Egunsola Oluwaseun, Raubenheimer Jacques, Buckley Nicholas
Discipline of Pharmacology, University of Sydney, Sydney, New South Wales, Australia
Discipline of Pharmacology, University of Sydney, Sydney, New South Wales, Australia.
BMJ Open. 2019 Aug 18;9(8):e027825. doi: 10.1136/bmjopen-2018-027825.
This study examines the impact of the type of method used on the estimation of the burden of diseases.
Comparison of methods of estimating disease burden.
Four metrics of burden of disease estimation, namely, years of potential life lost (YPLL), non-age weighted years of life lost (YLL) without discounting and YLL with uniform or non-uniform age weighting and discounting were used to calculate the burden of selected diseases in three countries: Australia, USA and South Africa.
Mortality data for all individuals from birth were obtained from the WHO database.
The burden of 10 common diseases with four metrices, and the relative contribution of each disease to the overall national burden when each metric is used.
There were variations in the burden of disease estimates with the four methods. The standardised YPLL estimates were higher than other methods of calculation for diseases common among young adults and lower for diseases common among the elderly. In the three countries, discounting decreased the contributions of diseases common among younger adults to the total burden of disease, while the contributions of diseases of the elderly increased. After discounting with age weighting, there were no distinct patterns for diseases of the elderly and young adults in the three countries.
Given the variability in the estimates of the burden of disease with different approaches, there should be transparency regarding the type of metric used and a generally acceptable method that incorporates all the relevant social values should be developed.
本研究考察所使用方法的类型对疾病负担估计的影响。
疾病负担估计方法的比较。
采用疾病负担估计的四个指标，即潜在寿命损失年数（YPLL）、未贴现的非年龄加权寿命损失年数（YLL）以及采用统一或非统一年龄加权和贴现的YLL，来计算澳大利亚、美国和南非这三个国家选定疾病的负担。
从世界卫生组织数据库获取所有个体自出生起的死亡率数据。
用四种指标得出的10种常见疾病的负担，以及每种指标使用时每种疾病对国家总体负担的相对贡献。
四种方法得出的疾病负担估计存在差异。标准化的YPLL估计对于年轻成年人中常见的疾病高于其他计算方法，而对于老年人中常见的疾病则较低。在这三个国家，贴现降低了年轻成年人中常见疾病对疾病总负担的贡献，而老年人疾病的贡献增加。在按年龄加权贴现后，这三个国家中老年人和年轻成年人的疾病没有明显模式。
鉴于不同方法对疾病负担的估计存在差异，应明确所使用指标的类型，并应制定一种纳入所有相关社会价值且普遍可接受的方法。
