For the Korean Burden of Disease (KBD) 2015 study, we have amended disability weights for causes of disease adapting the methodology of the KBD disability weight 2012 study.
We conducted a self-administered web-based survey in Korea using ranking five causes of disease. A total of 605 physicians and medical college students who were attending in third or fourth grade of a regular course performed the survey. We converted the ranked data into paired comparison data and ran a probit regression. The predicted probabilities for each cause of disease were calculated from the coefficient estimates of the probit regression. ‘Being dead (1)’ and ‘Full health (0)’ were utilized as anchor points to rescale the predicted probability on a scale from 0 to 1.
As a result, disability weights for a total of 289 causes of disease were estimated. In particular, we calculated the disability weights of 60 causes of disease considering severity level. These results show that prejudice about the severity of cause of disease itself can affect the estimation of disability weight, when estimating the disability weight for causes of disease without consideration of severity. Furthermore, we have shown that disability weights can be estimated based on a ranking method which can maximize efficiency of data collection.
Disability weights from this study can be used to estimate disability adjusted life year and healthy life expectancy. Furthermore, we expected that the use of the ranking method will increase gradually in disability weight studies.
Summary measures of population health (SMPH) are a combination of a fatal health condition that can lead to death and a health condition of a non-fatal health condition.
Among the SMPH, DALY and HALE are used to estimate the GBD, but there have been also many studies on DALY and HALE in Korea.
Since 1996, many studies have been conducted to estimate disability weights in many countries.
However, disability weights calculated in the past may not be valid at this time because of the emergence of new diseases or health states, changes in disease characteristics, development of treatment methods, and changes in social perspectives on disability.
For the KBD 2015 study, we have amended disability weights for causes of disease adapting the methodology of the KBD disability weight 2012 study. In particular, we attempted to further refine the severity level of diseases, such as cancer and diabetes, and to determine their disability weights.
We conducted a self-administered web-based survey in Korea, adapting the methodology of a preceding disability weights measurement study.
Each participant responded to his or her age, gender, specialty, and position at the beginning of the survey. Next, the participant evaluated the causes of diseases using a ranking method. That is, the participants ranked causes of disease in order of good health in the ranking method, considering mental and physical problems. Because the survey was conducted for the medical professionals, the descriptions of causes of disease were not developed and the response was obtained by presenting the causes of disease itself to the survey participants. We used a method ranking five causes of disease, which proved to be effective in previous study.
The five causes of disease were randomly selected among the 289 causes of disease. Among the 289 causes of disease, 211 causes of disease were taken from the previous disability weights measurement study without subdividing severity level.
Each participant performed a total of 20 ranking methods. In order to obtain a sufficient number of comparisons between ‘full health’ or ‘being dead’ and other causes of disease, ‘full health’ should be included in question 1 and 11, whereas ‘being dead’ should be included in question 5, 10, 15, and 20.
Initially, we conducted descriptive analyses for determining the characteristics of socio-demographic factors of the participants. Before the disability weight analyses, illogical response that ‘full health’ was not listed as the healthiest condition were excluded from the results. Then, we converted the ranked data into paired comparison data.
The calculated disability weights from this study were compared to those calculated in a preceding disability weights measurement study.
This study was approved by the Institutional Review Board of the Asan Medical Center (IRB No. 2016-1271). Each participant was informed about the purpose of the survey and only those individuals who provided informed consent joined this survey.
A total of 605 participants performed the survey.
Variables | No. (%) | |
---|---|---|
Age, yr | ||
19–29 | 206 (34.1) | |
30–39 | 395 (65.3) | |
≤ 40 | 4 (0.7) | |
Gender | ||
Men | 450 (74.4) | |
Women | 155 (25.6) | |
Specialty | ||
Medical part | 193 (31.9) | |
Surgical part | 78 (12.9) | |
Others | 334 (55.2) | |
Position | ||
Medical student | 164 (27.1) | |
General practitioner | 56 (9.3) | |
Resident | 6 (1.0) | |
Specialist | 362 (59.8) | |
Others | 17 (2.8) | |
Total | 605 (100.0) |
Of the 1,210 questions that included ‘full health,’ eight (0.7%) were illogical responses for which the ‘full health’ was not listed as the best health status. All of these illogical responses occurred in question 11.
No. | Cause of disease | Disability weight | 95% CI | |
---|---|---|---|---|
Lower | Upper | |||
1 | Tuberculosis | 0.519 | 0.462 | 0.575 |
2 | HIV disease resulting in mycobacterial infection | 0.746 | 0.694 | 0.792 |
3 | HIV disease resulting in other specified or unspecified diseases | 0.787 | 0.740 | 0.828 |
4 | Cholera | 0.355 | 0.298 | 0.415 |
5 | Other salmonella infections | 0.279 | 0.229 | 0.334 |
6 | Shigellosis | 0.248 | 0.198 | 0.303 |
7 | Enteropathogenic |
0.290 | 0.236 | 0.347 |
8 | Enterotoxigenic |
0.267 | 0.216 | 0.323 |
9 | 0.268 | 0.218 | 0.324 | |
10 | Amoebiasis | 0.380 | 0.321 | 0.440 |
11 | Cryptosporidiosis | 0.518 | 0.459 | 0.577 |
12 | Rotaviral enteritis | 0.188 | 0.146 | 0.236 |
13 | Intestinal infection | 0.270 | 0.217 | 0.327 |
14 | Typhoid and paratyphoid fevers | 0.382 | 0.322 | 0.445 |
15 | Influenza | 0.149 | 0.112 | 0.194 |
16 | Pneumococcal pneumonia | 0.427 | 0.369 | 0.486 |
17 | 0.407 | 0.348 | 0.468 | |
18 | Respiratory syncytial virus pneumonia | 0.367 | 0.309 | 0.428 |
19 | Upper respiratory infections | 0.131 | 0.096 | 0.173 |
20 | Otitis media | 0.176 | 0.134 | 0.224 |
21 | Pneumococcal meningitis | 0.590 | 0.532 | 0.645 |
22 | 0.557 | 0.498 | 0.614 | |
23 | Meningococcal infection | 0.530 | 0.470 | 0.588 |
24 | Encephalitis | 0.687 | 0.632 | 0.737 |
25 | Diphtheria | 0.340 | 0.284 | 0.398 |
26 | Whooping cough | 0.253 | 0.203 | 0.307 |
27 | Tetanus | 0.525 | 0.466 | 0.583 |
28 | Measles | 0.254 | 0.203 | 0.312 |
29 | Varicella | 0.241 | 0.193 | 0.293 |
30 | Malaria | 0.438 | 0.381 | 0.497 |
31 | Chagas disease | 0.547 | 0.489 | 0.604 |
32 | Leishmaniasis | 0.408 | 0.350 | 0.467 |
33 | African trypanosomiasis | 0.432 | 0.376 | 0.490 |
34 | Schistosomiasis | 0.381 | 0.323 | 0.442 |
35 | Cysticercosis | 0.372 | 0.316 | 0.431 |
36 | Echinococcosis | 0.412 | 0.354 | 0.471 |
37 | Lymphatic filariasis | 0.418 | 0.359 | 0.479 |
38 | Onchocerciasis | 0.319 | 0.264 | 0.378 |
39 | Trachoma | 0.437 | 0.376 | 0.498 |
40 | Dengue | 0.395 | 0.337 | 0.455 |
41 | Yellow fever | 0.504 | 0.444 | 0.563 |
42 | Rabies | 0.655 | 0.598 | 0.709 |
43 | Ascariasis | 0.231 | 0.183 | 0.284 |
44 | Trichuriasis | 0.253 | 0.202 | 0.309 |
45 | Hookworm disease | 0.241 | 0.193 | 0.295 |
46 | Food-borne trematodiases | 0.275 | 0.224 | 0.330 |
47 | Tsutsugamushi fever | 0.386 | 0.329 | 0.445 |
48 | Typhus fever | 0.390 | 0.332 | 0.449 |
49 | Hantaan virus disease | 0.472 | 0.411 | 0.532 |
50 | Intestinal helminth | 0.267 | 0.217 | 0.321 |
51 | Maternal hemorrhage | 0.514 | 0.453 | 0.575 |
52 | Maternal sepsis | 0.749 | 0.699 | 0.795 |
53 | Hypertensive disorders of pregnancy | 0.455 | 0.395 | 0.516 |
54 | Obstructed labor | 0.462 | 0.404 | 0.521 |
55 | Abortion | 0.300 | 0.245 | 0.359 |
56 | Preterm birth complications | 0.517 | 0.456 | 0.576 |
57 | Neonatal encephalopathy (birth asphyxia and birth trauma) | 0.858 | 0.815 | 0.893 |
58 | Sepsis and other infectious disorders of the newborn baby | 0.711 | 0.658 | 0.759 |
59 | Protein-energy malnutrition | 0.414 | 0.356 | 0.474 |
60 | Iodine deficiency | 0.200 | 0.155 | 0.250 |
61 | Vitamin A deficiency | 0.153 | 0.115 | 0.197 |
62 | Iron-deficiency anemia | 0.170 | 0.131 | 0.216 |
63 | Syphilis | 0.452 | 0.393 | 0.511 |
64 | Sexually transmitted chlamydial diseases | 0.253 | 0.205 | 0.307 |
65 | Gonococcal infection | 0.307 | 0.255 | 0.364 |
66 | Trichomoniasis | 0.316 | 0.259 | 0.377 |
67 | Herpes genitalia | 0.286 | 0.231 | 0.345 |
68 | Acute hepatitis A | 0.364 | 0.307 | 0.424 |
69 | Acute hepatitis B | 0.431 | 0.372 | 0.491 |
70 | Acute hepatitis C | 0.501 | 0.441 | 0.561 |
71 | Acute hepatitis E | 0.467 | 0.407 | 0.526 |
72 | Leprosy | 0.613 | 0.558 | 0.665 |
73 | Legionnaires' disease | 0.345 | 0.288 | 0.405 |
74 | Leptospirosis | 0.415 | 0.355 | 0.475 |
75 | Rubella | 0.359 | 0.301 | 0.418 |
76 | Mumps | 0.202 | 0.157 | 0.253 |
77 | Esophageal cancer | 0.841 | 0.802 | 0.875 |
78 | Stomach cancer (stage 1) | 0.462 | 0.403 | 0.520 |
79 | Stomach cancer (stage 2) | 0.669 | 0.614 | 0.720 |
80 | Stomach cancer (stage 3) | 0.823 | 0.780 | 0.860 |
81 | Stomach cancer (stage 4) | 0.880 | 0.840 | 0.912 |
82 | Liver cancer secondary to hepatitis B | 0.796 | 0.749 | 0.837 |
83 | Liver cancer secondary to hepatitis C | 0.802 | 0.755 | 0.842 |
84 | Liver cancer secondary to alcohol use (stage 1) | 0.603 | 0.541 | 0.661 |
85 | Liver cancer secondary to alcohol use (stage 2) | 0.718 | 0.666 | 0.766 |
86 | Liver cancer secondary to alcohol use (stage 3) | 0.785 | 0.737 | 0.827 |
87 | Liver cancer secondary to alcohol use (stage 4) | 0.876 | 0.838 | 0.907 |
88 | Larynx cancer | 0.824 | 0.784 | 0.859 |
89 | Trachea, bronchus and lung cancers (stage 1) | 0.600 | 0.542 | 0.656 |
90 | Trachea, bronchus and lung cancers (stage 2) | 0.738 | 0.686 | 0.785 |
91 | Trachea, bronchus and lung cancers (stage 3) | 0.758 | 0.710 | 0.801 |
92 | Trachea, bronchus and lung cancers (stage 4) | 0.906 | 0.873 | 0.932 |
93 | Breast cancer (stage 1) | 0.439 | 0.379 | 0.500 |
94 | Breast cancer (stage 2) | 0.597 | 0.535 | 0.657 |
95 | Breast cancer (stage 3) | 0.724 | 0.671 | 0.771 |
96 | Breast cancer (stage 4) | 0.864 | 0.826 | 0.895 |
97 | Cervical cancer (stage 1) | 0.431 | 0.372 | 0.491 |
98 | Cervical cancer (stage 2) | 0.553 | 0.493 | 0.611 |
99 | Cervical cancer (stage 3) | 0.813 | 0.767 | 0.851 |
100 | Cervical cancer (stage 4) | 0.855 | 0.815 | 0.889 |
101 | Uterine cancer | 0.711 | 0.661 | 0.757 |
102 | Prostate cancer (stage 1) | 0.458 | 0.399 | 0.518 |
103 | Prostate cancer (stage 2) | 0.613 | 0.552 | 0.672 |
104 | Prostate cancer (stage 3) | 0.742 | 0.692 | 0.787 |
105 | Prostate cancer (stage 4) | 0.838 | 0.795 | 0.874 |
106 | Colon and rectum cancers (stage 1) | 0.496 | 0.436 | 0.556 |
107 | Colon and rectum cancers (stage 2) | 0.689 | 0.631 | 0.742 |
108 | Colon and rectum cancers (stage 3) | 0.841 | 0.798 | 0.878 |
109 | Colon and rectum cancers (stage 4) | 0.870 | 0.833 | 0.900 |
110 | Mouth cancer | 0.870 | 0.828 | 0.905 |
111 | Nasopharynx cancer | 0.766 | 0.716 | 0.811 |
112 | Cancer of other part of pharynx and oropharynx | 0.811 | 0.764 | 0.851 |
113 | Gallbladder and biliary tract cancer | 0.800 | 0.752 | 0.843 |
114 | Pancreatic cancer | 0.879 | 0.843 | 0.909 |
115 | Malignant melanoma of skin | 0.786 | 0.737 | 0.829 |
116 | Non-melanoma skin cancer | 0.649 | 0.593 | 0.702 |
117 | Ovarian cancer | 0.776 | 0.727 | 0.821 |
118 | Testicular cancer | 0.692 | 0.637 | 0.744 |
119 | Kidney cancer (stage 1) | 0.570 | 0.509 | 0.627 |
120 | Kidney cancer (stage 2) | 0.731 | 0.678 | 0.778 |
121 | Kidney cancer (stage 3) | 0.809 | 0.762 | 0.849 |
122 | Kidney cancer (stage 4) | 0.902 | 0.870 | 0.927 |
123 | Other urinary organ cancers | 0.711 | 0.656 | 0.761 |
124 | Bladder cancer (stage 1) | 0.500 | 0.441 | 0.558 |
125 | Bladder cancer (stage 2) | 0.623 | 0.567 | 0.676 |
126 | Bladder cancer (stage 3) | 0.769 | 0.720 | 0.812 |
127 | Bladder cancer (stage 4) | 0.869 | 0.830 | 0.901 |
128 | Brain and nervous system cancers | 0.888 | 0.852 | 0.918 |
129 | Thyroid cancer (stage 1) | 0.301 | 0.248 | 0.359 |
130 | Thyroid cancer (stage 2) | 0.484 | 0.425 | 0.543 |
131 | Thyroid cancer (stage 3) | 0.639 | 0.583 | 0.691 |
132 | Thyroid cancer (stage 4) | 0.779 | 0.730 | 0.822 |
133 | Hodgkin's disease | 0.670 | 0.612 | 0.725 |
134 | Non-Hodgkin lymphoma | 0.689 | 0.636 | 0.737 |
135 | Multiple myeloma | 0.764 | 0.714 | 0.808 |
136 | Leukemia | 0.812 | 0.765 | 0.854 |
137 | Bone and connective tissue cancer | 0.765 | 0.717 | 0.809 |
138 | Benign neoplasm of brain and other parts of central nervous system | 0.505 | 0.442 | 0.567 |
139 | Rheumatic heart disease | 0.600 | 0.542 | 0.657 |
140 | Ischemic heart disease | 0.534 | 0.475 | 0.592 |
141 | Ischemic stroke (mild) | 0.540 | 0.477 | 0.601 |
142 | Ischemic stroke (moderate) | 0.787 | 0.740 | 0.828 |
143 | Ischemic stroke (severe) | 0.840 | 0.799 | 0.875 |
144 | Hemorrhagic and other non-ischemic stroke | 0.785 | 0.738 | 0.825 |
145 | Hypertensive heart disease | 0.502 | 0.444 | 0.560 |
146 | Cardiomyopathy and myocarditis | 0.717 | 0.661 | 0.768 |
147 | Atrial fibrillation and flutter | 0.584 | 0.526 | 0.641 |
148 | Aortic aneurysm | 0.647 | 0.591 | 0.700 |
149 | Peripheral vascular disease | 0.430 | 0.368 | 0.492 |
150 | Endocarditis | 0.646 | 0.589 | 0.700 |
151 | Hermorrhoid | 0.139 | 0.103 | 0.182 |
152 | Varicose veins of lower extremities | 0.173 | 0.132 | 0.219 |
153 | Chronic obstructive pulmonary disease (mild) | 0.408 | 0.351 | 0.466 |
154 | Chronic obstructive pulmonary disease (moderate) | 0.703 | 0.648 | 0.754 |
155 | Chronic obstructive pulmonary disease (severe) | 0.722 | 0.668 | 0.771 |
156 | Pneumoconiosis | 0.669 | 0.614 | 0.721 |
157 | Asthma | 0.396 | 0.337 | 0.458 |
158 | Interstitial lung disease and pulmonary sarcoidosis | 0.678 | 0.623 | 0.729 |
159 | Cirrhosis of the liver secondary to hepatitis B | 0.707 | 0.655 | 0.755 |
160 | Cirrhosis of the liver secondary to hepatitis C | 0.706 | 0.653 | 0.754 |
161 | Cirrhosis of the liver secondary to alcohol use (mild) | 0.484 | 0.424 | 0.543 |
162 | Cirrhosis of the liver secondary to alcohol use (moderate) | 0.668 | 0.612 | 0.722 |
163 | Cirrhosis of the liver secondary to alcohol use (severe) | 0.717 | 0.664 | 0.765 |
164 | Peptic ulcer disease | 0.260 | 0.207 | 0.319 |
165 | Gastritis and duodenitis | 0.144 | 0.107 | 0.187 |
166 | Appendicitis | 0.245 | 0.196 | 0.300 |
167 | Paralytic ileus and intestinal obstruction without hernia | 0.388 | 0.332 | 0.446 |
168 | Inguinal or femoral hernia | 0.269 | 0.220 | 0.322 |
169 | Crohn's disease | 0.597 | 0.538 | 0.653 |
170 | Ulcerative colitis | 0.545 | 0.485 | 0.604 |
171 | Vascular disorders of intestine | 0.515 | 0.455 | 0.573 |
172 | Gallbladder and bile duct disease | 0.448 | 0.386 | 0.511 |
173 | Pancreatitis | 0.498 | 0.436 | 0.559 |
174 | Gastroesophageal reflux disease | 0.163 | 0.123 | 0.209 |
175 | Alzheimer's disease and other dementias | 0.736 | 0.685 | 0.782 |
176 | Parkinson's disease | 0.660 | 0.606 | 0.711 |
177 | Epilepsy | 0.581 | 0.523 | 0.637 |
178 | Multiple sclerosis | 0.693 | 0.640 | 0.742 |
179 | Migraine | 0.190 | 0.148 | 0.237 |
180 | Tension-type headache | 0.163 | 0.121 | 0.212 |
181 | Schizophrenia | 0.666 | 0.612 | 0.717 |
182 | Alcohol use disorders | 0.350 | 0.295 | 0.407 |
183 | Opioid use disorders | 0.457 | 0.398 | 0.517 |
184 | Cocaine use disorders | 0.459 | 0.401 | 0.518 |
185 | Amphetamine use disorders | 0.473 | 0.413 | 0.534 |
186 | Cannabis use disorders | 0.355 | 0.299 | 0.413 |
187 | Major depressive disorder (mild) | 0.279 | 0.229 | 0.333 |
188 | Major depressive disorder (moderate) | 0.528 | 0.469 | 0.586 |
189 | Major depressive disorder (severe) | 0.569 | 0.509 | 0.627 |
190 | Dysthymia | 0.188 | 0.145 | 0.238 |
191 | Bipolar affective disorder | 0.483 | 0.424 | 0.542 |
192 | Panic disorder | 0.391 | 0.335 | 0.448 |
193 | Obsessive-compulsive disorder | 0.321 | 0.266 | 0.378 |
194 | Post-traumatic stress disorder | 0.415 | 0.357 | 0.474 |
195 | Anorexia nervosa | 0.420 | 0.363 | 0.478 |
196 | Bulimia nervosa | 0.392 | 0.334 | 0.451 |
197 | Autism | 0.510 | 0.449 | 0.570 |
198 | Asperger's syndrome | 0.408 | 0.349 | 0.469 |
199 | Attention-deficit hyperactivity disorder | 0.249 | 0.200 | 0.302 |
200 | Conduct disorder | 0.275 | 0.224 | 0.331 |
201 | Idiopathic intellectual disability | 0.483 | 0.422 | 0.543 |
202 | Borderline personality disorder | 0.397 | 0.340 | 0.455 |
203 | Diabetes mellitus without complications | 0.334 | 0.279 | 0.391 |
204 | Diabetes mellitus with complications | 0.663 | 0.605 | 0.717 |
205 | Acute glomerulonephritis | 0.420 | 0.362 | 0.480 |
206 | Chronic kidney disease due to diabetes mellitus | 0.674 | 0.617 | 0.727 |
207 | Chronic kidney disease due to hypertension | 0.594 | 0.534 | 0.652 |
208 | Tubulointerstitial nephritis, pyelonephritis, and urinary tract infections | 0.359 | 0.302 | 0.418 |
209 | Urolithiasis | 0.294 | 0.242 | 0.350 |
210 | Benign prostatic hyperplasia | 0.207 | 0.161 | 0.259 |
211 | Men infertility | 0.332 | 0.279 | 0.389 |
212 | Urinary incontinence | 0.287 | 0.233 | 0.345 |
213 | Uterine fibroids | 0.223 | 0.177 | 0.274 |
214 | Polycystic ovarian syndrome | 0.399 | 0.342 | 0.458 |
215 | Women infertility | 0.362 | 0.306 | 0.421 |
216 | Endometriosis | 0.349 | 0.292 | 0.408 |
217 | Genital prolapse | 0.404 | 0.338 | 0.471 |
218 | Premenstrual syndrome | 0.136 | 0.101 | 0.179 |
219 | Thalassemias | 0.485 | 0.425 | 0.545 |
220 | Sickle cell disorders | 0.552 | 0.494 | 0.609 |
221 | G6PD deficiency | 0.519 | 0.458 | 0.580 |
222 | Rheumatoid arthritis | 0.451 | 0.392 | 0.510 |
223 | Osteoarthritis (mild) | 0.216 | 0.171 | 0.268 |
224 | Osteoarthritis (moderate) | 0.415 | 0.357 | 0.474 |
225 | Osteoarthritis (severe) | 0.575 | 0.515 | 0.633 |
226 | Low back pain (mild) | 0.138 | 0.101 | 0.181 |
227 | Low back pain (moderate) | 0.310 | 0.257 | 0.368 |
228 | Low back pain (severe) | 0.456 | 0.396 | 0.517 |
229 | Neck pain | 0.133 | 0.097 | 0.177 |
230 | Gout | 0.390 | 0.332 | 0.451 |
231 | Systemic lupus erythematosus | 0.594 | 0.533 | 0.651 |
232 | Neural tube defects | 0.782 | 0.734 | 0.825 |
233 | Congenital heart anomalies | 0.679 | 0.622 | 0.731 |
234 | Cleft lip and cleft palate | 0.313 | 0.258 | 0.372 |
235 | Down's syndrome | 0.590 | 0.533 | 0.645 |
236 | Eczema | 0.135 | 0.098 | 0.179 |
237 | Psoriasis | 0.235 | 0.187 | 0.288 |
238 | Cellulitis | 0.273 | 0.222 | 0.329 |
239 | Abscess, impetigo, and other bacterial skin diseases | 0.267 | 0.215 | 0.324 |
240 | Scabies | 0.194 | 0.150 | 0.245 |
241 | Fungal skin diseases | 0.260 | 0.210 | 0.316 |
242 | Viral skin diseases | 0.166 | 0.126 | 0.212 |
243 | Acne vulgaris | 0.049 | 0.029 | 0.078 |
244 | Alopecia areata | 0.154 | 0.114 | 0.200 |
245 | Pruritus | 0.100 | 0.069 | 0.140 |
246 | Urticaria | 0.106 | 0.074 | 0.147 |
247 | Decubitus ulcer | 0.479 | 0.421 | 0.536 |
248 | Glaucoma | 0.449 | 0.388 | 0.510 |
249 | Cataracts | 0.324 | 0.267 | 0.383 |
250 | Macular degeneration | 0.457 | 0.396 | 0.518 |
251 | Refraction and accommodation disorders | 0.206 | 0.162 | 0.257 |
252 | Dental caries | 0.065 | 0.042 | 0.097 |
253 | Periodontal disease | 0.206 | 0.161 | 0.257 |
254 | Edentulism | 0.471 | 0.410 | 0.531 |
255 | Pedestrian injury by road vehicle | 0.470 | 0.410 | 0.530 |
256 | Road injury (pedal cycle vehicle) | 0.315 | 0.262 | 0.371 |
257 | Road injury (motorized vehicle with two wheels) | 0.495 | 0.435 | 0.555 |
258 | Road injury (motorized vehicle with three or more wheels) | 0.597 | 0.538 | 0.653 |
259 | Falls | 0.165 | 0.126 | 0.212 |
260 | Drowning | 0.514 | 0.454 | 0.573 |
261 | Fire, heat and hot substances | 0.362 | 0.304 | 0.423 |
262 | Poisonings | 0.475 | 0.415 | 0.536 |
263 | Mechanical forces (firearm) | 0.547 | 0.485 | 0.608 |
264 | Adverse effects of medical treatment | 0.362 | 0.306 | 0.420 |
265 | Animal contact (venomous) | 0.363 | 0.304 | 0.424 |
266 | Animal contact (non-venomous) | 0.132 | 0.095 | 0.176 |
267 | Self-harm | 0.516 | 0.455 | 0.577 |
268 | Assault by firearm | 0.488 | 0.429 | 0.548 |
269 | Assault by sharp object | 0.260 | 0.212 | 0.312 |
270 | Exposure to forces of nature | 0.235 | 0.188 | 0.287 |
271 | Collective violence and legal intervention | 0.432 | 0.373 | 0.492 |
272 | Allergic rhinitis | 0.087 | 0.059 | 0.123 |
273 | Atopic dermatitis | 0.231 | 0.182 | 0.285 |
274 | Metabolic syndrome | 0.304 | 0.250 | 0.361 |
275 | Allergic rhinitis and atopic dermatitis | 0.166 | 0.124 | 0.215 |
276 | Diabetes mellitus and osteoarthritis | 0.495 | 0.436 | 0.553 |
277 | Allergic rhinitis and asthma | 0.187 | 0.145 | 0.236 |
278 | Allergic rhinitis and osteoarthritis | 0.192 | 0.147 | 0.244 |
279 | Allergic rhinitis and major depressive disorder | 0.394 | 0.336 | 0.453 |
280 | Major depressive disorder and osteoarthritis | 0.478 | 0.418 | 0.539 |
281 | Diabetes mellitus and ischemic stroke | 0.629 | 0.570 | 0.685 |
282 | Diabetes mellitus and tuberculosis | 0.478 | 0.418 | 0.539 |
283 | Diabetes mellitus, osteoarthritis, and major depressive disorder | 0.543 | 0.484 | 0.601 |
284 | Diabetes mellitus, osteoarthritis, and ischemic stroke | 0.667 | 0.611 | 0.719 |
285 | Allergic rhinitis, asthma, and atopic dermatitis | 0.172 | 0.131 | 0.219 |
286 | Diabetes, osteoarthritis, and tuberculosis | 0.574 | 0.514 | 0.632 |
287 | Diabetes mellitus, osteoarthritis, rheumatoid arthritis | 0.494 | 0.431 | 0.556 |
288 | Full heath | 0.000 | 0.000 | 0.000 |
289 | Being dead | 1.000 | 1.000 | 1.000 |
CI = confidence interval,
The results of comparing the disability weights of 60 causes of disease that are more subdivided into severity are shown in the
Cause of disease | Disability weight from this study | 95% CI | Disability weight from a previous study | |
---|---|---|---|---|
Lower | Upper | |||
Stomach cancer (stage 1) | 0.462 | 0.403 | 0.520 | 0.724 |
Stomach cancer (stage 2) | 0.669 | 0.614 | 0.720 | |
Stomach cancer (stage 3) | 0.823 | 0.780 | 0.860 | |
Stomach cancer (stage 4) | 0.880 | 0.840 | 0.912 | |
Liver cancer secondary to alcohol use (stage 1) | 0.603 | 0.541 | 0.661 | 0.824 |
Liver cancer secondary to alcohol use (stage 2) | 0.718 | 0.666 | 0.766 | |
Liver cancer secondary to alcohol use (stage 3) | 0.785 | 0.737 | 0.827 | |
Liver cancer secondary to alcohol use (stage 4) | 0.876 | 0.838 | 0.907 | |
Trachea, bronchus and lung cancers (stage 1) | 0.600 | 0.542 | 0.656 | 0.917 |
Trachea, bronchus and lung cancers (stage 2) | 0.738 | 0.686 | 0.785 | |
Trachea, bronchus and lung cancers (stage 3) | 0.758 | 0.710 | 0.801 | |
Trachea, bronchus and lung cancers (stage 4) | 0.906 | 0.873 | 0.932 | |
Breast cancer (stage 1) | 0.439 | 0.379 | 0.500 | 0.704 |
Breast cancer (stage 2) | 0.597 | 0.535 | 0.657 | |
Breast cancer (stage 3) | 0.724 | 0.671 | 0.771 | |
Breast cancer (stage 4) | 0.864 | 0.826 | 0.895 | |
Cervical cancer (stage 1) | 0.431 | 0.372 | 0.491 | 0.744 |
Cervical cancer (stage 2) | 0.553 | 0.493 | 0.611 | |
Cervical cancer (stage 3) | 0.813 | 0.767 | 0.851 | |
Cervical cancer (stage 4) | 0.855 | 0.815 | 0.889 | |
Prostate cancer (stage 1) | 0.458 | 0.399 | 0.518 | 0.701 |
Prostate cancer (stage 2) | 0.613 | 0.552 | 0.672 | |
Prostate cancer (stage 3) | 0.742 | 0.692 | 0.787 | |
Prostate cancer (stage 4) | 0.838 | 0.795 | 0.874 | |
Colon and rectum cancers (stage 1) | 0.496 | 0.436 | 0.556 | 0.759 |
Colon and rectum cancers (stage 2) | 0.689 | 0.631 | 0.742 | |
Colon and rectum cancers (stage 3) | 0.841 | 0.798 | 0.878 | |
Colon and rectum cancers (stage 4) | 0.870 | 0.833 | 0.900 | |
Kidney cancer (stage 1) | 0.570 | 0.509 | 0.627 | 0.777 |
Kidney cancer (stage 2) | 0.731 | 0.678 | 0.778 | |
Kidney cancer (stage 3) | 0.809 | 0.762 | 0.849 | |
Kidney cancer (stage 4) | 0.902 | 0.870 | 0.927 | |
Bladder cancer (stage 1) | 0.500 | 0.441 | 0.558 | 0.792 |
Bladder cancer (stage 2) | 0.623 | 0.567 | 0.676 | |
Bladder cancer (stage 3) | 0.769 | 0.720 | 0.812 | |
Bladder cancer (stage 4) | 0.869 | 0.830 | 0.901 | |
Thyroid cancer (stage 1) | 0.301 | 0.248 | 0.359 | 0.466 |
Thyroid cancer (stage 2) | 0.484 | 0.425 | 0.543 | |
Thyroid cancer (stage 3) | 0.639 | 0.583 | 0.691 | |
Thyroid cancer (stage 4) | 0.779 | 0.730 | 0.822 | |
Ischemic stroke (mild) | 0.540 | 0.477 | 0.601 | 0.809 |
Ischemic stroke (moderate) | 0.787 | 0.740 | 0.828 | |
Ischemic stroke (severe) | 0.840 | 0.799 | 0.875 | |
Chronic obstructive pulmonary disease (mild) | 0.408 | 0.351 | 0.466 | 0.690 |
Chronic obstructive pulmonary disease (moderate) | 0.703 | 0.648 | 0.754 | |
Chronic obstructive pulmonary disease (severe) | 0.722 | 0.668 | 0.771 | |
Cirrhosis of the liver secondary to alcohol use (mild) | 0.484 | 0.424 | 0.543 | 0.614 |
Cirrhosis of the liver secondary to alcohol use (moderate) | 0.668 | 0.612 | 0.722 | |
Cirrhosis of the liver secondary to alcohol use (severe) | 0.717 | 0.664 | 0.765 | |
Major depressive disorder (mild) | 0.279 | 0.229 | 0.333 | 0.606 |
Major depressive disorder (moderate) | 0.528 | 0.469 | 0.586 | |
Major depressive disorder (severe) | 0.569 | 0.509 | 0.627 | |
Diabetes mellitus without complications | 0.334 | 0.279 | 0.391 | 0.593 |
Diabetes mellitus with complications | 0.663 | 0.605 | 0.717 | |
Osteoarthritis (mild) | 0.216 | 0.171 | 0.268 | 0.370 |
Osteoarthritis (moderate) | 0.415 | 0.357 | 0.474 | |
Osteoarthritis (severe) | 0.575 | 0.515 | 0.633 | |
Low back pain (mild) | 0.138 | 0.101 | 0.181 | 0.315 |
Low back pain (moderate) | 0.310 | 0.257 | 0.368 | |
Low back pain (severe) | 0.456 | 0.396 | 0.517 |
CI = confidence interval.
In this study, we have amended 289 disability weights for causes of disease adapting the methodology of the KBD disability weight 2012 study.
In the meantime, paired comparison has been used as a key value evaluation method in the latest international and domestic disability weight studies.
Another difference from previous studies is that we estimated disability weights considering the severity of the causes of disease. We calculated the disability weights of 60 causes of disease considering severity level and compared them with the disability weights in the previous study.
When conducting a disability weight study, we typically estimate disability weights for dozens to hundreds of health states or causes of disease, and the calculated disability weight has a value of a limited scale of 0 to 1. Thus, a disability weight for any health state or cause of disease may seem counterintuitive when compared to other health state or cause of disease's disability weight, and the absolute magnitude of the disability weight may not seem plausible. This will be the same in this study. However, since there is no golden standard for disability weights, it is not easy to assess the validity of disability weights.
In this study, the following indirect methods were used to evaluate and enhance the validity of the disability weights. First, we examined whether disability weights were reversed in diseases with different levels of severity. For example, when the severity of an ischemic stroke is classified as mild, moderate, or severe, the disability weight of the mild ischemic stroke should be the lowest, and the disability weight of the severe ischemic stroke should be the highest. No such reversal was found in this study. We also tried to compare the disability weights of the present study with the disability weights calculated in a previous study.
In the recent disability weighting study, the general public is used rather than the healthcare professionals as a participant in the questionnaire.
One limitation of this study is that it could not perform the verification of the disability weight model of multimorbidity properly. We included 16 causes of disease, such as diabetes mellitus with osteoarthritis, in the list of causes of disease and tried to preliminarily evaluate the validity of multiplicative model, additive model, and maximum model for disability weights in multimorbidity.
Another limitation is that physicians and medical students participating in the survey may not represent the preference for disease among all medical professionals. However, we tried to increase the number of survey participants and to include various specialist among survey participants. Therefore, it is expected that the disability weight derived from this study will not be significantly different from the judgment of the degree of disability of all medical professionals. Future disability weight studies need to involve more medical professionals with various specialties in the survey.
In conclusion, we have estimated 289 disability weights for causes of disease adapting the methodology of the KBD disability weight 2012 study. The disability weights estimated based on the severity can be used to estimate the more accurate burden of diseases. Furthermore, the disability weights from this study can be utilized to estimate health life expectancy, especially HALE, in Korea.
The authors would like to thank Gallup Korea for help in conducting survey. The authors also are grateful to the survey participants.
This study was supported by a grant from the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI13C0729).
The authors have no potential conflicts of interest to disclose.
Comparison of disability weights for overlapping causes of disease between this study and a previous study