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Population Health Metrics

, 15:8

First Online: 04 March 2017Received: 16 October 2015Accepted: 16 February 2017DOI: 10.1186-s12963-017-0125-5

Cite this article as: Poenaru, D., Pemberton, J., Frankfurter, C. et al. Popul Health Metrics 2017 15: 8. doi:10.1186-s12963-017-0125-5


BackgroundBurden of disease BoD as measured by Disability-Adjusted Life Years DALYs is one of the criteria for priority-setting in health care resource allocation. DALYs incorporate disability weights DWs, which are currently expert-derived estimates or non-existent for most pediatric surgical conditions. The objective of this study is to establish DWs for a subset of key pediatric congenital anomalies using a range of health valuation metrics with caregivers in both high- and low-resource settings.

MethodWe described 15 health states to health professionals physicians, nurses, social workers, and therapists and community caregivers in Kenya and Canada. The health states summaries were expert- and community-derived, consisting of a narrated description of the disease and a functional profile described in EQ-5D-5 L style. DWs for each health state were elicited using four health valuation exercises preference ranking, visual analogue scale VAS, paired comparison PC, and time trade-off TTO. The PC data were anchored internally to the TTO and externally to existing data to yield DWs for each health state on a scale from 0 health to 1 dead. Any differences in DWs between the two countries were analyzed.

ResultsIn total, 154 participants, matched by profession, were recruited from Kijabe, Kenya n = 78 and Hamilton, Canada n = 76. Overall calculated DWs for 15 health states ranged from 0.13 to 0.77, with little difference between countries intra-class coefficient 0.97. However, DWs generated in Kenya for severe hypospadias and undescended testes were higher than Canadian-derived DWs p = 0.04 and p < 0.003, respectively.

ConclusionsWe have derived country-specific DWs for pediatric congenital anomalies using several low-cost methods and inter-professional and community caregivers. The TTO-anchored PC method appears best suited for future use. The majority of DWs do not appear to differ significantly between the two cultural contexts and could be used to inform further work of estimating the burden of global pediatric surgical disease. Care should be taken in comparing the DWs obtained in the current study to the existent list of DWs because methodological differences may impact on their compatibility.

Electronic supplementary materialThe online version of this article doi:10.1186-s12963-017-0125-5 contains supplementary material, which is available to authorized users.

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Autor: D. Poenaru - J. Pemberton - C. Frankfurter - B. H. Cameron - E. Stolk


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