Estimating summary measures of health: a structured workbook approachReport as inadecuate

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Population Health Metrics

, 3:5

First Online: 11 May 2005Received: 20 September 2004Accepted: 11 May 2005DOI: 10.1186-1478-7954-3-5

Cite this article as: Flanagan, W., Boswell-Purdy, J., Le Petit, C. et al. Popul Health Metrics 2005 3: 5. doi:10.1186-1478-7954-3-5


BackgroundSummary measures of health that combine mortality and morbidity into a single indicator are being estimated in the Canadian context for approximately 200 diseases and conditions. To manage the large amount of data and calculations for this many diseases, we have developed a structured workbook system with easy to use tools. We expect this system will be attractive to researchers from other countries or regions of Canada who are interested in estimating the health-adjusted life years HALYs lost to premature mortality and year-equivalents lost to reduced functioning, as well as population attributable fractions PAFs associated with risk factors. This paper describes the workbook system using cancers as an example, and includes the entire system as a free, downloadable package.

MethodsThe workbook system was developed in Excel and runs on a personal computer. It is a database system that stores data on population structure, mortality, incidence, distributions of cases entering a multitude of health states, durations of time spent in health states, preference scores that weight for severity, life table estimates of life expectancies, and risk factor prevalence and relative risks. The tools are Excel files with embedded macro programs. The main tool generates workbooks that estimate HALY, one per disease, by copying data from the database into a pre-defined template. Other tools summarize the HALY results across diseases for easy analysis.

ResultsThe downloadable zip file contains the database files initialized with Canadian data for cancers, the tools, templates and workbooks that estimate PAF and a user guide. The workbooks that estimate HALY are generated from the system at a rate of approximately one minute per disease. The resulting workbooks are self-contained and can be used directly to explore the details of a particular disease. Results can be discounted at different rates through simple parameter modification.

ConclusionThe structured workbook approach offers researchers an efficient, easy to use, and easy to understand set of tools for estimating HALY and PAF summary measures for their country or region of interest.

Electronic supplementary materialThe online version of this article doi:10.1186-1478-7954-3-5 contains supplementary material, which is available to authorized users.

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Author: William Flanagan - Jane Boswell-Purdy - Christel Le Petit - Jean-Marie Berthelot


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