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Questions and Answers
What is the formula for calculating DALY?
What is the formula for calculating DALY?
What is the primary purpose of the 2019 Global Burden of Disease Survey?
What is the primary purpose of the 2019 Global Burden of Disease Survey?
What type of data does the Burden of Disease Studies provide?
What type of data does the Burden of Disease Studies provide?
Which organization conducted the 2019 Burden of Disease Survey?
Which organization conducted the 2019 Burden of Disease Survey?
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How does the Burden of Disease Studies assist in health policy formation?
How does the Burden of Disease Studies assist in health policy formation?
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What does a DALY measure?
What does a DALY measure?
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How is the DALY loss due to osteoarthritis calculated if untreated?
How is the DALY loss due to osteoarthritis calculated if untreated?
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What does YLD stand for?
What does YLD stand for?
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In calculating YLL, how is the value determined?
In calculating YLL, how is the value determined?
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If a woman has a life expectancy of 79 years at birth and lives in full health until age 60, what is her ideal life expectancy at birth?
If a woman has a life expectancy of 79 years at birth and lives in full health until age 60, what is her ideal life expectancy at birth?
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What quality of life score indicates a significant impairment for a person in a wheelchair?
What quality of life score indicates a significant impairment for a person in a wheelchair?
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What would be the DALY loss if the woman died at age 60 due to hip surgery?
What would be the DALY loss if the woman died at age 60 due to hip surgery?
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What is the coefficient of loss from diabetes according to the given context?
What is the coefficient of loss from diabetes according to the given context?
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What does a QALY score of 0 represent?
What does a QALY score of 0 represent?
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What does DALY primarily measure?
What does DALY primarily measure?
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If a person experiences a disability score of 0.8, what is the corresponding QALY score?
If a person experiences a disability score of 0.8, what is the corresponding QALY score?
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In the context of QALY, what does a score of 0.9 signify?
In the context of QALY, what does a score of 0.9 signify?
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How is YLD calculated in the DALY framework?
How is YLD calculated in the DALY framework?
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What total DALY value would result from 10 years of life lost due to an event with a disability score of 0.1?
What total DALY value would result from 10 years of life lost due to an event with a disability score of 0.1?
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What does a higher DALY indicate about an individual's health?
What does a higher DALY indicate about an individual's health?
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What is the YLL based on in the context of DALY?
What is the YLL based on in the context of DALY?
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How many QALYs were gained from the medical intervention after the first heart attack?
How many QALYs were gained from the medical intervention after the first heart attack?
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What is the DALY reduction resulting from the intervention in the example provided?
What is the DALY reduction resulting from the intervention in the example provided?
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What is the range of the QALY and DALY scales?
What is the range of the QALY and DALY scales?
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Which measure indicates the health expectancy equivalent to perfect health?
Which measure indicates the health expectancy equivalent to perfect health?
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What does the variable 'L' represent in the calculation of Disability-adjusted life-year (DALY)?
What does the variable 'L' represent in the calculation of Disability-adjusted life-year (DALY)?
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What does DALE account for in its calculation?
What does DALE account for in its calculation?
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Which of the following best describes Quality-adjusted life-year (QALY)?
Which of the following best describes Quality-adjusted life-year (QALY)?
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Which of the following is NOT a measure mentioned in the content?
Which of the following is NOT a measure mentioned in the content?
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What does 'D' stand for in the components of DALY?
What does 'D' stand for in the components of DALY?
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In which year was QALY finally shaped into its current form?
In which year was QALY finally shaped into its current form?
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What aspect does Healthy Year Equivalent (HYE) rely upon?
What aspect does Healthy Year Equivalent (HYE) rely upon?
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What is a primary application of QALY in healthcare decision-making?
What is a primary application of QALY in healthcare decision-making?
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How many QALYs did the example woman accumulate during her lifetime?
How many QALYs did the example woman accumulate during her lifetime?
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What is a challenge when comparing case-specific QALYs?
What is a challenge when comparing case-specific QALYs?
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What is the purpose of QALY score tables?
What is the purpose of QALY score tables?
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How is 1 QALY estimated to be the same as 0.50 QALY earned by one person and 0.25 QALY earned by two people?
How is 1 QALY estimated to be the same as 0.50 QALY earned by one person and 0.25 QALY earned by two people?
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What is a necessary condition for QALY to be a suitable index?
What is a necessary condition for QALY to be a suitable index?
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What was the main purpose of developing DALY?
What was the main purpose of developing DALY?
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In the context of DALY, what does a score of 0 represent?
In the context of DALY, what does a score of 0 represent?
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Which aspect is indicated by the Global Burden of Disease approach regarding healthy life years in different ages?
Which aspect is indicated by the Global Burden of Disease approach regarding healthy life years in different ages?
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What assumption is made about health status when it comes to scoring for QALY?
What assumption is made about health status when it comes to scoring for QALY?
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When was DALY developed?
When was DALY developed?
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Study Notes
QALY and DALY Measures
- QALY and DALY measure health states less than "excellent" health.
- DALY measures disability, while QALY measures quality of life.
- The perpendicular position of QALY and DALY on a graph can be seen in a later image.
QALY
- A chronic illness, such as schizophrenia, significantly impacting quality of life, will result in a disability score of 0.8.
- A score of 0 represents perfect health, and 1 represents death.
- A disability score of 0.8 also corresponds to a quality of life score of 0.2.
- One year of full health equals one QALY.
- Death means the QALY value drops to zero.
- QALY is used to calculate health-related quality across different life periods.
DALY
- DALY is calculated using years of life with disability (YLD) or years of life lost (YLL).
- YLL is based on gender and age-specific life expectancy, considering how many years life would continue with normal function if death did not occur.
- YLD is a product of disability severity and duration.
Case Study
- A 60-year-old experiences a heart attack.
- Without proper healthcare, the person would have died, but they survived.
- The person's health state corresponds to 0.9 on a scale of 0-1, representing 90% normal health.
- On a DALY chart, the equivalent value is 0.1.
- The person dies from a second heart attack at the age of 70.
Case Solution
- Years lost due to the first heart attack are calculated as follows: YLL (80-70) + YLD (10 * 0.1) = 11 DALY.
- The QALY from the medical intervention after the first heart attack is 10 years * 0.9 = 9 QALY.
- The sum of QALYs and DALYs equals the remaining time (60-80), which is 20 years.
QALY = DALY Reduction
- Comparing the cost of a medical intervention with its benefits yields comparable QALY gain and DALY reduction values.
- In the given example, the QALY gain is 9, and a DALY reduction of 11 was observed.
Scales
- QALY and DALY ranges are from 0 to 1.
- Calculating these criteria involves mathematical formulas.
Example: QALY Calculation
- A woman is expected to live 79 years.
- The first 40 years of her life had a QALY score of 0.95.
- Between ages 40 and 60, the QALY score was 0.90.
- Between ages 60 and 70, the score reduced to 0.80.
- Between ages 70 and 82, the QALY score is 0.70.
- The total QALY is calculated as: (40 x 0.95 + 20 x 0.9 + 10 x 0.8 + 12 x 0.7) = 72.4 QALY.
- Successful hip surgery at age 60 would've prevented a decline in QALY score until age 70, gaining an additional QALY (10 x (0.9 - 0.8)) = 1 QALY.
Calculation of QALYs as a Whole of the Country
- Generalizations in QALY calculations for an entire nation include:
- Older person's QALY is equivalent to a younger person's QALY.
- 0.50 QALY from one person and 0.25 QALY from two people are seen as equal.
For the QALY to be a Fit-for-Purpose Index
- The QALY index needs universally accepted definitions for health status and interventions.
- Assumptions in the Von Neumann-Morgenstern Expected Utilization Theory include a constant value for health status, regardless of duration, location, or other circumstances.
- Health status is also assumed to be equal for all individuals in the population contributing to QALY assessments.
DALY
- DALY was developed in the 1990s by WHO and WB to measure the negative impact of diseases and injuries on national health.
- More accurate health policies and decisions are expected based on these burdens.
DALY Calculation
- DALY is calculated using the International Classification of Impairments, Disabilities, and Handicaps.
- The index is not related to individual health but is indexed to illness, disability, and death.
- The Global Burden of Disease approach classifies data with 22 health-status-related indicators.
Burden of Disease Calculation
- Disease burden is calculated for all major diseases.
- Healthy life in younger ages is proportionally more valuable than in older ages.
DALY (Disability Adjusted Life Years)
- DALY is an absolute measure of health loss.
- It measures time lost due to premature death, diseases, or injuries, causing long-term functional impairments.
- A single DALY corresponds to the loss of one year of healthy life.
DALY Calculation Example
- Calculate DALY for a woman in a QALY assessment.
- Ideal life expectancy at birth is 82.5 years.
- Ideal life expectancy at age 60 is 84.83 years in the environment where the woman lives.
Assumptions for QALY Calculation
- The person lives in perfect health until age 60.
- Osteoarthritis occurs at age 60 with a disability score of 0.158 (untreated) or 0.108 (treated).
- Osteoarthritis's disability impact covers 24.83 years, with a calculated DALY loss of 3.9 (untreated) or 2.68 (treated).
- Diabetes may also be a factor contributing to loss in health, with a score between 0.012 and 0.078.
- Loss of 22.5 DALYs is calculated in case of death due to hip surgery at age 60.
Years of Life with Disability (YLD)
- YLD measures years lived with disabilities but does not lead to death.
- For example, a person who loses mobility from an accident and uses a wheelchair for 14 years has a YLD of 9.8 years.
Years of Life Lost (YLL)
- YLL represents years of life lost due to premature death.
- It is calculated by subtracting the person's age of death from the average life expectancy in that country.
DALY = YLL + YLD
- DALY is the sum of mortality and morbidity loads observed.
- Example: QALY calculated for a person is 80, morbidity is 9.8, and mortality is 6. The final QALY result is 80 - 15.8 = 64.2.
2019 Global Burden of Disease Survey
- The survey covers 286 causes of death, 369 diseases, and 87 risk factors.
- It evaluates the health profile of 204 countries nationally and globally.
- The survey was conducted by the University of Washington Institute for Health Metrics and Evaluation (IHME).
Disease Burden Studies
- Disease burden studies provide essential data for priority setting and evaluating health program effectiveness.
- The studies calculate the burden of diseases and injuries leading to premature death or long-term disability.
- The 2019 Burden of Disease Study provides detailed data at the level of gender, age, year, country, and region.
2019 Burden of Disease Survey
- The survey provides data on sex, age groups, years, countries, and regions.
- Disease and risk factors data are provided.
- Detailed comparisons for disease burdens are possible.
Other Measures
- Health-adjusted life expectancy (HALE) calculates health expectancy using a simple index equivalent to perfect health.
- Disability-adjusted life expectancy (DALE) is a variant of HALE focusing on years of healthy life lost due to disabilities.
- Disability-free life expectancy (DFLE) is a two-option criterion (0 for disability, 1 for no disability).
Active Life Expectancy (ALE)
- ALE is a bi-option, classifying individuals as active or inactive.
Healthy Year Equivalent (HYE)
- HYE uses QALY, but the evaluation criterion assesses perceived health (comfort and happiness) over time.
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Description
Test your knowledge on the Global Burden of Disease Survey conducted in 2019. This quiz covers essential concepts such as DALY, YLD, and health policy implications. Learn how health indicators are calculated and their significance in public health.
