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The European Journal of Public Health 2000 10(1):24-30; doi:10.1093/eurpub/10.1.24
© 2000 by European Journal of Public Health
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METHODOLOGY

Disability weights for diseases

A modified protocol and results for a Western European region

MARLIES E.A. STOUTHARD, MARIE-LOUISE ESSINK-BOT, GOUKE J. BONSEL and on behalf of the DUTCH DISABILITY WEIGHTS (DDW) GROUP

1 Institute of Social Medicine, Academic Medical Center, University of Amsterdam Amsterdam, The Netherlands
2 Department of Public Health, Erasmus University Rotterdam Rotterdam, The Netherlands
3 Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam Amsterdam, The Netherlands

Correspondence: Dr. M.E.A. Stouthard, Institute of Social Medicine, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DD Amsterdam, The Netherlands, tel. +31 20 5664618, fax +31 20 6972316, e-mail: m.e.stouthard{at}amc.uva.nl

Background: The objective of the study was to establish a comprehensive and consistent set of disability weights for a number of important diseases in a Western European (Dutch) context, to be applied in composite health outcome measures to quantify the burden of disease and in economic evaluation of health care services. The context of the study was the Dutch Public Health Status and Forecast study. Replication and refinement of the valuation protocol used in the Global Burden of Disease (GBD) Study was a secondary aim. Methods: The disease stages were valued in a panel study In two steps, enabling the evaluation of a large number of disease stages. The first step was a carefully designed group process, using person trade-off as the valuation method to establish disability weights for 16 selected disease stages. The second step consisted of interpolation of the remaining disease stages on a disability scale by the individual panel members. Panel members were Dutch health care professionals with sufficient knowledge of the consequences of a broad variety of diseases. Results: A comprehensive set of disease-specific disability weights for 175 disease stages associated with 52 disease categories (cf. ICD-9) was obtained. The internal consistency and validity of the set of Dutch disability weights were satisfactory. Considerable agreement existed within panels, between the panel members and panels. Conclusions: Establishing a comprehensive and coherent set of reliable disability weights, using a modified valuation protocol from the GBD Study appeared to be feasible. The results can be used in composite health outcome measures applied in public health research and in economic evaluations.

Keywords: burden of disease, composite health outcome measures, DALY, person trade-off, public health, valuation of health status


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