Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
Health Policy Plan. 2023 May 17;38(5):648-654. doi: 10.1093/heapol/czad017.
Disability-adjusted life years (DALYs) capture the mortality and morbidity arising from a disease: they incorporate the years of life lost (YLLs) and the years of life lived with disability (YLD) due to a disease. The relative importance of YLLs and YLDs differs across diseases. The magnitudes of YLLs and YLDs depend on parameters such as the age of onset of disease, duration of disease, the case fatality ratio and disability weight. In this paper, we examine the mathematical computation of the DALY and its underlying components, YLDs and YLLs. We aim to demonstrate under which circumstances (e.g. sets of input parameters) disease-specific YLDs and YLLs become sizeable relative to one another using the parameters of a set of diseases in low-income country settings. Researchers could then focus on understanding the key inputs that drive the relative extents of YLDs and YLLs (e.g. determine whether a detailed estimation of disability weights is essential), while maintaining DALYs as their key outcome metric consistent with disease burden assessments.
伤残调整生命年（DALYs）捕捉到疾病导致的死亡和发病：它包含了因疾病而损失的生命年（YLLs）和因疾病而残疾的生命年（YLDs）。YLLs 和 YLDs 的相对重要性因疾病而异。YLLs 和 YLDs 的大小取决于疾病发病年龄、疾病持续时间、病死率和残疾权重等参数。在本文中，我们研究了 DALY 及其基本组成部分 YLDs 和 YLLs 的数学计算。我们旨在展示在何种情况下（例如，一组输入参数），特定于疾病的 YLDs 和 YLLs 相对于彼此变得相当大，使用的是低收入国家背景下一组疾病的参数。然后，研究人员可以专注于理解驱动 YLDs 和 YLLs 相对程度的关键输入（例如，确定是否需要对残疾权重进行详细估计），同时保持 DALYs 作为其关键结果指标，与疾病负担评估一致。
