Abstract
BackgroundDisability 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.MethodsWe 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).FindingsWe 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.ConclusionsThis 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.
Highlights
Disability weights (DWs) are weight factors that reflect the severity of health states for estimates of disability-adjusted life years
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
Summary
Disability weights (DWs) are weight factors that reflect the severity of health states for estimates of disability-adjusted life years. DWs for a parsimonious set of 220 health states covering all disabling outcomes of the diseases and injuries quantified in GBD were derived. Following these initial surveys, there was criticism of the wording of some of the health state descriptions. When the opportunity of a new DW study using a web-based survey in four European countries arose, some lay descriptions were altered to include key components of disability such as the effect of social isolation in someone with more severe hearing loss and incontinence as part of the description of spinal cord injury [5]. The modifications of lay descriptions resulted in a change of DWs in the expected direction
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