Advanced Biomedical Research Institute, Seoul Hospital, Ewha Womans University, Seoul, Korea.
College of Nursing, Ewha Womans University, Seoul, Korea.
J Prev Med Public Health. 2022 Jan;55(1):28-36. doi: 10.3961/jpmph.21.583. Epub 2022 Jan 31.
The current multimorbidity correction method in the Global Burden of Disease studies assumes the independent occurrence of diseases. Those studies use Monte-Carlo simulations to adjust for the presence of multiple disease conditions for all diseases. The present study investigated whether the above-mentioned assumption is reasonable based on the prevalence confirmed from actual data. This study compared multimorbidity-adjusted years of lived with disability (YLD) obtained by Monte-Carlo simulations and multimorbidity-adjusted YLD using multimorbidity prevalence derived from National Health Insurance Service data. The 5 most common diseases by sex and age groups were selected as diseases of interest. No significant differences were found between YLD estimations made using actual data and Monte-Carlo simulations, even though assumptions about the independent occurrence of diseases should be carefully applied. The prevalence was not well reflected according to disease characteristics in those under the age of 30, among whom there was a difference in YLD between the 2 methods. Therefore, when calculating the burden of diseases for Koreans over the age of 30, it is possible to calculate the YLD with correction for multimorbidity through Monte-Carlo simulation, but care should be taken with under-30s. It is useful to apply the efficiency and suitability of calibration for multiplicative methods using Monte-Carlo simulations in research on the domestic disease burden, especially in adults in their 30s and older. Further research should be carried out on multimorbidity correction methodology according to the characteristics of multiple diseases by sex and age.
目前，全球疾病负担研究中的多病症校正方法假设疾病是独立发生的。这些研究使用蒙特卡罗模拟来调整所有疾病的多种疾病状况的存在。本研究根据实际数据中确认的患病率，调查了上述假设是否合理。本研究比较了蒙特卡罗模拟得到的多病症调整后的残疾生存年（YLD）和使用国家健康保险服务数据得出的多病症患病率调整后的 YLD。选择了按性别和年龄组划分的最常见的 5 种疾病作为研究对象。尽管应该谨慎应用关于疾病独立发生的假设，但使用实际数据和蒙特卡罗模拟进行的 YLD 估计没有发现显著差异。在 30 岁以下人群中，根据疾病特征，患病率并不能很好地反映出来，这两种方法之间存在 YLD 的差异。因此，在计算 30 岁以上韩国人的疾病负担时，可以通过蒙特卡罗模拟计算多病症校正后的 YLD，但对于 30 岁以下人群需要谨慎。在研究国内疾病负担时，使用蒙特卡罗模拟的乘法校正方法的效率和适用性是有用的，特别是在 30 多岁及以上的成年人中。应根据性别和年龄的多病症特点进一步研究多病症校正方法。
