Common values in assessing health outcomes from disease and injury: Disability weights measurement study for the Global Burden of Disease Study 2010

Joshua A. Salomon, Theo Vos, Daniel R. Hogan, Michael Gagnon, Mohsen Naghavi, Ali Mokdad, Nazma Begum, Razibuzzaman Shah, Muhammad Karyana, Soewarta Kosen, Mario Reyna Farje, Gilberto Moncada, Arup Dutta, Sunil Sazawal, Andrew Dyer, Jason Seiler, Victor Aboyans, Lesley Baker, Amanda Baxter, Emelia J. BenjaminKavi Bhalla, Aref Bin Abdulhak, Fiona Blyth, Rupert Bourne, Tasanee Braithwaite, Peter Brooks, Traolach S. Brugha, Claire Bryan-Hancock, Rachelle Buchbinder, Peter Burney, Bianca Calabria, Honglei Chen, Sumeet S. Chugh, Rebecca Cooley, Michael H. Criqui, Marita Cross, Kaustubh C. Dabhadkar, Nabila Dahodwala, Adrian Davis, Louisa Degenhardt, Cesar Díaz-Torné, E. Ray Dorsey, Tim Driscoll, Karen Edmond, Alexis Elbaz, Majid Ezzati, Valery Feigin, Cleusa P. Ferri, Abraham D. Flaxman, Louise Flood, Marlene Fransen, Kana Fuse, Belinda J. Gabbe, Richard F. Gillum, Juanita Haagsma, James E. Harrison, Rasmus Havmoeller, Roderick J. Hay, Abdullah Hel-Baqui, Hans W. Hoek, Howard Hoffman, Emily Hogeland, Damian Hoy, Deborah Jarvis, Ganesan Karthikeyan, Lisa Marie Knowlton, Tim Lathlean, Janet L. Leasher, Stephen S. Lim, Steven E Lipshultz, Alan D. Lopez, Rafael Lozano, Ronan Lyons, Reza Malekzadeh, Wagner Marcenes, Lyn March, David J. Margolis, Neil McGill, John McGrath, George A. Mensah, Ana Claire Meyer, Catherine Michaud, Andrew Moran, Rintaro Mori, Michele E. Murdoch, Luigi Naldi, Charles R. Newton, Rosana Norman, Saad B. Omer, Richard Osborne, Neil Pearce, Fernando Perez-Ruiz, Norberto Perico, Konrad Pesudovs, David Phillips, Farshad Pourmalek, Martin Prince, Jürgen T. Rehm, Guiseppe Remuzzi, Kathryn Richardson, Robin Room, Sukanta Saha, Uchechukwu Sampson, Lidia Sanchez-Riera, Maria Segui-Gomez, Saeid Shahraz, Kenji Shibuya, David Singh, Karen Sliwa, Emma Smith, Isabelle Soerjomataram, Timothy Steiner, Wilma A. Stolk, Lars Jacob Stovner, Christopher Sudfeld, Hugh R. Taylor, Imad M. Tleyjeh, Marieke J. Van Der Werf, Wendy L. Watson, David J. Weatherall, Robert Weintraub, Marc G. Weisskopf, Harvey Whiteford, James D. Wilkinson, Anthony D. Woolf, Zhi Jie Zheng, Christopher J L Murray

Research output: Contribution to journalArticle

713 Citations (Scopus)

Abstract

Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these weights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden of Disease Study 2010 through a large-scale empirical investigation in which judgments about health losses associated with many causes of disease and injury were elicited from the general public in diverse communities through a new, standardised approach. Methods We surveyed respondents in two ways: household surveys of adults aged 18 years or older (face-to-face interviews in Bangladesh, Indonesia, Peru, and Tanzania; telephone interviews in the USA) between Oct 28, 2009, and June 23, 2010; and an open-access web-based survey between July 26, 2010, and May 16, 2011. The surveys used paired comparison questions, in which respondents considered two hypothetical individuals with different, randomly selected health states and indicated which person they regarded as healthier. The web survey added questions about population health equivalence, which compared the overall health benefits of different life-saving or diseaseprevention programmes. We analysed paired comparison responses with probit regression analysis on all 220 unique states in the study. We used results from the population health equivalence responses to anchor the results from the paired comparisons on the disability weight scale from 0 (implying no loss of health) to 1 (implying a health loss equivalent to death). Additionally, we compared new disability weights with those used in WHO's most recent update of the Global Burden of Disease Study for 2004. Findings 13 902 individuals participated in household surveys and 16 328 in the web survey. Analysis of paired comparison responses indicated a high degree of consistency across surveys: correlations between individual survey results and results from analysis of the pooled dataset were 0 9 or higher in all surveys except in Bangladesh (r=0 75). Most of the 220 disability weights were located on the mild end of the severity scale, with 58 (26%) having weights below 0 05. Five (11%) states had weights below 0 01, such as mild anaemia, mild hearing or vision loss, and secondary infertility. The health states with the highest disability weights were acute schizophrenia (0 76) and severe multiple sclerosis (0 71). We identified a broad pattern of agreement between the old and new weights (r=0 70), particularly in the moderate-to-severe range. However, in the mild range below 0 2, many states had significantly lower weights in our study than previously. Interpretation This study represents the most extensive empirical effort as yet to measure disability weights. By contrast with the popular hypothesis that disability assessments vary widely across samples with different cultural environments, we have reported strong evidence of highly consistent results.

Original languageEnglish
Pages (from-to)2129-2143
Number of pages15
JournalThe Lancet
Volume380
Issue number9859
DOIs
StatePublished - Dec 1 2012
Externally publishedYes

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Weights and Measures
Health
Wounds and Injuries
Matched-Pair Analysis
Bangladesh
Global Burden of Disease
Surveys and Questionnaires
Deaf-Blind Disorders
Interviews
Peru
Indonesia
Tanzania
Quality-Adjusted Life Years
Insurance Benefits
Infertility
Population
Multiple Sclerosis
Anemia
Schizophrenia
Regression Analysis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Common values in assessing health outcomes from disease and injury : Disability weights measurement study for the Global Burden of Disease Study 2010. / Salomon, Joshua A.; Vos, Theo; Hogan, Daniel R.; Gagnon, Michael; Naghavi, Mohsen; Mokdad, Ali; Begum, Nazma; Shah, Razibuzzaman; Karyana, Muhammad; Kosen, Soewarta; Farje, Mario Reyna; Moncada, Gilberto; Dutta, Arup; Sazawal, Sunil; Dyer, Andrew; Seiler, Jason; Aboyans, Victor; Baker, Lesley; Baxter, Amanda; Benjamin, Emelia J.; Bhalla, Kavi; Abdulhak, Aref Bin; Blyth, Fiona; Bourne, Rupert; Braithwaite, Tasanee; Brooks, Peter; Brugha, Traolach S.; Bryan-Hancock, Claire; Buchbinder, Rachelle; Burney, Peter; Calabria, Bianca; Chen, Honglei; Chugh, Sumeet S.; Cooley, Rebecca; Criqui, Michael H.; Cross, Marita; Dabhadkar, Kaustubh C.; Dahodwala, Nabila; Davis, Adrian; Degenhardt, Louisa; Díaz-Torné, Cesar; Dorsey, E. Ray; Driscoll, Tim; Edmond, Karen; Elbaz, Alexis; Ezzati, Majid; Feigin, Valery; Ferri, Cleusa P.; Flaxman, Abraham D.; Flood, Louise; Fransen, Marlene; Fuse, Kana; Gabbe, Belinda J.; Gillum, Richard F.; Haagsma, Juanita; Harrison, James E.; Havmoeller, Rasmus; Hay, Roderick J.; Hel-Baqui, Abdullah; Hoek, Hans W.; Hoffman, Howard; Hogeland, Emily; Hoy, Damian; Jarvis, Deborah; Karthikeyan, Ganesan; Knowlton, Lisa Marie; Lathlean, Tim; Leasher, Janet L.; Lim, Stephen S.; Lipshultz, Steven E; Lopez, Alan D.; Lozano, Rafael; Lyons, Ronan; Malekzadeh, Reza; Marcenes, Wagner; March, Lyn; Margolis, David J.; McGill, Neil; McGrath, John; Mensah, George A.; Meyer, Ana Claire; Michaud, Catherine; Moran, Andrew; Mori, Rintaro; Murdoch, Michele E.; Naldi, Luigi; Newton, Charles R.; Norman, Rosana; Omer, Saad B.; Osborne, Richard; Pearce, Neil; Perez-Ruiz, Fernando; Perico, Norberto; Pesudovs, Konrad; Phillips, David; Pourmalek, Farshad; Prince, Martin; Rehm, Jürgen T.; Remuzzi, Guiseppe; Richardson, Kathryn; Room, Robin; Saha, Sukanta; Sampson, Uchechukwu; Sanchez-Riera, Lidia; Segui-Gomez, Maria; Shahraz, Saeid; Shibuya, Kenji; Singh, David; Sliwa, Karen; Smith, Emma; Soerjomataram, Isabelle; Steiner, Timothy; Stolk, Wilma A.; Stovner, Lars Jacob; Sudfeld, Christopher; Taylor, Hugh R.; Tleyjeh, Imad M.; Van Der Werf, Marieke J.; Watson, Wendy L.; Weatherall, David J.; Weintraub, Robert; Weisskopf, Marc G.; Whiteford, Harvey; Wilkinson, James D.; Woolf, Anthony D.; Zheng, Zhi Jie; Murray, Christopher J L.

In: The Lancet, Vol. 380, No. 9859, 01.12.2012, p. 2129-2143.

Research output: Contribution to journalArticle

Salomon, JA, Vos, T, Hogan, DR, Gagnon, M, Naghavi, M, Mokdad, A, Begum, N, Shah, R, Karyana, M, Kosen, S, Farje, MR, Moncada, G, Dutta, A, Sazawal, S, Dyer, A, Seiler, J, Aboyans, V, Baker, L, Baxter, A, Benjamin, EJ, Bhalla, K, Abdulhak, AB, Blyth, F, Bourne, R, Braithwaite, T, Brooks, P, Brugha, TS, Bryan-Hancock, C, Buchbinder, R, Burney, P, Calabria, B, Chen, H, Chugh, SS, Cooley, R, Criqui, MH, Cross, M, Dabhadkar, KC, Dahodwala, N, Davis, A, Degenhardt, L, Díaz-Torné, C, Dorsey, ER, Driscoll, T, Edmond, K, Elbaz, A, Ezzati, M, Feigin, V, Ferri, CP, Flaxman, AD, Flood, L, Fransen, M, Fuse, K, Gabbe, BJ, Gillum, RF, Haagsma, J, Harrison, JE, Havmoeller, R, Hay, RJ, Hel-Baqui, A, Hoek, HW, Hoffman, H, Hogeland, E, Hoy, D, Jarvis, D, Karthikeyan, G, Knowlton, LM, Lathlean, T, Leasher, JL, Lim, SS, Lipshultz, SE, Lopez, AD, Lozano, R, Lyons, R, Malekzadeh, R, Marcenes, W, March, L, Margolis, DJ, McGill, N, McGrath, J, Mensah, GA, Meyer, AC, Michaud, C, Moran, A, Mori, R, Murdoch, ME, Naldi, L, Newton, CR, Norman, R, Omer, SB, Osborne, R, Pearce, N, Perez-Ruiz, F, Perico, N, Pesudovs, K, Phillips, D, Pourmalek, F, Prince, M, Rehm, JT, Remuzzi, G, Richardson, K, Room, R, Saha, S, Sampson, U, Sanchez-Riera, L, Segui-Gomez, M, Shahraz, S, Shibuya, K, Singh, D, Sliwa, K, Smith, E, Soerjomataram, I, Steiner, T, Stolk, WA, Stovner, LJ, Sudfeld, C, Taylor, HR, Tleyjeh, IM, Van Der Werf, MJ, Watson, WL, Weatherall, DJ, Weintraub, R, Weisskopf, MG, Whiteford, H, Wilkinson, JD, Woolf, AD, Zheng, ZJ & Murray, CJL 2012, 'Common values in assessing health outcomes from disease and injury: Disability weights measurement study for the Global Burden of Disease Study 2010', The Lancet, vol. 380, no. 9859, pp. 2129-2143. https://doi.org/10.1016/S0140-6736(12)61680-8
Salomon, Joshua A. ; Vos, Theo ; Hogan, Daniel R. ; Gagnon, Michael ; Naghavi, Mohsen ; Mokdad, Ali ; Begum, Nazma ; Shah, Razibuzzaman ; Karyana, Muhammad ; Kosen, Soewarta ; Farje, Mario Reyna ; Moncada, Gilberto ; Dutta, Arup ; Sazawal, Sunil ; Dyer, Andrew ; Seiler, Jason ; Aboyans, Victor ; Baker, Lesley ; Baxter, Amanda ; Benjamin, Emelia J. ; Bhalla, Kavi ; Abdulhak, Aref Bin ; Blyth, Fiona ; Bourne, Rupert ; Braithwaite, Tasanee ; Brooks, Peter ; Brugha, Traolach S. ; Bryan-Hancock, Claire ; Buchbinder, Rachelle ; Burney, Peter ; Calabria, Bianca ; Chen, Honglei ; Chugh, Sumeet S. ; Cooley, Rebecca ; Criqui, Michael H. ; Cross, Marita ; Dabhadkar, Kaustubh C. ; Dahodwala, Nabila ; Davis, Adrian ; Degenhardt, Louisa ; Díaz-Torné, Cesar ; Dorsey, E. Ray ; Driscoll, Tim ; Edmond, Karen ; Elbaz, Alexis ; Ezzati, Majid ; Feigin, Valery ; Ferri, Cleusa P. ; Flaxman, Abraham D. ; Flood, Louise ; Fransen, Marlene ; Fuse, Kana ; Gabbe, Belinda J. ; Gillum, Richard F. ; Haagsma, Juanita ; Harrison, James E. ; Havmoeller, Rasmus ; Hay, Roderick J. ; Hel-Baqui, Abdullah ; Hoek, Hans W. ; Hoffman, Howard ; Hogeland, Emily ; Hoy, Damian ; Jarvis, Deborah ; Karthikeyan, Ganesan ; Knowlton, Lisa Marie ; Lathlean, Tim ; Leasher, Janet L. ; Lim, Stephen S. ; Lipshultz, Steven E ; Lopez, Alan D. ; Lozano, Rafael ; Lyons, Ronan ; Malekzadeh, Reza ; Marcenes, Wagner ; March, Lyn ; Margolis, David J. ; McGill, Neil ; McGrath, John ; Mensah, George A. ; Meyer, Ana Claire ; Michaud, Catherine ; Moran, Andrew ; Mori, Rintaro ; Murdoch, Michele E. ; Naldi, Luigi ; Newton, Charles R. ; Norman, Rosana ; Omer, Saad B. ; Osborne, Richard ; Pearce, Neil ; Perez-Ruiz, Fernando ; Perico, Norberto ; Pesudovs, Konrad ; Phillips, David ; Pourmalek, Farshad ; Prince, Martin ; Rehm, Jürgen T. ; Remuzzi, Guiseppe ; Richardson, Kathryn ; Room, Robin ; Saha, Sukanta ; Sampson, Uchechukwu ; Sanchez-Riera, Lidia ; Segui-Gomez, Maria ; Shahraz, Saeid ; Shibuya, Kenji ; Singh, David ; Sliwa, Karen ; Smith, Emma ; Soerjomataram, Isabelle ; Steiner, Timothy ; Stolk, Wilma A. ; Stovner, Lars Jacob ; Sudfeld, Christopher ; Taylor, Hugh R. ; Tleyjeh, Imad M. ; Van Der Werf, Marieke J. ; Watson, Wendy L. ; Weatherall, David J. ; Weintraub, Robert ; Weisskopf, Marc G. ; Whiteford, Harvey ; Wilkinson, James D. ; Woolf, Anthony D. ; Zheng, Zhi Jie ; Murray, Christopher J L. / Common values in assessing health outcomes from disease and injury : Disability weights measurement study for the Global Burden of Disease Study 2010. In: The Lancet. 2012 ; Vol. 380, No. 9859. pp. 2129-2143.
@article{680198b1328247f795d44dc91d977422,
title = "Common values in assessing health outcomes from disease and injury: Disability weights measurement study for the Global Burden of Disease Study 2010",
abstract = "Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these weights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden of Disease Study 2010 through a large-scale empirical investigation in which judgments about health losses associated with many causes of disease and injury were elicited from the general public in diverse communities through a new, standardised approach. Methods We surveyed respondents in two ways: household surveys of adults aged 18 years or older (face-to-face interviews in Bangladesh, Indonesia, Peru, and Tanzania; telephone interviews in the USA) between Oct 28, 2009, and June 23, 2010; and an open-access web-based survey between July 26, 2010, and May 16, 2011. The surveys used paired comparison questions, in which respondents considered two hypothetical individuals with different, randomly selected health states and indicated which person they regarded as healthier. The web survey added questions about population health equivalence, which compared the overall health benefits of different life-saving or diseaseprevention programmes. We analysed paired comparison responses with probit regression analysis on all 220 unique states in the study. We used results from the population health equivalence responses to anchor the results from the paired comparisons on the disability weight scale from 0 (implying no loss of health) to 1 (implying a health loss equivalent to death). Additionally, we compared new disability weights with those used in WHO's most recent update of the Global Burden of Disease Study for 2004. Findings 13 902 individuals participated in household surveys and 16 328 in the web survey. Analysis of paired comparison responses indicated a high degree of consistency across surveys: correlations between individual survey results and results from analysis of the pooled dataset were 0 9 or higher in all surveys except in Bangladesh (r=0 75). Most of the 220 disability weights were located on the mild end of the severity scale, with 58 (26{\%}) having weights below 0 05. Five (11{\%}) states had weights below 0 01, such as mild anaemia, mild hearing or vision loss, and secondary infertility. The health states with the highest disability weights were acute schizophrenia (0 76) and severe multiple sclerosis (0 71). We identified a broad pattern of agreement between the old and new weights (r=0 70), particularly in the moderate-to-severe range. However, in the mild range below 0 2, many states had significantly lower weights in our study than previously. Interpretation This study represents the most extensive empirical effort as yet to measure disability weights. By contrast with the popular hypothesis that disability assessments vary widely across samples with different cultural environments, we have reported strong evidence of highly consistent results.",
author = "Salomon, {Joshua A.} and Theo Vos and Hogan, {Daniel R.} and Michael Gagnon and Mohsen Naghavi and Ali Mokdad and Nazma Begum and Razibuzzaman Shah and Muhammad Karyana and Soewarta Kosen and Farje, {Mario Reyna} and Gilberto Moncada and Arup Dutta and Sunil Sazawal and Andrew Dyer and Jason Seiler and Victor Aboyans and Lesley Baker and Amanda Baxter and Benjamin, {Emelia J.} and Kavi Bhalla and Abdulhak, {Aref Bin} and Fiona Blyth and Rupert Bourne and Tasanee Braithwaite and Peter Brooks and Brugha, {Traolach S.} and Claire Bryan-Hancock and Rachelle Buchbinder and Peter Burney and Bianca Calabria and Honglei Chen and Chugh, {Sumeet S.} and Rebecca Cooley and Criqui, {Michael H.} and Marita Cross and Dabhadkar, {Kaustubh C.} and Nabila Dahodwala and Adrian Davis and Louisa Degenhardt and Cesar D{\'i}az-Torn{\'e} and Dorsey, {E. Ray} and Tim Driscoll and Karen Edmond and Alexis Elbaz and Majid Ezzati and Valery Feigin and Ferri, {Cleusa P.} and Flaxman, {Abraham D.} and Louise Flood and Marlene Fransen and Kana Fuse and Gabbe, {Belinda J.} and Gillum, {Richard F.} and Juanita Haagsma and Harrison, {James E.} and Rasmus Havmoeller and Hay, {Roderick J.} and Abdullah Hel-Baqui and Hoek, {Hans W.} and Howard Hoffman and Emily Hogeland and Damian Hoy and Deborah Jarvis and Ganesan Karthikeyan and Knowlton, {Lisa Marie} and Tim Lathlean and Leasher, {Janet L.} and Lim, {Stephen S.} and Lipshultz, {Steven E} and Lopez, {Alan D.} and Rafael Lozano and Ronan Lyons and Reza Malekzadeh and Wagner Marcenes and Lyn March and Margolis, {David J.} and Neil McGill and John McGrath and Mensah, {George A.} and Meyer, {Ana Claire} and Catherine Michaud and Andrew Moran and Rintaro Mori and Murdoch, {Michele E.} and Luigi Naldi and Newton, {Charles R.} and Rosana Norman and Omer, {Saad B.} and Richard Osborne and Neil Pearce and Fernando Perez-Ruiz and Norberto Perico and Konrad Pesudovs and David Phillips and Farshad Pourmalek and Martin Prince and Rehm, {J{\"u}rgen T.} and Guiseppe Remuzzi and Kathryn Richardson and Robin Room and Sukanta Saha and Uchechukwu Sampson and Lidia Sanchez-Riera and Maria Segui-Gomez and Saeid Shahraz and Kenji Shibuya and David Singh and Karen Sliwa and Emma Smith and Isabelle Soerjomataram and Timothy Steiner and Stolk, {Wilma A.} and Stovner, {Lars Jacob} and Christopher Sudfeld and Taylor, {Hugh R.} and Tleyjeh, {Imad M.} and {Van Der Werf}, {Marieke J.} and Watson, {Wendy L.} and Weatherall, {David J.} and Robert Weintraub and Weisskopf, {Marc G.} and Harvey Whiteford and Wilkinson, {James D.} and Woolf, {Anthony D.} and Zheng, {Zhi Jie} and Murray, {Christopher J L}",
year = "2012",
month = "12",
day = "1",
doi = "10.1016/S0140-6736(12)61680-8",
language = "English",
volume = "380",
pages = "2129--2143",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "9859",

}

TY - JOUR

T1 - Common values in assessing health outcomes from disease and injury

T2 - Disability weights measurement study for the Global Burden of Disease Study 2010

AU - Salomon, Joshua A.

AU - Vos, Theo

AU - Hogan, Daniel R.

AU - Gagnon, Michael

AU - Naghavi, Mohsen

AU - Mokdad, Ali

AU - Begum, Nazma

AU - Shah, Razibuzzaman

AU - Karyana, Muhammad

AU - Kosen, Soewarta

AU - Farje, Mario Reyna

AU - Moncada, Gilberto

AU - Dutta, Arup

AU - Sazawal, Sunil

AU - Dyer, Andrew

AU - Seiler, Jason

AU - Aboyans, Victor

AU - Baker, Lesley

AU - Baxter, Amanda

AU - Benjamin, Emelia J.

AU - Bhalla, Kavi

AU - Abdulhak, Aref Bin

AU - Blyth, Fiona

AU - Bourne, Rupert

AU - Braithwaite, Tasanee

AU - Brooks, Peter

AU - Brugha, Traolach S.

AU - Bryan-Hancock, Claire

AU - Buchbinder, Rachelle

AU - Burney, Peter

AU - Calabria, Bianca

AU - Chen, Honglei

AU - Chugh, Sumeet S.

AU - Cooley, Rebecca

AU - Criqui, Michael H.

AU - Cross, Marita

AU - Dabhadkar, Kaustubh C.

AU - Dahodwala, Nabila

AU - Davis, Adrian

AU - Degenhardt, Louisa

AU - Díaz-Torné, Cesar

AU - Dorsey, E. Ray

AU - Driscoll, Tim

AU - Edmond, Karen

AU - Elbaz, Alexis

AU - Ezzati, Majid

AU - Feigin, Valery

AU - Ferri, Cleusa P.

AU - Flaxman, Abraham D.

AU - Flood, Louise

AU - Fransen, Marlene

AU - Fuse, Kana

AU - Gabbe, Belinda J.

AU - Gillum, Richard F.

AU - Haagsma, Juanita

AU - Harrison, James E.

AU - Havmoeller, Rasmus

AU - Hay, Roderick J.

AU - Hel-Baqui, Abdullah

AU - Hoek, Hans W.

AU - Hoffman, Howard

AU - Hogeland, Emily

AU - Hoy, Damian

AU - Jarvis, Deborah

AU - Karthikeyan, Ganesan

AU - Knowlton, Lisa Marie

AU - Lathlean, Tim

AU - Leasher, Janet L.

AU - Lim, Stephen S.

AU - Lipshultz, Steven E

AU - Lopez, Alan D.

AU - Lozano, Rafael

AU - Lyons, Ronan

AU - Malekzadeh, Reza

AU - Marcenes, Wagner

AU - March, Lyn

AU - Margolis, David J.

AU - McGill, Neil

AU - McGrath, John

AU - Mensah, George A.

AU - Meyer, Ana Claire

AU - Michaud, Catherine

AU - Moran, Andrew

AU - Mori, Rintaro

AU - Murdoch, Michele E.

AU - Naldi, Luigi

AU - Newton, Charles R.

AU - Norman, Rosana

AU - Omer, Saad B.

AU - Osborne, Richard

AU - Pearce, Neil

AU - Perez-Ruiz, Fernando

AU - Perico, Norberto

AU - Pesudovs, Konrad

AU - Phillips, David

AU - Pourmalek, Farshad

AU - Prince, Martin

AU - Rehm, Jürgen T.

AU - Remuzzi, Guiseppe

AU - Richardson, Kathryn

AU - Room, Robin

AU - Saha, Sukanta

AU - Sampson, Uchechukwu

AU - Sanchez-Riera, Lidia

AU - Segui-Gomez, Maria

AU - Shahraz, Saeid

AU - Shibuya, Kenji

AU - Singh, David

AU - Sliwa, Karen

AU - Smith, Emma

AU - Soerjomataram, Isabelle

AU - Steiner, Timothy

AU - Stolk, Wilma A.

AU - Stovner, Lars Jacob

AU - Sudfeld, Christopher

AU - Taylor, Hugh R.

AU - Tleyjeh, Imad M.

AU - Van Der Werf, Marieke J.

AU - Watson, Wendy L.

AU - Weatherall, David J.

AU - Weintraub, Robert

AU - Weisskopf, Marc G.

AU - Whiteford, Harvey

AU - Wilkinson, James D.

AU - Woolf, Anthony D.

AU - Zheng, Zhi Jie

AU - Murray, Christopher J L

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these weights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden of Disease Study 2010 through a large-scale empirical investigation in which judgments about health losses associated with many causes of disease and injury were elicited from the general public in diverse communities through a new, standardised approach. Methods We surveyed respondents in two ways: household surveys of adults aged 18 years or older (face-to-face interviews in Bangladesh, Indonesia, Peru, and Tanzania; telephone interviews in the USA) between Oct 28, 2009, and June 23, 2010; and an open-access web-based survey between July 26, 2010, and May 16, 2011. The surveys used paired comparison questions, in which respondents considered two hypothetical individuals with different, randomly selected health states and indicated which person they regarded as healthier. The web survey added questions about population health equivalence, which compared the overall health benefits of different life-saving or diseaseprevention programmes. We analysed paired comparison responses with probit regression analysis on all 220 unique states in the study. We used results from the population health equivalence responses to anchor the results from the paired comparisons on the disability weight scale from 0 (implying no loss of health) to 1 (implying a health loss equivalent to death). Additionally, we compared new disability weights with those used in WHO's most recent update of the Global Burden of Disease Study for 2004. Findings 13 902 individuals participated in household surveys and 16 328 in the web survey. Analysis of paired comparison responses indicated a high degree of consistency across surveys: correlations between individual survey results and results from analysis of the pooled dataset were 0 9 or higher in all surveys except in Bangladesh (r=0 75). Most of the 220 disability weights were located on the mild end of the severity scale, with 58 (26%) having weights below 0 05. Five (11%) states had weights below 0 01, such as mild anaemia, mild hearing or vision loss, and secondary infertility. The health states with the highest disability weights were acute schizophrenia (0 76) and severe multiple sclerosis (0 71). We identified a broad pattern of agreement between the old and new weights (r=0 70), particularly in the moderate-to-severe range. However, in the mild range below 0 2, many states had significantly lower weights in our study than previously. Interpretation This study represents the most extensive empirical effort as yet to measure disability weights. By contrast with the popular hypothesis that disability assessments vary widely across samples with different cultural environments, we have reported strong evidence of highly consistent results.

AB - Background Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these weights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden of Disease Study 2010 through a large-scale empirical investigation in which judgments about health losses associated with many causes of disease and injury were elicited from the general public in diverse communities through a new, standardised approach. Methods We surveyed respondents in two ways: household surveys of adults aged 18 years or older (face-to-face interviews in Bangladesh, Indonesia, Peru, and Tanzania; telephone interviews in the USA) between Oct 28, 2009, and June 23, 2010; and an open-access web-based survey between July 26, 2010, and May 16, 2011. The surveys used paired comparison questions, in which respondents considered two hypothetical individuals with different, randomly selected health states and indicated which person they regarded as healthier. The web survey added questions about population health equivalence, which compared the overall health benefits of different life-saving or diseaseprevention programmes. We analysed paired comparison responses with probit regression analysis on all 220 unique states in the study. We used results from the population health equivalence responses to anchor the results from the paired comparisons on the disability weight scale from 0 (implying no loss of health) to 1 (implying a health loss equivalent to death). Additionally, we compared new disability weights with those used in WHO's most recent update of the Global Burden of Disease Study for 2004. Findings 13 902 individuals participated in household surveys and 16 328 in the web survey. Analysis of paired comparison responses indicated a high degree of consistency across surveys: correlations between individual survey results and results from analysis of the pooled dataset were 0 9 or higher in all surveys except in Bangladesh (r=0 75). Most of the 220 disability weights were located on the mild end of the severity scale, with 58 (26%) having weights below 0 05. Five (11%) states had weights below 0 01, such as mild anaemia, mild hearing or vision loss, and secondary infertility. The health states with the highest disability weights were acute schizophrenia (0 76) and severe multiple sclerosis (0 71). We identified a broad pattern of agreement between the old and new weights (r=0 70), particularly in the moderate-to-severe range. However, in the mild range below 0 2, many states had significantly lower weights in our study than previously. Interpretation This study represents the most extensive empirical effort as yet to measure disability weights. By contrast with the popular hypothesis that disability assessments vary widely across samples with different cultural environments, we have reported strong evidence of highly consistent results.

UR - http://www.scopus.com/inward/record.url?scp=84871070051&partnerID=8YFLogxK

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U2 - 10.1016/S0140-6736(12)61680-8

DO - 10.1016/S0140-6736(12)61680-8

M3 - Article

C2 - 23245605

AN - SCOPUS:84871070051

VL - 380

SP - 2129

EP - 2143

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 9859

ER -