry to reduce sodium in processed foods. Aim: We aimed to estimate the potential CVD, equity and economic impacts of implementing this policy. Methods: We used the validated US IMPACT Food Policy microsimulation model to estimate the CVD cases averted, quality-adjusted life-years (QALYs) gained and cost-effectiveness from 2017-2036 of the FDA sodium reformulation policy in US adults (30+ years). Model inputs included national demographics and sodium intakes from NHANES, FDA short- and long-term sodium reformulation targets, sodium effects on blood pressure and of blood pressure on CVD from meta-analyses, government costs to administer and monitor the policy and industry reformulation costs, and validated healthcare and productivity costs. We modelled 3 scenarios: a) Optimal, 100% compliance of 10-year reformulation targets b) Modest, 50% compliance of 10-year reformulation targets c) Pessimistic, 100% compliance of 2-year reformulation targets with no further progress Costs were inflated to 2017 US dollars and outputs were discounted annually by 3%. We took a societal perspective for this analysis. Rigorous probabilistic sensitivity analyses were conducted. Results: The optimal scenario achieving the 10-year sodium reduction targets could prevent ~ 450,000 CVD cases (95% Uncertainty Interval: 240,000-740,000), gain 2.1 million QALYs (1.7m-2.4m), and produce $41billion ($14bn-$81bn) cost-savings from 2017-2036. The modest and pessimistic scenarios were also cost-saving, with both health gains and savings about one half and one quarter, respectively, of the optimal scenario. Relative disparities between non-Hispanic white and non-Hispanic black populations would be reduced in all scenarios. The pessimistic scenario yielded the largest reduction in absolute disparities (70,000 CVD cases (33,000-120,000) prevented in non-Hispanic blacks vs. 13,000 (0-54,000) in non-Hispanic whites). The optimal scenario would prevent approximately 4.6% (130,000 cases (65,0000-220,000)) of all CVD cases in non-Hispanic blacks compared to 1.5% (220,000 cases (120,000-360,000)) in non-Hispanic whites. Despite a smaller population, total net savings would be over 50% larger in non-Hispanic blacks than non-Hispanic whites ($19bn vs $12bn) in the optimal scenario. Conclusions: Implementing and even partly achieving the FDA sodium reduction targets could generate substantial health gains and net cost savings. Crucially, this policy could also reduce CVD disparities between non-Hispanic black and non-Hispanic white populations.

Microscopic examination of Gram-stained smears for anogenital gonorrhoea in men who have sex with men is cost-effective: evidence from a modelling study

2018 ◽  
Vol 95 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Jolijn M Zwart ◽  
Marie-Josee J Mangen ◽  
Menne Bartelsman ◽  
Martijn S van Rooijen ◽  
Henry J C de Vries ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Nucleic Acid Amplification ◽  
Sensitivity Analyses ◽  
Transmission Model ◽  
Uncertainty Interval ◽  
Testing Strategies ◽  
Life Years ◽  
Additional Costs ◽  
Sex With Men

ObjectiveTo assess the cost-effectiveness of three testing strategies with or without light microscopic Gram-stained smear (GSS) evaluation for the detection of anogenital gonorrhoea among men who have sex with men (MSM) at the Amsterdam STI clinic using a healthcare payer perspective.MethodsThree testing strategies for MSM were compared: (1) GSS in symptomatic MSM only (currently practised strategy), (2) no GSS and (3) GSS in symptomatic and asymptomatic MSM. The three testing protocols include testing with nucleic acid amplification test to verify the GSS results in (1) and (3), or as the only test in (2). A transmission model was employed to calculate the influence of the testing strategies on the prevalence of anogenital gonorrhoea over 10 years. An economic model combined cost data on medical consultations, tests and treatment and utility data to estimate the number of epididymitis cases and quality-adjusted life years (QALY) associated with gonorrhoea. Incremental cost-effectiveness ratios (ICERs) for the testing scenarios were estimated. Uncertainty and sensitivity analyses were performed.ResultsNo GSS testing compared with GSS in symptomatic MSM only (current strategy) resulted in nine extra epididymitis cases (95% uncertainty interval (UI): 2–22), 72 QALYs lost (95% UI: 59–187) and €7300 additional costs (95% UI: −€185 000 (i.e.cost-saving) to €407 000) over 10 years. GSS testing in both symptomatic and asymptomatic MSM compared with GSS in symptomatic MSM only resulted in one prevented epididymitis case (95% UI: 0–2), 1.1 QALY gained (95% UI: 0.1–3.3), €148 000 additional costs (95% UI: €86 000 to–€217 000) and an ICER of €177 000 (95% UI: €67 000–to €705 000) per QALY gained over 10 years. The results were robust in sensitivity analyses.ConclusionsGSS for symptomatic MSM only is cost-effective compared with no GSS for MSM and with GSS for both symptomatic and asymptomatic MSM.

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