Quality-Adjusted Life Years and Disability-Adjusted Life Years Are Better With Concurrent Chemoradiation Therapy Than Induction Chemotherapy Followed by Chemoradiation Therapy in Nasopharyngeal Carcinoma

Life Years ◽

Study Designs ◽

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.

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

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462320000124 ◽

2020 ◽

Vol 36 (2) ◽

pp. 96-103 ◽

Cited By ~ 2

Author(s):

Xue Feng ◽

David D. Kim ◽

Joshua T. Cohen ◽

Peter J. Neumann ◽

Daniel A. Ollendorf

Keyword(s):

Cost Effectiveness ◽

Medical Center ◽

Effectiveness Analysis ◽

Disability Weights ◽

Life Years ◽

Relative Differences ◽

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.

Burden of Disease in Asian Countries and the use of Disability-Adjusted Life-Years and Quality-Adjusted Life-Years

Value in Health ◽

10.1016/j.jval.2014.08.199 ◽

2014 ◽

Vol 17 (7) ◽

pp. A751

Author(s):

Z.C. Groom ◽

R.C. Beale ◽

C. Brooks-Rooney

Keyword(s):

Burden Of Disease ◽

Asian Countries ◽

Life Years ◽

Disability-Adjusted Life Years Averted Versus Quality-Adjusted Life Years Gained: A Model Analysis for Breast Cancer Screening

Value in Health ◽

10.1016/j.jval.2020.10.018 ◽

2021 ◽

Vol 24 (3) ◽

pp. 353-360

Author(s):

Maša Davidović ◽

Nadine Zielonke ◽

Iris Lansdorp-Vogelaar ◽

Nereo Segnan ◽

Harry J. de Koning ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Model Analysis ◽

Life Years ◽

Plasma EBV DNA as a Predictive Biomarker in Patients With Endemic Nasopharyngeal Carcinoma Treated With Induction Chemotherapy and Concurrent Chemoradiation Therapy

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2014.05.555 ◽

2014 ◽

Vol 90 (1) ◽

pp. S120-S121 ◽

Cited By ~ 7

Author(s):

M. Chua ◽

O. Whee Sze ◽

J. Wee ◽

Y. Soong ◽

D. Lim ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Induction Chemotherapy ◽

Predictive Biomarker ◽

Chemoradiation Therapy ◽

Concurrent Chemoradiation ◽

Ebv Dna ◽

Concurrent Chemoradiation Therapy

Efficacy and Factor Affecting Outcome of Induction Chemotherapy Combined Concurrent Chemoradiation Therapy in 263 Patients With Locally Advanced Nasopharyngeal Carcinoma

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2014.05.1601 ◽

2014 ◽

Vol 90 (1) ◽

pp. S524 ◽

Cited By ~ 2

Author(s):

F. Ma ◽

F. Jin ◽

F. Jin

Keyword(s):

Nasopharyngeal Carcinoma ◽

Induction Chemotherapy ◽

Locally Advanced ◽

Chemoradiation Therapy ◽

Concurrent Chemoradiation ◽

Concurrent Chemoradiation Therapy

Population health, economics and ethics in the age of COVID-19

BMJ Global Health ◽

10.1136/bmjgh-2020-003259 ◽

2020 ◽

Vol 5 (7) ◽

pp. e003259 ◽

Cited By ~ 1

Author(s):

Sanjay G Reddy

Keyword(s):

Public Health ◽

Population Health ◽

Health Measures ◽

Balanced Approach ◽

Life Years ◽

Aggregate Population ◽

Are the steps that have been taken to arrest the spread of COVID-19 justifiable? Specifically, are they likely to have improved public health understood according to widely used aggregate population health measures, such as Quality Adjusted Life Years (QALYs) and Disability Adjusted Life Years (DALYs) as much or more than alternatives? This is a reasonable question, since such measures have been promoted extensively in global and national health policy by influential actors, and they have become almost synonymous with quantification of public health. If the steps taken against COVID-19 did not meet this test, then either the measures or the policies must be re-evaluated. There are indications that policies against COVID-19 may have been unbalanced and therefore not optimal. A balanced approach to protecting population health should be proportionate in its effects across distinct health concerns at a moment, across populations over time and across populations over space. These criteria provide a guide to designing and implementing policies that diminish harm from COVID-19 while also providing due attention to other threats to aggregate population health. They should shape future policies in response to this pandemic and others.