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Chatterton ML, Lee YY, Le LKD, Nichols M, Carter R, Berk M, Mihalopoulos C. Cost-utility analysis of adjunct repetitive transcranial magnetic stimulation for treatment resistant bipolar depression. J Affect Disord 2024; 356:639-646. [PMID: 38657770 DOI: 10.1016/j.jad.2024.04.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 01/30/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To evaluate the cost-effectiveness of repetitive transcranial magnetic stimulation (rTMS) as an adjunct to standard care from an Australian health sector perspective, compared to standard care alone for adults with treatment-resistant bipolar depression (TRBD). METHODS An economic model was developed to estimate the cost per disability-adjusted life-year (DALY) averted and quality-adjusted life-year (QALY) gained for rTMS added to standard care compared to standard care alone, for adults with TRBD. The model simulated the time in three health states (mania, depression, residual) over one year. Response to rTMS was sourced from a meta-analysis, converted to a relative risk and used to modify the time in the depressed state. Uncertainty and sensitivity tested the robustness of results. RESULTS Base-case incremental cost-effectiveness ratios (ICERs) were $72,299 per DALY averted (95 % Uncertainty Interval (UI): $60,915 to $86,668) and $46,623 per QALY gained (95 % UI: $39,676 - $55,161). At a willingness to pay (WTP) threshold of $96,000 per DALY averted, the base-case had a 100 % probability of being marginally cost-effective. At a WTP threshold of $64,000 per QALY gained, the base-case had a 100 % probability of being cost-effective. Sensitivity analyses decreasing the number of sessions provided, increasing the disability weight or the time spent in the depression state for standard care improved the ICERs for rTMS. CONCLUSIONS Dependent on the outcome measure utilised and assumptions, rTMS would be considered a very cost-effective or marginally cost-effective adjunct to standard care for TRBD compared to standard care alone.
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Affiliation(s)
- Mary Lou Chatterton
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Yong Yi Lee
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; School of Public Health, The University of Queensland, Herston, Australia; Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Long Khanh-Dao Le
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Melanie Nichols
- Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Rob Carter
- Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Institute for Health Transformation, Deakin University, Geelong, Australia
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Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2133-2161. [PMID: 38642570 DOI: 10.1016/s0140-6736(24)00757-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/07/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. METHODS The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. FINDINGS Global DALYs increased from 2·63 billion (95% UI 2·44-2·85) in 2010 to 2·88 billion (2·64-3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7-17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8-6·3) in 2020 and 7·2% (4·7-10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0-234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7-198·3]), neonatal disorders (186·3 million [162·3-214·9]), and stroke (160·4 million [148·0-171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3-51·7) and for diarrhoeal diseases decreased by 47·0% (39·9-52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54-1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5-9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0-19·8]), depressive disorders (16·4% [11·9-21·3]), and diabetes (14·0% [10·0-17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7-27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6-63·6) in 2010 to 62·2 years (59·4-64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6-2·9) between 2019 and 2021. INTERPRETATION Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. FUNDING Bill & Melinda Gates Foundation.
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Bebell LM, Ngonzi J, Butler A, Kumbakumba E, Adong J, Loos C, Boatin AA, Bassett IV, Siedner MJ, Williams PL, Mattie H, Hedt-Gauthier B, Correia KFB, Lake E, Alter G. Distinct cytokine profiles in late pregnancy in Ugandan people with HIV. Sci Rep 2024; 14:10980. [PMID: 38744864 PMCID: PMC11093984 DOI: 10.1038/s41598-024-61764-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 05/09/2024] [Indexed: 05/16/2024] Open
Abstract
During pregnancy, multiple immune regulatory mechanisms establish an immune-tolerant environment for the allogeneic fetus, including cellular signals called cytokines that modify immune responses. However, the impact of maternal HIV infection on these responses is incompletely characterized. We analyzed paired maternal and umbilical cord plasma collected during labor from 147 people with HIV taking antiretroviral therapy and 142 HIV-uninfected comparators. Though cytokine concentrations were overall similar between groups, using Partial Least Squares Discriminant Analysis we identified distinct cytokine profiles in each group, driven by higher IL-5 and lower IL-8 and MIP-1α levels in pregnant people with HIV and higher RANTES and E-selectin in HIV-unexposed umbilical cord plasma (P-value < 0.01). Furthermore, maternal RANTES, SDF-α, gro α -KC, IL-6, and IP-10 levels differed significantly by HIV serostatus (P < 0.01). Although global maternal and umbilical cord cytokine profiles differed significantly (P < 0.01), umbilical cord plasma profiles were similar by maternal HIV serostatus. We demonstrate that HIV infection is associated with a distinct maternal plasma cytokine profile which is not transferred across the placenta, indicating a placental role in coordinating local inflammatory response. Furthermore, maternal cytokine profiles in people with HIV suggest an incomplete shift from Th2 to Th1 immune phenotype at the end of pregnancy.
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Affiliation(s)
- Lisa M Bebell
- Medical Practice Evaluation Center and Center for Global Health, Massachusetts General Hospital Division of Infectious Diseases, GRJ-504, 55 Fruit St, Boston, MA, 02114, USA.
| | - Joseph Ngonzi
- Department of Obstetrics and Gynaecology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Audrey Butler
- State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Elias Kumbakumba
- Department of Paediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Julian Adong
- Department of Paediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Carolin Loos
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - Adeline A Boatin
- Department of Obstetrics and Gynecology and Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
| | - Ingrid V Bassett
- Division of Infectious Diseases and Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
| | - Mark J Siedner
- Division of Infectious Diseases and Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
| | - Paige L Williams
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Heather Mattie
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bethany Hedt-Gauthier
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Erin Lake
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
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Travor MD, Levine ES, Catomeris AJ, Purt B, Gensheimer WG, Justin GA, Trevino JD, Haagsma JA, Colyer MH, Staudt AM. Disability-Adjusted Life Years Resulting from Ocular Injury among Deployed Service Members, 2001-2020. Ophthalmology 2024; 131:534-544. [PMID: 38008289 DOI: 10.1016/j.ophtha.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023] Open
Abstract
PURPOSE To quantify the burden of ocular injuries on deployed US service members by calculating disability-adjusted life years (DALYs). DESIGN Retrospective, observational cohort study. PARTICIPANTS US service members with ocular injuries sustained in combat zones from January 1, 2001 to May 19, 2020. METHODS Health states and duration of injuries were identified using data from the Defense and Veterans Eye Injury and Vision Registry. These health states were mapped to disability weights from the Global Burden of Disease (GBD) study. Average duration of injury or illness was calculated until remission or death. For the latter, life expectancy at age of sustaining injury, as identified from US Life Tables from the National Vital Statistics Reports 2020, was used. Using Defense Manpower Data Center reports capturing number of service members deployed per year, incidence rates were calculated for ocular injury and DALYs. MAIN OUTCOME MEASURES Disability-adjusted life years of ocular injury. RESULTS Seventeen thousand five hundred fifty-five patients sustained ocular injury that incurred DALYs. In total, these injuries resulted in 11 214 DALYs (average, 0.64 DALYs per included patient and 20.6 DALYs per 10 000 US service members per year). Severe impairment of distance vision (77.9%) and blindness (10.6%) were the primary contributors of DALYs. Although only 9.3% of patients sustained a permanent ocular injury, permanent disability accounted for 99.5% of total DALYs. The average yearly incidence rate of ocular injury was 32.0 cases per 10 000 US service members. Foreign body was the most frequent injury type (2754 occurrences), followed by abrasion (2419 occurrences) and multiple injury types (1429 occurrences). The most DALYs occurred in patients with multiple injury types (2485 DALYs), followed by abrasion (accounting for 725 DALYs) and foreign body (accounting for 461 DALYs). DISCUSSION We report higher average DALYs per case ratio among US service members compared with the general population studied by the GBD study, highlighting the differences in probabilities of permanent injury between the two studies. Our study provides understanding of the impact of ocular injuries on active-duty service members and lays the groundwork for further research and interventions to mitigate their burden. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Mark D Travor
- Ophthalmology Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Emily S Levine
- Ophthalmology Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Andrew J Catomeris
- Ophthalmology Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Boonkit Purt
- Walter Reed-Uniformed Services University Department of Surgery, Uniformed Services University, Bethesda, Maryland; Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan
| | - William G Gensheimer
- Ophthalmology Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Ophthalmology Section, White River Junction VA Medical Center, White River Junction, Vermont
| | - Grant A Justin
- Walter Reed-Uniformed Services University Department of Surgery, Uniformed Services University, Bethesda, Maryland
| | - Jennifer D Trevino
- Department of Data Analytics and Epidemiology, The Geneva Foundation, JBSA Fort Sam Houston, San Antonio, Texas
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marcus H Colyer
- Walter Reed-Uniformed Services University Department of Surgery, Uniformed Services University, Bethesda, Maryland
| | - Amanda M Staudt
- Department of Data Analytics and Epidemiology, The Geneva Foundation, JBSA Fort Sam Houston, San Antonio, Texas.
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de Leeuw A, Ester WA, Kinfe M, Girma F, Abdurahman R, Zerihun T, Teklehaimanot A, Hanlon C, Hoek HW, Hoekstra RA. The impact of raising a child with a developmental or physical health condition in Ethiopia. Res Dev Disabil 2024; 148:104716. [PMID: 38490136 DOI: 10.1016/j.ridd.2024.104716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE Raising a child with a developmental disability or physical health condition can have a major impact on the lives of their families, especially in low-income countries. We explored the impact on such families in Ethiopia. STUDY DESIGN A total of 241 child-caregiver dyads were recruited from two public hospitals in Addis Ababa, Ethiopia. Of these, 139 children were diagnosed with a developmental disability (e.g. autism, intellectual disability) and 102 children with a physical health condition (e.g. malnutrition, severe HIV infection). The family quality of life was assessed using caregiver reports on the Pediatric Quality of Life Inventory™ (PedsQL-FIM™). The disability weight score, which is a Global Burden of Disease measure to quantify health loss, was estimated for each child. RESULTS Families with a child with a developmental disability reported lower quality of life than families caring for a child with a physical health condition (p < .001). Mean disability weight scores in children with a developmental disability were higher than in children with a physical health condition (p < .001), indicating more severe health loss. Disability weight scores were negatively associated with the family quality of life in the whole group (B=-16.8, SE=7.5, p = .026), but not in the stratified analyses. CONCLUSIONS Caring for a child with a developmental disability in Ethiopia is associated with a substantial reduction in the family quality of life. Scaling up support for these children in resource-limited contexts should be prioritized.
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Affiliation(s)
- Anne de Leeuw
- Parnassia Psychiatric Institute, The Hague, the Netherlands; University Medical Center Groningen, the Netherlands
| | - Wietske A Ester
- Parnassia Psychiatric Institute, The Hague, the Netherlands; Sarr Autism Rotterdam, Youz Child and Adolescent Psychiatry, Rotterdam, the Netherlands; LUMC-Curium, Child and Adolescent Psychiatry, Oegstgeest, the Netherlands
| | - Mersha Kinfe
- Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia
| | - Fikirte Girma
- Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia
| | - Rehana Abdurahman
- Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia; Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia; St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Tigist Zerihun
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia; Neurodiversity Center Ethiopia, Ethiopia
| | | | - Charlotte Hanlon
- Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia; King's College London, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Hans W Hoek
- Parnassia Psychiatric Institute, The Hague, the Netherlands; University Medical Center Groningen, the Netherlands; Columbia University New York, United States
| | - Rosa A Hoekstra
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
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Nishi M, Nagamitsu R, Matoba S. Association between daily step counts and healthy life years: a national cross-sectional study in Japan. BMJ Health Care Inform 2024; 31:e101051. [PMID: 38688685 PMCID: PMC11103203 DOI: 10.1136/bmjhci-2024-101051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Despite accumulating evidence concerning the association between daily step counts and mortality or disease risks, it is unclear whether daily step counts are associated with healthy life years. METHODS We used the combined dataset of the Comprehensive Survey of Living Conditions and the National Health and Nutrition Survey conducted for a randomly sampled general population in Japan, 2019. Daily step counts were measured for 4957 adult participants. The associations of daily step counts with activity limitations in daily living and self-assessed health were evaluated using a multivariable logistic regression model. The bootstrap method was employed to mitigate uncertainties in estimating the threshold of daily step counts. RESULTS The median age was 60 (44-71) years, and 2592 (52.3%) were female. The median daily step counts were 5650 (3332-8452). The adjusted OR of activity limitations in daily living for the adjacent daily step counts was 0.27 (95% CI 0.26 to 0.27) for all ages and 0.25 (95% CI 0.25 to 0.26) for older adults at the lowest, with the thresholds of significant association at 9000 step counts. The OR of self-assessed unhealthy status was 0.45 (95% CI 0.44 to 0.46) for all ages and 0.42 (95% CI 0.41 to 0.43) for older adults at the lowest, with the thresholds at 11 000 step counts. CONCLUSION Daily step counts were significantly associated with activity limitations in daily living and self-assessed health as determinants of healthy life years, up to 9000 and 11 000 step counts, respectively. These results suggest a target of daily step counts to prolong healthy life years within health initiatives.
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Affiliation(s)
- Masahiro Nishi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Health and Welfare, Kyoto Prefectural Government, Kyoto, Japan
| | - Reo Nagamitsu
- Department of Epidemiology for Community Health and Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Health and Welfare, Kyoto Prefectural Government, Kyoto, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Zhang L, Lu H, Yang C. Global, regional, and national burden of stroke from 1990 to 2019: A temporal trend analysis based on the Global Burden of Disease Study 2019. Int J Stroke 2024:17474930241246955. [PMID: 38567822 DOI: 10.1177/17474930241246955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
BACKGROUND Stroke is the second leading cause of death and the leading cause of disability worldwide. However, how the prevalence of stroke varies across the world is uncertain. AIMS The aim of this study was to analyze temporal trends of prevalence for stroke, including ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) at the global, regional, and national levels. METHODS The age-standardized prevalence rates (ASPR) of stroke, IS, ICH, and SAH, along with their corresponding 95% uncertainty intervals (UI), were derived from data in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. This provides estimates for the burden of 369 diseases and injuries globally in 2019, as well as their temporal trends over the past 30 years. Joinpoint regression analysis was used to analyze the 1990-2019 temporal trends by calculating the annual percentage change (APC) and average annual percentage change (AAPC), as well as their 95% confidence interval (CI). RESULTS In 2019, the global ASPR of stroke was 1240.263 per 100,000 population (95% UI: 1139.711 to 1352.987), with ASPRs generally lower in Europe compared to other regions. Over the period from 1990 to 2019, a significant global decrease in ASPR was observed for stroke (AAPC -0.200, 95% CI: -0.215 to -0.183), IS (AAPC -0.059%, 95% CI: -0.077 to -0.043), SAH (AAPC -0.476, 95% CI: -0.483 to -0.469), and ICH (AAPC -0.626, 95% CI: -0.642 to -0.611). The trends of ASPR of stroke, IS, SAH, and ICH varied significantly across 204 countries and territories. CONCLUSION Our findings highlight significant global disparities in stroke prevalence, emphasizing the need for ongoing monitoring and intensified efforts in developing regions to reduce the global burden of stroke.
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Affiliation(s)
- Liwei Zhang
- Department of Anesthesiology, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Hao Lu
- School of Medicine, Xiamen University, Xiamen, China
| | - Chunhua Yang
- Department of Blood Transfusion, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
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Liu C, He L, Shan X, Zhang L, Ge E, Zhang K, Luo B. The Burden of Occupational Noise-Induced Hearing Loss From 1990 to 2019: An Analysis of Global Burden of Disease Data. Ear Hear 2024:00003446-990000000-00271. [PMID: 38616317 DOI: 10.1097/aud.0000000000001505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
OBJECTIVES The relationship between long-term exposure to occupational noise and hearing loss has been extensively documented. We aimed to assess spatial and temporal changes in the burden of occupational noise-induced hearing loss (ONIHL) in 204 countries and territories with varying socio-demographic indexes (SDI) from 1990 to 2019. DESIGN Temporal and spatial trends in age-standardized disability-adjusted life year rates (ASDR) for ONIHL were estimated by sex, age, SDI level, country, and geographic region from 1990 to 2019. We used the Joinpoint model to calculate annual average percentage changes to assess such trends and projected trends in ASDR for ONIHL globally and across different income regions from 2020 to 2044 using an age-period-cohort model. We fitted the relationship between ASDR and SDI, ASDR and healthcare access and quality index, respectively. RESULTS Overall, the global burden of ONIHL has decreased since 1990, especially in middle and lower SDI regions. In 2019, the global ASDR for ONIHL was 84.23 (95% confidence interval: 57.46 to 120.52) per 100,000 population. From 1990 to 2019, the global ASDR for ONIHL decreased by 1.72% (annual average percentage change = -0.05, 95% confidence interval: -0.07 to -0.03). Our projections showed a decreasing trend in the global ONIHL burden until 2044. ASDR and SDI (R = -0.8, p < 0.05), ASDR and healthcare access and quality index (R = -0.75, p < 0.05) showed significant negative correlations. CONCLUSIONS The global ONIHL burden has decreased over the past three decades, especially in regions with middle and lower SDI levels. However, the global ONIHL burden still remained severe in 2019, notably among males, the middle-aged and elderly, and regions with lower SDI levels.
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Affiliation(s)
- Ce Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Li He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Xiaobing Shan
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Ling Zhang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Erjia Ge
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, USA
- These authors contributed equally to this work
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
- These authors contributed equally to this work
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Waliszewska-Prosół M, Montisano DA, Antolak M, Bighiani F, Cammarota F, Cetta I, Corrado M, Ihara K, Kartamysheva R, Petrušić I, Pocora MM, Takizawa T, Vaghi G, Martelletti P, Corso B, Raggi A. The impact of primary headaches on disability outcomes: a literature review and meta-analysis to inform future iterations of the Global Burden of Disease study. J Headache Pain 2024; 25:27. [PMID: 38433202 PMCID: PMC10910736 DOI: 10.1186/s10194-024-01735-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/23/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The burden and disability associated with headaches are conceptualized and measured differently at patients' and populations' levels. At the patients' level, through patient-reported outcome measures (PROMs); at population level, through disability weights (DW) and years lived with a disability (YLDs) developed by the Global Burden of Disease Study (GBD). DW are 0-1 coefficients that address health loss and have been defined through lay descriptions. With this literature review, we aimed to provide a comprehensive analysis of disability in headache disorders, and to present a coefficient referring to patients' disability which might inform future GBD definitions of DW for headache disorders. METHODS We searched SCOPUS and PubMed for papers published between 2015 and 2023 addressing disability in headache disorders. The selected manuscript included a reference to headache frequency and at least one PROM. A meta-analytic approach was carried out to address relevant differences for the most commonly used PROMs (by headache type, tertiles of medication intake, tertiles of females' percentage in the sample, and age). We developed a 0-1 coefficient based on the MIDAS, on the HIT-6, and on MIDAS + HIT-6 which was intended to promote future DW iterations by the GBD consortium. RESULTS A total of 366 studies, 596 sub-samples, and more than 133,000 single patients were available, mostly referred to cases with migraine. Almost all PROMs showed the ability to differentiate disability severity across conditions and tertiles of medication intake. The indexes we developed can be used to inform future iterations of DW, in particular considering their ability to differentiate across age and tertiles of medication intake. CONCLUSIONS Our review provides reference values for the most commonly used PROMS and a data-driven coefficient whose main added value is its ability to differentiate across tertiles of age and medication intake which underlie on one side the increased burden due to aging (it is likely connected to the increased impact of common comorbidities), and by the other side the increased burden due to medication consumption, which can be considered as a proxy for headache severity. Both elements should be considered when describing disability of headache disorders at population levels.
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Affiliation(s)
| | - Danilo Antonio Montisano
- Dipartimento Di Neuroalgologia, Centro Cefalee, Fondazione IRRCS Istituto Neurologico Carlo Besta, Milan, Italy.
| | - Mariola Antolak
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | - Federico Bighiani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Francescantonio Cammarota
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Ilaria Cetta
- Neuroimaging Research Unit and Neurology Unit, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
| | - Michele Corrado
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Keiko Ihara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
- Japanese Red Cross, Ashikaga Hospital, Tochigi, Japan
| | - Regina Kartamysheva
- Department of Neurology, University Clinic of Kazan Federal University, Kazan, Russian Federation
| | - Igor Petrušić
- Faculty of Physical Chemistry, Laboratory for Advanced Analysis of Neuroimages, University of Belgrade, Belgrade, Serbia
| | - Maria Magdalena Pocora
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Tsubasa Takizawa
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Gloria Vaghi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Headache Science & Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | | | - Barbara Corso
- Neuroscience Institute, National Research Council, Padua, Italy
| | - Alberto Raggi
- SC Neurologia, Salute Pubblica, Disabilità, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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10
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Abasi U, Okello Damoi J, Turumanya Kalumuna A, Giibwa A, Park S, Cuva D, Yu AT, Emoru A, Bakaleke Binoga M, Villavisanis D, Kiani SN, Glerum K, Waye J, Marin M, Zhang L. Ambulatory Surgery Center in Rural Uganda: A Novel Approach to Providing Surgical Care. Cureus 2024; 16:e55848. [PMID: 38590474 PMCID: PMC11001256 DOI: 10.7759/cureus.55848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Despite evidence that ambulatory surgery is safe with faster recovery compared to in-patient hospitalization, surgeons in low- and middle-income countries like Uganda have been hesitant to embrace this practice. Kyabirwa Surgical Center (KSC) is the first freestanding ambulatory surgery center (ASC) in rural Uganda. We aim to report the impact of a rural ASC since its establishment, in alleviating surgically-treatable morbidity within its catchment area. METHODS KSC is located in Jinja, Uganda. The center's electronic medical record was used to analyze the utilization of services, and the Uganda Bureau of Statistics was used to calculate KSC's catchment area. Effectiveness was calculated using disability-adjusted life years (DALYs) averted. RESULTS Between July 2019 and December 2021, 7,391 patients (57.7% female, 42.3% male) visited KSC from a catchment area of 570,790 people. Of 1,355 procedures, 64.6% were general surgery, 21.3% endoscopy, 9.2% gynecological/genitourinary), 2.8% ENT, 1.5% colorectal, and 0.6% orthopedics. There were no postoperative hospital admissions for complications or mortalities. From the seven most common procedures with an associated disability weight, 2,193.16 total DALYs were averted. CONCLUSION ASCs can be effective in addressing surgical care gaps in Uganda by increasing the yearly surgical capacity of the local catchment area and averting DALYs within the population.
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Affiliation(s)
- Unwana Abasi
- Surgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | | | | | - So Park
- Surgery, Mount Sinai Hospital, New York, USA
| | - Dylan Cuva
- Surgery, Mount Sinai Hospital, New York, USA
| | - Allen T Yu
- Surgery, Mount Sinai Hospital, New York, USA
| | - Arthur Emoru
- Anesthesiology, Kyabirwa Surgical Center, Jinja, UGA
| | | | - Dillan Villavisanis
- Plastic and Reconstructive Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Sara N Kiani
- Surgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Jerome Waye
- Gastroenterology, Mount Sinai Hospital, New York, USA
| | | | - Linda Zhang
- Surgery, Mount Sinai Hospital, New York, USA
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11
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Miao P, Terris-Prestholt F, Fairley CK, Tucker JD, Wiseman V, Mayaud P, Zhang Y, Rowley J, Gottlieb S, Korenromp EL, Watts CG, Ong JJ. Ignored and undervalued in public health: a systematic review of health state utility values associated with syphilis infection. Health Qual Life Outcomes 2024; 22:17. [PMID: 38350925 PMCID: PMC10863090 DOI: 10.1186/s12955-024-02234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/29/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Syphilis is a sexually transmitted infection causing significant global morbidity and mortality. To inform policymaking and economic evaluation studies for syphilis, we summarised utility and disability weights for health states associated with syphilis. METHODS We conducted a systematic review, searching six databases for economic evaluations and primary valuation studies related to syphilis from January 2000 to February 2022. We extracted health state utility values or disability weights, including identification of how these were derived. The study was registered in the international prospective register of systematic reviews (PROSPERO, CRD42021230035). FINDINGS Of 3401 studies screened, 22 economic evaluations, two primary studies providing condition-specific measures, and 13 burden of disease studies were included. Fifteen economic evaluations reported outcomes as disability-adjusted life years (DALYs) and seven reported quality-adjusted life years (QALYs). Fourteen of 15 economic evaluations that used DALYS based their values on the original Global Burden of Disease (GBD) study from 1990 (published in 1996). For the seven QALY-related economic evaluations, the methodology varied between studies, with some studies using assumptions and others creating utility weights or converting them from disability weights. INTERPRETATION We found a limited evidence base for the valuation of health states for syphilis, a lack of transparency for the development of existing health state utility values, and inconsistencies in the application of these values to estimate DALYs and QALYs. Further research is required to expand the evidence base so that policymakers can access accurate and well-informed economic evaluations to allocate resources to address syphilis and implement syphilis programs that are cost-effective.
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Affiliation(s)
- Patrick Miao
- Central Clinical School, Monash University, Melbourne, Australia
- Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, Victoria, 3053, Australia
| | - Fern Terris-Prestholt
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- UNAIDS, Geneva, Switzerland
| | - Christopher K Fairley
- Central Clinical School, Monash University, Melbourne, Australia
- Melbourne Sexual Health Centre, Melbourne, Australia
| | - Joseph D Tucker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Virginia Wiseman
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Philippe Mayaud
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ying Zhang
- Central Clinical School, Monash University, Melbourne, Australia
| | - Jane Rowley
- Global HIV, Hepatitis and Sexual Transmitted Infections Programme, World Health Organization, Geneva, Switzerland
| | - Sami Gottlieb
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Caroline G Watts
- Kirby Institute, University of New South Wales, Sydney, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Jason J Ong
- Central Clinical School, Monash University, Melbourne, Australia.
- Melbourne Sexual Health Centre, Melbourne, Australia.
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
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12
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Bordino V, Vicentini C, Cornio AR, Gianino MM, Zotti CM. Hip prosthesis and colon surgery, a decade of surveillance on surgical site infections in Italy, a prospective cohort study: rates, trends, and disease burden in DALYs. Antimicrob Resist Infect Control 2024; 13:17. [PMID: 38347612 PMCID: PMC10863245 DOI: 10.1186/s13756-024-01377-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/06/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Surveillance programs are a key element of interventions aiming to reduce rates of surgical site infections (SSIs). The aim of this study was to evaluate rates and trends of SSIs following hip arthroplasty and colon surgery procedures in Piedmont, a region in North-western Italy, from 2010 to 2019. Further, we aimed to assess the burden of SSIs in terms of Disability-Adjusted Life-Years (DALYs). METHODS A prospective cohort study was conducted among 42 hospitals participating in the surveillance system. Procedure-specific SSI rates were calculated and the 2010 - 2019 trend was evaluated using Spearman's Rho test. Patients were stratified according to age, sex and infection risk index according to life expectancy in order to calculate DALYs, using a modified version of the ECDC's BCoDE toolkit: disease models for both procedure types were adapted to incorporate long-term disability associated with SSIs. RESULTS Overall, 20,356 hip arthroplasty and 11,011 colon surgery procedures were monitored over 10 years and were included in our analyses. Hip arthroplasty and colon surgery cumulative SSIs rates were 1.5% and 8% respectively. Using the Spearman's Rho test, we evaluated a significant downward trend from 2010 to 2019 for colon surgery interventions (Rs - 0.7, p < 0.05), while there was no difference for hip arthroplasty. (Rs - 0.04, p > 0.05). Regarding disease burden, a total of 955.3 (95%CI 837.7-1102.98) and 208.65 (95%CI 180.87-240.90) DALYs were calculated for SSIs following hip arthroplasty, whilst 76.58 (95%CI 67.15-90.71) and 38.62 (95% CI 33.09-45.36) DALYs for SSIs in colon surgery, in 2010 and 2019, respectively. CONCLUSIONS The significant decrease both in terms of incidence and DALYs found in this study for colon surgery and the stability for hip arthroplasty support the role of surveillance networks in improving quality of care. Despite the smaller SSI rate, the burden associated with SSIs following hip arthroplasty was higher, which is important to consider in light of the aging population in Italy.
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Affiliation(s)
- Valerio Bordino
- Paediatrics and Public Health Sciences Department, University of Turin, Via Santena 5bis, 10126, Turin, Italy.
| | - Costanza Vicentini
- Paediatrics and Public Health Sciences Department, University of Turin, Via Santena 5bis, 10126, Turin, Italy
| | - Alessandro Roberto Cornio
- Paediatrics and Public Health Sciences Department, University of Turin, Via Santena 5bis, 10126, Turin, Italy
| | - Maria Michela Gianino
- Paediatrics and Public Health Sciences Department, University of Turin, Via Santena 5bis, 10126, Turin, Italy
| | - Carla Maria Zotti
- Paediatrics and Public Health Sciences Department, University of Turin, Via Santena 5bis, 10126, Turin, Italy
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13
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Brown V, Sheppard L, Salmon J, Arundell L, Cerin E, Ridgers ND, Hesketh KD, Daly RM, Dunstan DW, Brown H, Gatta JD, Chinapaw JMM, Moodie M. Cost-effectiveness of reducing children's sedentary time and increasing physical activity at school: the Transform-Us! intervention. Int J Behav Nutr Phys Act 2024; 21:15. [PMID: 38347579 PMCID: PMC10860323 DOI: 10.1186/s12966-024-01560-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Improving physical activity and reducing sedentary behavior represent important areas for intervention in childhood in order to reduce the burden of chronic disease related to obesity and physical inactivity in later life. This paper aims to determine the cost-effectiveness of a multi-arm primary school-based intervention to increase physical activity and/or reduce sedentary time in 8-9 year old children (Transform-Us!). METHODS Modelled cost-utility analysis, using costs and effects from a cluster randomized controlled trial of a 30-month intervention that used pedagogical and environmental strategies to reduce and break up sedentary behaviour (SB-I), promote physical activity (PA-I), or a combined approach (PA + SB-I), compared to current practice. A validated multiple-cohort lifetable model (ACE-Obesity Policy model) estimated the obesity and physical activity-related health outcomes (measured as change in body mass index and change in metabolic equivalent task minutes respectively) and healthcare cost-savings over the cohort's lifetime from the public-payer perspective, assuming the intervention was delivered to all 8-9 year old children attending Australian Government primary schools. Sensitivity analyses tested the impact on cost-effectiveness of varying key input parameters, including maintenance of intervention effect assumptions. RESULTS Cost-effectiveness results demonstrated that, when compared to control schools, the PA-I and SB-I intervention arms were "dominant", meaning that they resulted in net health benefits and healthcare cost-savings if the intervention effects were maintained. When the costs and effects of these intervention arms were extrapolated to the Australian population, results suggested significant potential as obesity prevention measures (PA-I: 60,780 HALYs saved (95% UI 15,007-109,413), healthcare cost-savings AUD641M (95% UI AUD165M-$1.1B); SB-I: 61,126 HALYs saved (95% UI 11,770 - 111,249), healthcare cost-savings AUD654M (95% UI AUD126M-1.2B)). The PA-I and SB-I interventions remained cost-effective in sensitivity analysis, assuming the full decay of intervention effect after 10 years. CONCLUSIONS The PA-I and SB-I Transform-Us! intervention arms represent good value for money and could lead to health benefits and healthcare cost-savings arising from the prevention of chronic disease in later life if intervention effects are sustained. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN83725066). Australia and New Zealand Clinical Trials Registry Number (ACTRN12609000715279).
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Affiliation(s)
- Vicki Brown
- Deakin University, Deakin Health Economics, Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation (IHT), Geelong, Australia.
| | - Lauren Sheppard
- Deakin University, Deakin Health Economics, Institute for Health Transformation, Geelong, Australia
| | - Jo Salmon
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), Geelong, Australia
| | - Lauren Arundell
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), Geelong, Australia
| | - Ester Cerin
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Nicola D Ridgers
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia; Deakin University, Institute for Physical Activity and Nutrition, Geelong, Australia
| | - Kylie D Hesketh
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), Geelong, Australia
| | - Robin M Daly
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), Geelong, Australia
| | | | - Helen Brown
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), Geelong, Australia
| | - Jacqueline Della Gatta
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), Geelong, Australia
| | - J M M Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, Netherlands
| | - Marj Moodie
- Deakin University, Deakin Health Economics, Institute for Health Transformation, Geelong, Australia
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14
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Liu X, Yu C. Author's reply: "Eliciting national and subnational sets of disability weights in mainland China: findings from the Chinese disability weight measurement study". Lancet Reg Health West Pac 2024; 43:101009. [PMID: 38303747 PMCID: PMC10832453 DOI: 10.1016/j.lanwpc.2024.101009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 01/02/2024] [Indexed: 02/03/2024]
Affiliation(s)
- Xiaoxue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China
- Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, No. 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China
- Global Health Institute, Wuhan University, Wuhan, 430072, China
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15
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Luo J, Tang L, Kong X, Li Y. Global, regional, and national burdens of depressive disorders in adolescents and young adults aged 10-24 years from 1990 to 2019: A trend analysis based on the Global Burden of Disease Study 2019. Asian J Psychiatr 2024; 92:103905. [PMID: 38262303 DOI: 10.1016/j.ajp.2023.103905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/21/2023] [Accepted: 12/31/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Depressive disorders (DD) including dysthymia and major depressive disorder (MDD) are common among adolescents and young adults. However, global trends in DD burden remain unclear. METHODS We analysed data from the Global Burden of Disease 2019 study on incidence, prevalence, disability-adjusted life years (DALYs), and mortality due to DD from 1990 to 2019 at global, regional and national levels. RESULTS Globally, dysthymia incidence increased notably in females, older age groups, and lower-middle income countries from 1990 to 2019. In contrast, MDD incidence decreased slightly over this period except in high-income North America. Females and middle-income countries had the highest dysthymia burden while North America had the highest MDD incidence and DALYs. Oman and Malaysia experienced largest increases in dysthymia and MDD burden respectively. CONCLUSION Despite certain global indicators suggesting a leveling off or decrease, it's clear that depressive disorders continue to be a significant and increasing issue, particularly among women, teenagers, and young adults. Differences between regions and countries indicate that specific interventions aimed at addressing economic inequalities, improving healthcare systems, and taking cultural factors into account could make a real difference in lessening the burden of depressive disorders. More research is needed to understand what's driving these trends so that we can develop better strategies for preventing and managing these conditions.
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Affiliation(s)
- Jianzhang Luo
- Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Lijuan Tang
- Institute of Prevention and Control of Non‑communicable Chronic Diseases, Hebei Province Center for Disease Prevention and Control, Shijiazhuang 050021, China
| | - Xiangjun Kong
- Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Yu Li
- Department of Cardiovascular Surgery, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361102, China.
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16
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Rogowski W, John J. Preferences as fairness judgments: a critical review of normative frameworks of preference elicitation and development of an alternative based on constitutional economics. Cost Eff Resour Alloc 2024; 22:10. [PMID: 38291472 PMCID: PMC10826070 DOI: 10.1186/s12962-024-00510-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 01/02/2024] [Indexed: 02/01/2024] Open
Abstract
Preference elicitation is widely used within health economic evaluations to inform coverage decisions. However, coverage decisions involve questions of social justice and it is unclear what role empirical evidence about preferences can play here. This study reviews the prevalent normative frameworks for using population-based preference elicitation and the criticisms they face, and proposes an alternative based on constitutional economics. The frameworks reviewed include a supposedly value-neutral framework of preferences as predictors of choice, preference utilitarian frameworks that aim to maximize preference satisfaction, and substantive consequentialist frameworks that aim to maximize happiness, health, or capabilities. The proposed alternative implements the idea that indices of social value are tools for conflict resolution, rather than tools for maximization. Preference elicitation is used for validating values generated by multi-criteria decision analysis results within representative processes of stakeholder deliberation.
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Affiliation(s)
- Wolf Rogowski
- Department of Health Care Management, Institute of Public Health and Nursing Research, Health Sciences, University of Bremen, Grazer Str. 2a, 28359, Bremen, Germany.
- Institute of Health Economics and Health Care Management (IGM), Helmholtz Zentrum München (GmbH) German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
| | - Jürgen John
- Institute of Health Economics and Health Care Management (IGM), Helmholtz Zentrum München (GmbH) German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
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17
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Huang Y, Zhang D, Yin L, Zhao J, Li Z, Lu J, Zhang X, Wu C, Wu W. Modeling the Health Impact and Cost-Effectiveness of a Combined Schoolgirl HPV Vaccination and Cervical Cancer Screening Program in Guangdong Province, China. Children (Basel) 2024; 11:103. [PMID: 38255416 PMCID: PMC10814869 DOI: 10.3390/children11010103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/02/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024]
Abstract
Low human papillomavirus (HPV) vaccine uptake is a key barrier to cervical cancer elimination. We aimed to evaluate the health impact and cost-effectiveness of introducing different HPV vaccines into immunization programs and scaling up the screening program in Guangdong. We used a dynamic compartmental model to estimate the impact of intervention strategies during 2023-2100. We implemented the incremental cost-effectiveness ratio (ICER) in costs per averted disability-adjusted life year (DALY) as an indicator to assess the effectiveness of the intervention. We used an age-standardized incidence of 4 cases per 100,000 women as the threshold for the elimination of cervical cancer. Compared with the status quo, scaling up cervical cancer screening coverage alone would prevent 215,000 (95% CI: 205,000 to 227,000) cervical cancer cases and 49,000 (95% CI: 48,000 to 52,000) deaths during 2023-2100. If the coverage of vaccination reached 90%, domestic two-dose 2vHPV vaccination would be more cost-effective than single-dose and two-dose 9vHPV vaccination. If Guangdong introduced domestic two-dose 2vHPV vaccination at 90% coverage for schoolgirls from 2023 and increased the screening coverage, cervical cancer would be eliminated by 2049 (95% CI 2047 to 2051). Introducing two doses of domestic 2vHPV vaccination for schoolgirls and expanding cervical cancer screening is estimated to be highly cost-effective to accelerate the elimination of cervical cancer in Guangdong.
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Affiliation(s)
- Yating Huang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510200, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Dantao Zhang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lihua Yin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianguo Zhao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Zhifeng Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jing Lu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Xiaoming Zhang
- The Second Division Center for Disease Control and Prevention of Xinjiang Production and Construction Corps, Tiemenguan 841007, China
| | - Chenggang Wu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Wei Wu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510200, China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
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Cao Y, Lu H, Duan P, Wang D, Wei G. Global, regional, and national burdens of interpersonal violence in young women aged 10-24 years from 1990 to 2019: a trend analysis based on the global burden of disease study 2019. Front Psychol 2024; 14:1241862. [PMID: 38282853 PMCID: PMC10811790 DOI: 10.3389/fpsyg.2023.1241862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 12/21/2023] [Indexed: 01/30/2024] Open
Abstract
Background Interpersonal violence (IPV) against young women, including physical and sexual violence, poses a major threat to public health. We analyzed global, regional and national trends in violence against females aged 10-24 years from 1990 to 2019. Methods We extracted age-standardized prevalence rates (ASPRs) of physical violence by firearm (PVF), physical violence by other means (PVOM), physical violence by sharp object (PVSO), and sexual violence (SV) from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Joinpoint regression analysis calculated annual and average annual percentage changes (AAPCs) in ASPRs. Results Globally, the ASPRs of the four measures of IPV decreased between 1990 and 2019, with the steepest declines between 2000 and 2009, except for SV, which increased slightly. However, the ASPRs of PVF and PVOM increased slightly between 2010 and 2019. Regionally, PVF prevalence declined most in East Asia (-0.9505, -1.0011 to -0.8975), South Asia (-0.277, -0.3089 to -0.244) and Latin America but PVOM prevalence increased in Oceania (0.6275, 0.6036 to 0.6498) and SV prevalence increased in Caribbean (0.4267, 0.4069 to 0.4495). Nationally, PVF prevalence decreased most in Thailand (-2.4031, -2.4634 to -2.3328) but increased most in Libya (6.8143, 6.6194 to 7.0113). SV prevalence increased most in Oman (0.4561, 0.4338 to 0.478) and the largest increase in Disability-adjusted life years (DALYs) from PVOM was observed in Botswana (6.2725, 6.0951 to 6.4082). DALYs showed similar trends. Conclusion While global declines over 30 years are encouraging, IPV against young women persists. Urgent, tailored approaches across sectors are critical to curb drivers of violence against young women, including poverty, inequality and sociocultural attitudes. High-quality data and in-depth analyses can inform locally-relevant solutions. Overall, intensified political will and resource investment are needed to overcome this pervasive human rights violation.
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Affiliation(s)
- Yu Cao
- The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, Zhejiang Province, China
- School of Medicine, Xiamen University, Xiamen, Fujian Province, China
| | - Hao Lu
- School of Medicine, Xiamen University, Xiamen, Fujian Province, China
| | - Pengqian Duan
- School of Medicine, Xiamen University, Xiamen, Fujian Province, China
| | - Dongmei Wang
- School of Medicine, Xiamen University, Xiamen, Fujian Province, China
- Xiang'an Hospital of Xiamen University, Xiamen, Fujian Province, China
| | - Guojun Wei
- The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, Zhejiang Province, China
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Adde HA, Oghogho MD, van Duinen AJ, Grimes CE, Hampaye TC, Quaife M, Bolkan HA. The economic burden associated with unmet surgical needs in Liberia: a retrospective macroeconomic analysis based on a nationwide enumeration of surgical procedures. BMJ Open 2024; 14:e076293. [PMID: 38191260 PMCID: PMC10806694 DOI: 10.1136/bmjopen-2023-076293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/15/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVES The economic consequences of untreated surgical disease are potentially large. The aim of this study was to estimate the economic burden associated with unmet surgical needs in Liberia. DESIGN A nationwide enumeration of surgical procedures and providers was conducted in Liberia in 2018. We estimated the number of disability-adjusted life years (DALYs) saved by operative activities and converted these into economic losses averted using gross national income per capita and value of a statistical life (VSL) approaches. The total, the met and the unmet needs for surgery were determined, and economic losses caused by unmet surgical needs were estimated. Finally, we valued the economic losses avoided by various surgical provider groups. RESULTS A total of 55 890 DALYs were averted by surgical activities in 2018; these activities prevented an economic loss of between US$35 and US$141 million. About half of these values were generated by the non-specialist physician workforce. Furthermore, a non-specialist physician working a full-time position for 1 year prevented an economic loss of US$717 069 using the VSL approach, while a specialist resident and a certified specialist saved US$726 606 and US$698 877, respectively. The burden of unmet surgical need was associated with productivity losses of between US$388 million and US$1.6 billion; these losses equate to 11% and 46% of the annual gross domestic product for Liberia. CONCLUSION The economic burden of untreated surgical disease is large in Liberia. There is a need to strengthen the surgical system to reduce ongoing economic losses; a framework where specialist and non-specialist physicians collaborate may result in better economic return than a narrower focus on training specialists alone.
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Affiliation(s)
- Håvard A Adde
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Surgery, Ålesund Hospital, Møre and Romsdal Hospital Trust, Ålesund, Norway
- CapaCare, Trondheim, Norway, & Tappita, Liberia
| | | | - Alex J van Duinen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- CapaCare, Trondheim, Norway, & Tappita, Liberia
- Department of Surgery, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Surgery, ELWA Hospital, Monrovia, Liberia
| | - Caris E Grimes
- King's Centre for Global Health and Health Partnerships, King's College, London, UK
- Medway NHS Foundation Trust, Gillingham, UK
| | | | - Matthew Quaife
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
- Evidera Ltd, London, UK
| | - Håkon A Bolkan
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- CapaCare, Trondheim, Norway, & Tappita, Liberia
- Department of Surgery, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
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Da Costa S, O'Donnell O, Van Gestel R. Distributionally sensitive measurement and valuation of population health. J Health Econ 2024; 93:102847. [PMID: 38154202 DOI: 10.1016/j.jhealeco.2023.102847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 12/10/2023] [Accepted: 12/12/2023] [Indexed: 12/30/2023]
Abstract
We introduce a measure of population health that is sensitive to inequality in both age-specific health and lifespan and can be calculated from a health-extended period life table. By allowing for inequality aversion, the measure generalises health-adjusted life expectancy without requiring more data. A transformation of change in the (life-years) measure gives a distributionally sensitive monetary valuation of change in population health and disease burden. Application to Sub-Saharan Africa between 1990 and 2019 reveals that the change in population health is sensitive to allowing for lifespan inequality but is less sensitive to age-specific health inequality. Allowing for distributional sensitivity changes relative burdens of diseases, reduces convergence between the burdens of communicable and non-communicable diseases, and so could influence disease prioritisation. It increases the value of health improvements relative to GDP.
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Affiliation(s)
| | - Owen O'Donnell
- Erasmus University Rotterdam, The Netherlands; Tinbergen Institute, The Netherlands.
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21
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Lin T, Zarate DA, Iribarren N, Lindau H, Ramos-Gomez F, Gansky S. Quality-Adjusted Life Year Proxies for Caries in Primary Dentition: A Discrete Choice Experiment. JDR Clin Trans Res 2024; 9:85-94. [PMID: 36789915 PMCID: PMC10850881 DOI: 10.1177/23800844221149337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION Cost-utility analysis (CUA)-a method to evaluate intervention cost-effectiveness-transforms benefits of alternatives into a measure of quantity and quality of life, such as quality-adjusted life year (QALY), to enable comparison across heterogeneous programs. Measurement challenges prevent directly estimating utilities and calculating QALYs for caries in primary dentition. Proxy disease QALYs are often used as a substitute; however, there lacks quantitative evidence that these proxy diseases are comparable to caries. OBJECTIVE To employ a discrete choice experiment (DCE) to quantitatively determine the most comparable proxy disease for different levels of caries in primary dentition. METHODS A cross-sectional DCE survey was administered to respondents (N = 461) who resided in California, were aged ≥18 y, and were primary caretakers for ≥1 child aged 3 to 12 y. Four attributes were included: pain level, disease duration, treatment cost, and family life impacts. Mixed effects logistic regression and conditional logistic regression were used to analyze the survey data. RESULTS Respondents from the overall sample preferred no pain over mild (odds ratio [OR] = 0.50, P < 0.05), moderate (OR = 0.57, P < 0.05), and severe pain (OR = 0.48, P < 0.05). Acute gastritis (OR = 0.44, P < 0.05), chronic gastritis (OR = 0.31, P < 0.01), and cold sore (OR = 0.38, P < 0.05) were less preferred than stage 1 caries. Acute tonsilitis (OR = 0.43, P < 0.05), acute gastritis (OR = 0.38, P < 0.05), chronic gastritis (OR = 0.26, P < 0.01), and cold sore (OR = 0.33, P < 0.01) were less preferred than stage 2 caries. Chronic gastritis (OR = 0.42,P < 0.05) was less preferred than stage 4 caries. CONCLUSIONS Parents viewed the characteristics of many diseases with similar QALYs differently. Findings suggest that otitis media and its QALY-as commonly used in CUAs-may be a suitable proxy disease and substitute. However, other disease states with slightly different QALYs may be suitable. As such, the recommendation is to consider a range of proxy diseases and their QALYs when conducting a CUA for child caries interventions. KNOWLEDGE TRANSFER STATEMENT This study reviews and systematically compares pediatric diseases that are comparable to caries in primary dentition. The findings may inform future research using cost-utility analysis to examine the incremental cost-effectiveness ratio of interventions to prevent and treat caries as compared with an alternative.
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Affiliation(s)
- T.K. Lin
- Institute for Health & Aging, Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, San Francisco, CA, USA
- Center to Address Disparities in Children’s Oral Health, Department of Preventive Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA
| | - D.E. Arriola Zarate
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA
| | - N. Iribarren
- Center to Address Disparities in Children’s Oral Health, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
| | - H. Lindau
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA
- Center to Address Disparities in Children’s Oral Health, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
| | - F. Ramos-Gomez
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA
- Center to Address Disparities in Children’s Oral Health, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
| | - S.A. Gansky
- Center to Address Disparities in Children’s Oral Health, School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
- Center to Address Disparities in Children’s Oral Health, Department of Preventive Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA
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Meili KW, Mulhern B, Ssegonja R, Norström F, Feldman I, Månsdotter A, Hjelte J, Lindholm L. Eliciting a value set for the Swedish Capability-Adjusted Life Years instrument (CALY-SWE). Qual Life Res 2024; 33:59-72. [PMID: 37695477 PMCID: PMC10784385 DOI: 10.1007/s11136-023-03507-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE Our aim was to elicit a value set for Capability-Adjusted Life Years Sweden (CALY-SWE); a capability-grounded quality of life instrument intended for use in economic evaluations of social interventions with broad consequences beyond health. METHODS Building on methods commonly used in the quality-adjusted life years EQ-5D context, we collected time-trade off (TTO) and discrete choice experiment (DCE) data through an online survey from a general population sample of 1697 Swedish participants. We assessed data quality using a score based on the severity of inconsistencies. For generating the value set, we compared different model features, including hybrid modeling of DCE and TTO versus TTO data only, censoring of TTO answers, varying intercept, and accommodating for heteroskedasticity. We also assessed the models' DCE logit fidelity to measure agreement with potentially less-biased DCE data. To anchor the best capability state to 1 on the 0 to 1 scale, we included a multiplicative scaling factor. RESULTS We excluded 20% of the TTO answers of participants with the largest inconsistencies to improve data quality. A hybrid model with an anchor scale and censoring was chosen to generate the value set; models with heteroskedasticity considerations or individually varying intercepts did not offer substantial improvement. The lowest capability weight was 0.114. Health, social relations, and finance and housing attributes contributed the largest capability gains, followed by occupation, security, and political and civil rights. CONCLUSION We elicited a value set for CALY-SWE for use in economic evaluations of interventions with broad social consequences.
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Affiliation(s)
- Kaspar Walter Meili
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sidney, Ultimo, Australia
| | - Richard Ssegonja
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Respiratory, Allergy and Sleep Medicine Research Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Fredrik Norström
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Inna Feldman
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anna Månsdotter
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Jan Hjelte
- Department of Social Work, Umeå University, Umeå, Sweden
| | - Lars Lindholm
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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23
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Ghaddaf AA, Alsharef JF, Alsharef NK, Alsaegh MH, Alshaban RM, Almutairi AO, Abualola AH, Alshehri MS. Minimally invasive sacroiliac joint fusion using triangular titanium implants versus nonsurgical management for sacroiliac joint dysfunction: a systematic review and meta-analysis. Can J Surg 2024; 67:E16-E26. [PMID: 38278549 PMCID: PMC10824395 DOI: 10.1503/cjs.004523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Minimally invasive sacroiliac joint (MISIJ) fusion is a surgical option to relieve SIJ pain. The aim of this systematic review and meta-analysis was to compare MISIJ fusion with triangular titanium implants (TTI) to nonoperative management of SIJ dysfunction. METHODS We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials. We included prospective clinical trials that compared MISIJ fusion to nonoperative management in individuals with chronic low back pain attributed to SIJ dysfunction. We evaluated pain on visual analogue scale, Oswestry Disability Index (ODI) score, health-related quality of life (HRQoL) using the 36-Item Short Form Health Survey (SF-36) physical component (PCS) and mental component summary (MCS) scores, patient satisfaction, and adverse events. RESULTS A total of 8 articles representing 3 trials that enrolled 423 participants were deemed eligible. There was a significant reduction in pain score with MISIJ fusion compared with nonoperative management (standardized mean difference [SMD] -1.71, 95% confidence interval [CI] -2.03 to -1.39). Similarly, ODI scores (SMD -1.03, 95% CI -1.24 to -0.81), SF-36 PCS scores (SMD 1.01, 95% CI 0.83 to 1.19), SF-36 MCS scores (SMD 0.72, 95% CI 0.54 to 0.9), and patient satisfaction (odds ratio 6.87, 95% CI 3.73 to 12.64) were significantly improved with MISIJ fusion. No significant difference was found between the 2 groups with respect to adverse events (SMD -0.03, 95% CI -0.28 to 0.23). CONCLUSION Our analysis showed that MISIJ fusion with TTI shows a clinically important and statistically significant improvement in pain, disability score, HRQoL, and patient satisfaction with a similar adverse event profile to nonoperative management in patients with chronic low back pain attributed to SIJ dysfunction.
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Affiliation(s)
- Abdullah A Ghaddaf
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia (Ghaddaf, J. Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); the King Abdullah International Medical Research Center, Jeddah, Saudi Arabia (Ghaddaf, J.Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); and the Department of Orthopedic Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia (Alshehri).
| | - Jawaher F Alsharef
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia (Ghaddaf, J. Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); the King Abdullah International Medical Research Center, Jeddah, Saudi Arabia (Ghaddaf, J.Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); and the Department of Orthopedic Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia (Alshehri)
| | - Noor K Alsharef
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia (Ghaddaf, J. Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); the King Abdullah International Medical Research Center, Jeddah, Saudi Arabia (Ghaddaf, J.Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); and the Department of Orthopedic Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia (Alshehri)
| | - Mawaddah H Alsaegh
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia (Ghaddaf, J. Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); the King Abdullah International Medical Research Center, Jeddah, Saudi Arabia (Ghaddaf, J.Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); and the Department of Orthopedic Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia (Alshehri)
| | - Raneem M Alshaban
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia (Ghaddaf, J. Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); the King Abdullah International Medical Research Center, Jeddah, Saudi Arabia (Ghaddaf, J.Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); and the Department of Orthopedic Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia (Alshehri)
| | - Amal O Almutairi
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia (Ghaddaf, J. Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); the King Abdullah International Medical Research Center, Jeddah, Saudi Arabia (Ghaddaf, J.Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); and the Department of Orthopedic Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia (Alshehri)
| | - Amal H Abualola
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia (Ghaddaf, J. Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); the King Abdullah International Medical Research Center, Jeddah, Saudi Arabia (Ghaddaf, J.Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); and the Department of Orthopedic Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia (Alshehri)
| | - Mohammed S Alshehri
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia (Ghaddaf, J. Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); the King Abdullah International Medical Research Center, Jeddah, Saudi Arabia (Ghaddaf, J.Alsharef, N. Alsharef, Alsaegh, Alshaban, Almutairi, Abualola, Alshehri); and the Department of Orthopedic Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia (Alshehri)
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24
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Kullberg MJ, Schoorl M, Oprel DAC, Hoeboer CM, Smit F, van der Does W, de Kleine RA, van Minnen A, van den Hout W. Exposure-based treatments for childhood abuse-related post-traumatic stress disorder in adults: a health-economic evaluation. Eur J Psychotraumatol 2023; 14. [PMID: 37052103 PMCID: PMC9930771 DOI: 10.1080/20008066.2023.2171752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Background: Prolonged exposure (PE) is an effective treatment for post-traumatic stress disorder (PTSD).Objective: This study aimed to analyse the cost-effectiveness of three exposure-based treatments in patients with childhood abuse-related PTSD.Method: A net-benefit analysis was conducted alongside a pragmatic randomized controlled trial with participants (N = 149) randomized to three conditions: PE (n = 48), intensified PE (i-PE, n = 51), and phase-based PE [Skills Training in Affective and Interpersonal Regulation (STAIR) + PE, n = 50]. Assessments took place at baseline (T0), post-treatment (T3), 6 month follow-up (T4), and 12 month follow-up (T5). Costs stemming from healthcare utilization and productivity losses were estimated using the Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness. Quality-adjusted life-years (QALYs) were based on the 5-level EuroQoL 5 Dimensions (EQ-5D-5L) using the Dutch tariff. Missing values of costs and utilities were multiply imputed. To compare i-PE to PE and STAIR + PE to PE, pair-wise unequal-variance t-tests were conducted. Net-benefit analysis was used to relate costs to QALYs and to draw acceptability curves.Results: Intervention costs did not differ across the three treatment conditions. Total medical costs, productivity losses, total societal costs, and EQ-5D-5L-based QALYs did not differ between treatment conditions either (all p > .10). At the relevant €50,000/QALY threshold, the probability of one treatment being more cost-effective than another was 32%, 28%, and 40% for PE, i-PE, and STAIR-PE, respectively.Conclusion: Three equally effective treatments were compared and no differences in cost-effectiveness between treatments were found. Therefore, we advocate the implementation and adoption of any of the treatments and endorse shared decision making.
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Kotre CJ. Comparing benefit and detriment from medical diagnostic radiation exposure using disability-adjusted life years: towards quantitative justification. J Radiol Prot 2023; 43:041512. [PMID: 38035392 DOI: 10.1088/1361-6498/ad1159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/30/2023] [Indexed: 12/02/2023]
Abstract
Justification of medical radiation exposure is one of the main elements of radiation protection for patients. For a medical exposure to proceed, the benefit from the procedure must have been determined to be greater than the detriment. It is rare, however, that justification can be stated quantitatively as a ratio of benefit to detriment, or as a net benefit, and this is particularly true for medical diagnostic exposures associated with non-fatal diseases where survival statistics do not apply. The concept of the disability-adjusted life year (DALY) is well established as a measure of disease severity in public health, and there have been calls to revise the international system of radiation protection dosimetry to employ the DALY as a measure of radiation detriment. This paper looks at possible routes to quantify the benefit and detriment aspects of justification based on initial published results for the use of the DALY as a measure of radiation detriment, together with established values of DALY for a range of diseases. Although spreadsheet-style solutions for the calculation of a justification factor based on statistical life tables can be devised, these will be shown to have some limitations. A justification factor based on the rate of change of benefit divided by the rate of change of detriment following medical exposure is proposed. This factor is simple to calculate, is age independent, can apply to non-fatal diseases and is argued to have logical and ethical advantages for the explanation of the relative benefits and detriments of radiological procedures to patients.
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Affiliation(s)
- C J Kotre
- Visiting Research Fellow Institute of Health University of Cumbria, Lancaster, United Kingdom
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Simms KT, Keane A, Nguyen DTN, Caruana M, Hall MT, Lui G, Gauvreau C, Demke O, Arbyn M, Basu P, Wentzensen N, Lauby-Secretan B, Ilbawi A, Hutubessy R, Almonte M, De Sanjosé S, Kelly H, Dalal S, Eckert LO, Santesso N, Broutet N, Canfell K. Benefits, harms and cost-effectiveness of cervical screening, triage and treatment strategies for women in the general population. Nat Med 2023; 29:3050-3058. [PMID: 38087115 PMCID: PMC10719104 DOI: 10.1038/s41591-023-02600-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 09/19/2023] [Indexed: 12/17/2023]
Abstract
In 2020, the World Health Organization (WHO) launched a strategy to eliminate cervical cancer as a public health problem. To support the strategy, the WHO published updated cervical screening guidelines in 2021. To inform this update, we used an established modeling platform, Policy1-Cervix, to evaluate the impact of seven primary screening scenarios across 78 low- and lower-middle-income countries (LMICs) for the general population of women. Assuming 70% coverage, we found that primary human papillomavirus (HPV) screening approaches were the most effective and cost-effective, reducing cervical cancer age-standardized mortality rates by 63-67% when offered every 5 years. Strategies involving triaging women before treatment (with 16/18 genotyping, cytology, visual inspection with acetic acid (VIA) or colposcopy) had close-to-similar effectiveness to HPV screening without triage and fewer pre-cancer treatments. Screening with VIA or cytology every 3 years was less effective and less cost-effective than HPV screening every 5 years. Furthermore, VIA generated more than double the number of pre-cancer treatments compared to HPV. In conclusion, primary HPV screening is the most effective, cost-effective and efficient cervical screening option in LMICs. These findings have directly informed WHO's updated cervical screening guidelines for the general population of women, which recommend primary HPV screening in a screen-and-treat or screen-triage-and-treat approach, starting from age 30 years with screening every 5 years or 10 years.
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Affiliation(s)
- Kate T Simms
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia.
| | - Adam Keane
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Diep Thi Ngoc Nguyen
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Michael Caruana
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Michaela T Hall
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Gigi Lui
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Cindy Gauvreau
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- SUCCESS Project, Expertise France, Paris, France
| | - Owen Demke
- Global Diagnostics, Clinton Health Access Initiative, Kigali, Rwanda
| | - Marc Arbyn
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, University Ghent, Ghent, Belgium
| | - Partha Basu
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Beatrice Lauby-Secretan
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer (IARC), Lyon, France
| | - Andre Ilbawi
- Department for the Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland
| | - Raymond Hutubessy
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Maribel Almonte
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
- Department of Sexual and Reproductive Health, World Health Organization, Geneva, Switzerland
| | - Silvia De Sanjosé
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
- ISGlobal, Barcelona, Spain
| | - Helen Kelly
- London School of Hygiene & Tropical Medicine, London, UK
| | - Shona Dalal
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Linda O Eckert
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Nancy Santesso
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Nathalie Broutet
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Karen Canfell
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
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Huse O, Backholer K, Nguyen P, Calibo A, Guirindola M, Desnacido JP, Sacks G, Bell AC, Peeters A, Angeles-Agdeppa I, Ananthapavan J. A comparative analysis of the cost-utility of the Philippine tax on sweetened beverages as proposed and as implemented. Lancet Reg Health West Pac 2023; 41:100912. [PMID: 37780636 PMCID: PMC10534259 DOI: 10.1016/j.lanwpc.2023.100912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/01/2023] [Accepted: 09/10/2023] [Indexed: 10/03/2023]
Abstract
Background In response to increasing overweight and obesity, the Philippine government introduced a tax on sweetened beverages (SBs) in 2018. Evidence suggests that the beverage industry influenced the final tax design, making it more favourable for industry than the initially proposed bill. This study aimed to compare the relative health and economic benefits of the proposed SB tax with the implemented SB tax. Methods Philippine dietary consumption data were combined with price elasticity data from Mexico and data from Australia adapted to the Philippine context to estimate reductions in SB purchases and changes in body mass index (BMI) following the implementation of the tax. A multi-state, multiple-cohort Markov model was used to estimate the change in health-adjusted life years (HALYs) due to reduction in the epidemiology of obesity-related diseases, healthcare cost savings and government taxation revenue, resulting from both the proposed and implemented tax policies, over the lifetime of the 2018 Philippine population. Findings The proposed and implemented taxes were modelled to be dominant (cost-saving and improving health). Intervention costs were modelled to be PHP305.2 million (M) (approximately US$6M). Compared to the proposed tax, the implemented tax was modelled to result in a 43.0% smaller reduction in targeted beverage intake (51.1 ml/person/day vs. 89.7 ml/person/day), a 43.5% smaller reduction in BMI (0.35 kg/m2 vs. 0.62 kg/m2), 39.7% fewer HALYs gained (2,503,118 vs. 4,149,030), 39.9% fewer healthcare cost savings (PHP16.4 billion (B) vs. PHP27.3B), and 27.7% less government taxation revenue (PHP426.3B vs. PHP589.4B). Interpretation While the implemented tax in the Philippines will benefit population health, it is likely to yield less benefit than the proposed tax. The influence of the food and beverage industry on policy processes has the potential to lessen the benefits of population NCD prevention policies. Funding OH was supported to conduct this research by an Australian Government Research Training Program Stipend Scholarship. The funding body had no role in data collection and analysis, or manuscript preparation.
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Affiliation(s)
- Oliver Huse
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Phuong Nguyen
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Anthony Calibo
- Child Health Division, Department of Health, Medical Specialist IV, Disease Prevention and Control Bureau, Manila (2011-2020), Philippines
- Institute of Pediatrics and Child Health, St. Luke's Medical Center, Quezon City, Philippines
| | - Mildred Guirindola
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Josie P. Desnacido
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Gary Sacks
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Andrew Colin Bell
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Anna Peeters
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Imelda Angeles-Agdeppa
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Jaithri Ananthapavan
- Global Centre for Preventative Health and Nutrition, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
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Tiller J, Maguire T, Newman-Taylor K. Early intervention in psychosis services: A systematic review and narrative synthesis of barriers and facilitators to seeking access. Eur Psychiatry 2023; 66:e92. [PMID: 37929296 PMCID: PMC10755576 DOI: 10.1192/j.eurpsy.2023.2465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/09/2023] [Accepted: 10/12/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND The duration of untreated psychosis (DUP) continues to be a global priority. Early intervention services were established to reduce treatment delays but have had limited impact. This systematic review examines barriers and facilitators to seeking access to these services, to identify targets for service level change. METHODS We conducted a systematic review of relevant databases (PsychINFO, MEDLINE, CINAHL, and PsychARTICLES) using pre-defined search terms for psychosis, early intervention, and barriers and facilitators. Given the majority of qualitative studies, a thematic synthesis rather than meta-analysis was indicated. RESULTS The search yielded 10 studies. Mental health stigma and discrimination predict DUP, compounded by structural barriers which limit the impact of early intervention services on timely access to recommended treatments. Synthesis of the qualitative studies generated three themes: knowledge, relationships, and stigma. Lack of knowledge, absence of supportive relationships (social and professional), and self-stigma constitute significant barriers to seeking access to early intervention services. CONCLUSIONS This is the first review of the barriers and facilitators to seeking access to early intervention services. The findings highlight public health and secondary care service targets to expedite access to recommended treatments and thereby reduce the DUP.
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Affiliation(s)
- Jacqui Tiller
- School of Psychology, University of Southampton, Southampton, UK
| | - Tess Maguire
- School of Psychology, University of Southampton, Southampton, UK
- Psychology Department, Southern Health NHS Foundation Trust, Southampton, UK
| | - Katherine Newman-Taylor
- School of Psychology, University of Southampton, Southampton, UK
- Psychology Department, Southern Health NHS Foundation Trust, Southampton, UK
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Ashby F, Park H, Svensson M, Heldermon CD. Economic Burden of Sanfilippo Syndrome in the United States. Res Sq 2023:rs.3.rs-3001450. [PMID: 37398464 PMCID: PMC10312916 DOI: 10.21203/rs.3.rs-3001450/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Introduction Sanfilippo syndrome is a rare disease and fatal genetic disorder with no FDA-approved treatment in the United States (US), and no comprehensive assessment of economic disease burden is available. Objectives To develop a model to estimate the economic burden associated with Sanfilippo syndrome in the US using direct costs, indirect costs and valued intangibles (disability-adjusted life years, or DALYs) from 2023 onward. Design and Setting A multistage comorbidity model was generated based on Sanfilippo syndrome symptoms, and disability weights from the 2010 Global Burden of Disease Study. Attributable increase in caregiver mental health burden were estimated using data from the CDC National Comorbidity Survey and retrospective studies on caregiver burden. Direct costs were approximated from the 2019 EveryLife Foundation survey, and indirect costs were estimated from Federal income data. Monetary valuations were adjusted to USD 2023 and given a 3% discount rate from 2023 onward. Main Outcome Measures Incidence of Sanfilippo syndrome was calculated for each year, and year-over-year DALYs due to patient years lived with disability (YLDs) and years life lost (YLLs) were calculated by comparing to the health-adjusted life expectancy (HALE) in the US. Direct and indirect costs were calculated for each simulated patient from onset of symptoms to death. Results From 2023-2043, overall economic burden in the US attributable to Sanfilippo syndrome was estimated to be $2.04 billion USD present value (2023) with current standard of care. The burden to individual families exceeded $8 million present value from time of birth per child born with Sanfilippo syndrome. Conclusion Sanfilippo syndrome is a rare lysosomal storage disease, however the severe burden associated with the disease for individual families demonstrates a considerable cumulative impact. Our model represents the first disease burden value estimate associated with Sanfilippo syndrome, and underscores the substantial morbidity and mortality burden of Sanfilippo syndrome.
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Affiliation(s)
- Frederick Ashby
- College of Medicine, University of Florida - Gainesville, Florida, USA
| | - Haesuk Park
- College of Pharmacy, University of Florida - Gainesville, Florida, USA
| | - Mikael Svensson
- College of Pharmacy, University of Florida - Gainesville, Florida, USA
| | - Coy D Heldermon
- College of Medicine, University of Florida - Gainesville, Florida, USA
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Silva V, Gai L, Harkes P, Tan G, Ritsema CJ, Alcon F, Contreras J, Abrantes N, Campos I, Baldi I, Bureau M, Christ F, Mandrioli D, Sgargi D, Pasković I, Polić Pasković M, Glavan M, Hofman J, Huerta Lwanga E, Norgaard T, Bílková Z, Osman R, Khurshid C, Navarro I, de la Torre A, Sanz P, Ángeles Martínez M, Dias J, Mol H, Gort G, Martins Figueiredo D, Scheepers PTJ, Schlünssen V, Vested A, Alaoui A, Geissen V. Pesticide residues with hazard classifications relevant to non-target species including humans are omnipresent in the environment and farmer residences. Environ Int 2023; 181:108280. [PMID: 37924602 DOI: 10.1016/j.envint.2023.108280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 11/06/2023]
Abstract
Intensive and widespread use of pesticides raises serious environmental and human health concerns. The presence and levels of 209 pesticide residues (active substances and transformation products) in 625 environmental samples (201 soil, 193 crop, 20 outdoor air, 115 indoor dust, 58 surface water, and 38 sediment samples) have been studied. The samples were collected during the 2021 growing season, across 10 study sites, covering the main European crops, and conventional and organic farming systems. We profiled the pesticide residues found in the different matrices using existing hazard classifications towards non-target organisms and humans. Combining monitoring data and hazard information, we developed an indicator for the prioritization of pesticides, which can support policy decisions and sustainable pesticide use transitions. Eighty-six percent of the samples had at least one residue above the respective limit of detection. One hundred residues were found in soil, 112 in water, 99 in sediments, 78 in crops, 76 in outdoor air, and 197 in indoor dust. The number, levels, and profile of residues varied between farming systems. Our results show that non-approved compounds still represent a significant part of environmental cocktails and should be accounted for in monitoring programs and risk assessments. The hazard profiles analysis confirms the dominance of compounds of low-moderate hazard and underscores the high hazard of some approved compounds and recurring "no data available" situations. Overall, our results support the idea that risk should be assessed in a mixture context, taking environmentally relevant mixtures into consideration. We have uncovered uncertainties and data gaps that should be addressed, as well as the policy implications at the EU approval status level. Our newly introduced indicator can help identify research priority areas, and act as a reference for targeted scenarios set forth in the Farm to Fork pesticide reduction goals.
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Affiliation(s)
- Vera Silva
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Lingtong Gai
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands.
| | - Paula Harkes
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Gaowei Tan
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Coen J Ritsema
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Francisco Alcon
- Agricultural Engineering School, Universidad Politécnica de Cartagena, Spain
| | - Josefa Contreras
- Agricultural Engineering School, Universidad Politécnica de Cartagena, Spain
| | - Nelson Abrantes
- CESAM and Department of Biology, University of Aveiro, Portugal
| | - Isabel Campos
- CESAM and Department of Biology, University of Aveiro, Portugal
| | - Isabelle Baldi
- Univ. Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Mathilde Bureau
- Univ. Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Florian Christ
- Institute of Geography, University of Bern, Hallerstrasse 12, 3012 Bern, Switzerland
| | | | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Italy
| | - Igor Pasković
- Department of Agriculture and Nutrition, Institute of Agriculture and Tourism, K. Huguesa 8, 52440 Poreč, Croatia
| | - Marija Polić Pasković
- Department of Agriculture and Nutrition, Institute of Agriculture and Tourism, K. Huguesa 8, 52440 Poreč, Croatia
| | - Matjaž Glavan
- Agronomy Department, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia
| | - Jakub Hofman
- RECETOX, Faculty of Science, Masaryk University, Brno, The Czech Republic
| | | | - Trine Norgaard
- Department of Agroecology, Aarhus University, Blichers Allé 20, 8830 Tjele, Denmark
| | - Zuzana Bílková
- RECETOX, Faculty of Science, Masaryk University, Brno, The Czech Republic
| | - Rima Osman
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Chrow Khurshid
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Irene Navarro
- Unit of POPs and Emerging Pollutants in Environment, Department of Environment, CIEMAT, Madrid, Spain
| | - Adrián de la Torre
- Unit of POPs and Emerging Pollutants in Environment, Department of Environment, CIEMAT, Madrid, Spain
| | - Paloma Sanz
- Unit of POPs and Emerging Pollutants in Environment, Department of Environment, CIEMAT, Madrid, Spain
| | - María Ángeles Martínez
- Unit of POPs and Emerging Pollutants in Environment, Department of Environment, CIEMAT, Madrid, Spain
| | - Jonatan Dias
- Wageningen Food Safety Research (WFSR), part of Wageningen University & Research, Wageningen, The Netherlands
| | - Hans Mol
- Wageningen Food Safety Research (WFSR), part of Wageningen University & Research, Wageningen, The Netherlands
| | - Gerrit Gort
- Biometris, Wageningen University, The Netherlands
| | | | - Paul T J Scheepers
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, the Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Anne Vested
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Abdallah Alaoui
- Institute of Geography, University of Bern, Hallerstrasse 12, 3012 Bern, Switzerland
| | - Violette Geissen
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
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Wastler HM, Cowan HR, Hamilton SA, Lundin NB, Manges M, Moe AM, Breitborde NJK. Variability in suicidal ideation during treatment for individuals at clinical high risk for psychosis: The importance of repeated assessment. Early Interv Psychiatry 2023; 17:1038-1041. [PMID: 37021533 DOI: 10.1111/eip.13413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/01/2023] [Accepted: 03/28/2023] [Indexed: 04/07/2023]
Abstract
AIM Suicide risk is elevated among individuals at clinical high risk for psychosis (CHR-P). The current study examined variability in suicidal ideation during treatment for individuals at CHR-P. METHODS A retrospective chart review was used to examine the course of suicidal ideation during 16 sessions of individual psychotherapy for 25 individuals at CHR-P. RESULTS Suicidal ideation was reported by 24% of participants at session 1 and 16% at session 16, with minimal within-subject change in the presence of suicidal ideation across the two time points. However, a more fine-grained investigation at each session indicated that 60% of individuals at CHR-P experienced suicidal ideation at least once during treatment. Additionally, there was great variability in suicidal ideation both within and between participants over the course of the 16 sessions. CONCLUSIONS These findings highlight the importance of repeated assessment when examining suicidal ideation as a treatment outcome for individuals at CHR-P.
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Affiliation(s)
- Heather M Wastler
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Henry R Cowan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Sarah A Hamilton
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Nancy B Lundin
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Margaret Manges
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Aubrey M Moe
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Nicholas J K Breitborde
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
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Li G, Duan S, Zhu T, Ren Z, Xia H, Wang Z, Liu L, Liu Z. Efficacy and safety of intranasal agents for the acute treatment of migraine: a systematic review and network meta-analysis. J Headache Pain 2023; 24:129. [PMID: 37723470 PMCID: PMC10506288 DOI: 10.1186/s10194-023-01662-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/28/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Intranasal agents may be ideal for the treatment of migraine patients. Many new acute intranasal-specific therapies have been developed, but few of them have been directly compared. The aim of this network meta-analysis (NMA) was to compare the efficacy and safety of various intranasal agents for the treatment of acute migraine in adult patients. METHODS The Cochrane Register of Controlled Trials, Embase, and PubMed were searched from inception to 15 August 2023. Randomized controlled trials (RCTs) using intranasal agents (no restrictions on dose, formulation, dosing regimen or timing of the first dose) to treat adult patients with acute migraine were included. The primary efficacy endpoint was pain freedom at 2 h, and the primary safety endpoint was adverse events (AEs). The analysis process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Nineteen studies (21 RCTs, 9738 participants) were included. Compared to the placebo, 5 mg of zolmitriptan using a conventional liquid nasal spray device was the most effective for pain freedom at 2 h [odds ratio (OR): 4.67, 95% confidence interval (CI): 3.43 to 6.43] and 24 h (OR: 5.49, 95% CI: 3.58 to 8.42) among all the interventions. Butorphanol nasal spray 1 mg was the most effective (OR: 8.62, 95% CI: 1.11 to 66.92) for pain freedom at 1 h, but with low-quality evidence. DFN-02 presented the highest freedom from nausea (OR: 4.95, 95% CI: 1.29 to 19.01) and phonophobia (OR: 5.36, 95% CI: 1.67 to 17.22) at 2 h, albeit with lower odds of achieving complete pain freedom. ROX-828 showed the highest improvement in freedom from photophobia at 2 h (OR: 4.03, 95% CI: 1.66 to 9.81). Dihydroergotamine nasal spray was significantly associated with the highest risk of AEs (OR: 9.65, 95% CI: 4.39 to 21.22) and was not recommended for routine use. Zavegepant nasal spray demonstrated the lowest risk of AEs (OR: 2.04, 95% CI: 1.37 to 3.03). The results of sensitivity analyses for the primary endpoints (pain freedom at 2 h and AEs) were generally consistent with those of the base case model. CONCLUSIONS Compared with other new intranasal-specific therapies in treating migraine attacks, zolmitriptan nasal spray 5 mg was the most effective agent for pain freedom at 2 h. Zavegepant nasal spray 10 mg had the fewest adverse side effects.
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Affiliation(s)
- Guanglu Li
- Graduate School of Beijing, University of Chinese Medicine, Beijing, China
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Shaojie Duan
- Department of Geriatrics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China
| | - Tiantian Zhu
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhiying Ren
- Graduate School of Beijing, University of Chinese Medicine, Beijing, China
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Hui Xia
- Graduate School of Beijing, University of Chinese Medicine, Beijing, China
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Ziyao Wang
- Graduate School of Beijing, University of Chinese Medicine, Beijing, China
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Lei Liu
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China.
| | - Zunjing Liu
- Department of Neurology, Peking University People's Hospital, Beijing, China.
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Mubarik S, Malik SS, Yanran Z, Hak E, Nawsherwan, Wang F, Yu C. Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus. BMC Med 2023; 21:299. [PMID: 37653535 PMCID: PMC10472654 DOI: 10.1186/s12916-023-03004-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/25/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Numerous studies over the past four decades have revealed that breast cancer screening (BCS) significantly reduces breast cancer (BC) mortality. However, in BRICS-plus countries, the association between BCS and BC case fatality and disability are unknown. This study examines the association of different BCS approaches with age-standardized mortality, case-fatality, and disability-adjusted life years (DALYs) rates, as well as with other biological and sociodemographic risk variables, across BRICS-plus from a national and economic perspective. METHODS In this ecological study applying mixed-effect multilevel regression models, a country-specific dataset was analyzed by combining data from the Global Burden of Disease study 2019 on female age-standardized BC mortality, incidence, and DALYs rates with information on national/regional BCS availability (against no such program or only a pilot program) and BCS type (only self-breast examination (SBE) and/or clinical breast examination (CBE) [SBE/CBE] versus SBE/CBE with mammographic screening availability [MM and/or SBE/CBE] versus SBE/CBE/mammographic with digital mammography and/or ultrasound (US) [DMM/US and/or previous tests] in BRICS-plus countries. RESULTS Compared to self/clinical breast examinations (SBE/CBE) across BRICS-plus, more complex BCS program availability was the most significant predictor of decreased mortality [MM and/or SBE/CBE: - 2.64, p < 0.001; DMM/US and/or previous tests: - 1.40, p < 0.001]. In the BRICS-plus, CVD presence, high BMI, second-hand smoke, and active smoking all contributed to an increase in BC mortality and DALY rate. High-income and middle-income regions in BRICS-plus had significantly lower age-standardized BC mortality, case-fatality, and DALYs rates than low-income regions when nationwide BC screening programs were implemented. CONCLUSIONS The availability of mammography (digital or traditional) and BCS is associated with breast cancer burden in BRICS-plus countries, with regional variations. In light of high-quality evidence from previous causal studies, these findings further support the preventive role of mammography screening for BCS at the national level. Intervening on BCS related risk factors may further reduce the disease burden associated with BC.
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Affiliation(s)
- Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185 Donghu Road, Wuhan, 430071, Hubei, China
- PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Saima Shakil Malik
- Center for Biotechnology & Genomic Medicine (CBGM) Medical College of Georgia Augusta University, 1462 Laney Walker Blvd, Augusta, GA, 30912-4810, USA
| | - Zhang Yanran
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185 Donghu Road, Wuhan, 430071, Hubei, China
- Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Research Center for Infectious Diseases; Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences; Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, Hubei, China
| | - Eelko Hak
- PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Nawsherwan
- Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361000, China
| | - Fang Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185 Donghu Road, Wuhan, 430071, Hubei, China.
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Wastler HM, Llamocca E, Moe AM, Steelsmith DL, Brock G, Bridge JA, Campo JV, Fontanella CA. Impact of Treatment Initiation and Engagement on Deliberate Self-Harm Among Individuals With First-Episode Psychosis. Psychiatr Serv 2023; 74:921-928. [PMID: 36852553 DOI: 10.1176/appi.ps.20220372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVE Individuals with psychosis are at increased risk for suicide, with the greatest risk being present during the first few months after diagnosis. The authors aimed to examine whether treatment initiation within 14 days of diagnosis and treatment engagement within 90 days of initiation reduce the risk for deliberate self-harm (DSH) among individuals with first-episode psychosis (FEP). METHODS A retrospective longitudinal cohort design was adopted by using Ohio Medicaid claims for 6,349 adolescents and young adults ages 15-24 years with FEP. Logistic regression was used to examine factors associated with treatment initiation and engagement. Cox proportional hazard models were used to estimate the impact of treatment initiation and engagement on DSH. Propensity score weighting was used to control for sociodemographic and clinical covariates. RESULTS Approximately 70% of the sample initiated treatment, 55% of whom engaged in treatment. Treatment initiation and engagement were associated with both demographic and clinical variables. Treatment initiation significantly reduced the hazard of DSH (average treatment effect in the entire population: hazard ratio [HR]=0.62, 95% CI=0.47-0.81; average treatment effect among those treated: HR=0.64, 95% CI=0.52-0.80). In contrast, treatment engagement was not significantly associated with DSH. CONCLUSIONS These results suggest that the initial treatment contact is essential for reducing DSH among adolescents and young adults with FEP. Additionally, the finding that treatment engagement did not reduce DSH suggests that standard clinical care may not be sufficient for reducing DSH in this population. These findings highlight the need for suicide-specific interventions for individuals with FEP.
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Affiliation(s)
- Heather M Wastler
- Departments of Psychiatry and Behavioral Health (Wastler, Llamocca, Moe, Fontanella), Psychology (Moe), Biomedical Informatics (Brock), and Pediatrics (Bridge), Ohio State University, Columbus; Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Llamocca); Center for Suicide Prevention and Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio (Steelsmith, Bridge, Fontanella); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Campo)
| | - Elyse Llamocca
- Departments of Psychiatry and Behavioral Health (Wastler, Llamocca, Moe, Fontanella), Psychology (Moe), Biomedical Informatics (Brock), and Pediatrics (Bridge), Ohio State University, Columbus; Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Llamocca); Center for Suicide Prevention and Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio (Steelsmith, Bridge, Fontanella); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Campo)
| | - Aubrey M Moe
- Departments of Psychiatry and Behavioral Health (Wastler, Llamocca, Moe, Fontanella), Psychology (Moe), Biomedical Informatics (Brock), and Pediatrics (Bridge), Ohio State University, Columbus; Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Llamocca); Center for Suicide Prevention and Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio (Steelsmith, Bridge, Fontanella); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Campo)
| | - Danielle L Steelsmith
- Departments of Psychiatry and Behavioral Health (Wastler, Llamocca, Moe, Fontanella), Psychology (Moe), Biomedical Informatics (Brock), and Pediatrics (Bridge), Ohio State University, Columbus; Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Llamocca); Center for Suicide Prevention and Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio (Steelsmith, Bridge, Fontanella); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Campo)
| | - Guy Brock
- Departments of Psychiatry and Behavioral Health (Wastler, Llamocca, Moe, Fontanella), Psychology (Moe), Biomedical Informatics (Brock), and Pediatrics (Bridge), Ohio State University, Columbus; Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Llamocca); Center for Suicide Prevention and Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio (Steelsmith, Bridge, Fontanella); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Campo)
| | - Jeffrey A Bridge
- Departments of Psychiatry and Behavioral Health (Wastler, Llamocca, Moe, Fontanella), Psychology (Moe), Biomedical Informatics (Brock), and Pediatrics (Bridge), Ohio State University, Columbus; Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Llamocca); Center for Suicide Prevention and Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio (Steelsmith, Bridge, Fontanella); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Campo)
| | - John V Campo
- Departments of Psychiatry and Behavioral Health (Wastler, Llamocca, Moe, Fontanella), Psychology (Moe), Biomedical Informatics (Brock), and Pediatrics (Bridge), Ohio State University, Columbus; Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Llamocca); Center for Suicide Prevention and Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio (Steelsmith, Bridge, Fontanella); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Campo)
| | - Cynthia A Fontanella
- Departments of Psychiatry and Behavioral Health (Wastler, Llamocca, Moe, Fontanella), Psychology (Moe), Biomedical Informatics (Brock), and Pediatrics (Bridge), Ohio State University, Columbus; Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Llamocca); Center for Suicide Prevention and Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio (Steelsmith, Bridge, Fontanella); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Campo)
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Huang S, Lin X, Yin P, Yin Y, Zhou M, Qi J, Yu C, Chen T, Zhong W. Assessment of disability weights at the provincial and city levels based on 93,254 respondents in Fujian, China: Findings from the Fujian disability weight measurement study. Chin Med J (Engl) 2023:00029330-990000000-00765. [PMID: 37612264 DOI: 10.1097/cm9.0000000000002812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Indexed: 08/25/2023] Open
Affiliation(s)
- Shaofen Huang
- Institute for Endemic and Chronic and Non-communicable Diseases, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian350012, China
| | - Xiuquan Lin
- Department of Epidemiology and Health Statistics, The School of Public Health, Fujian Medical University, Fuzhou, Fujian350122, China
| | - Peng Yin
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing100050, China
| | - Yanrong Yin
- Institute for Endemic and Chronic and Non-communicable Diseases, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian350012, China
| | - Maigeng Zhou
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing100050, China
| | - Jinlei Qi
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing100050, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, Hubei430071, China
| | - Tiehui Chen
- Institute for Endemic and Chronic and Non-communicable Diseases, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian350012, China
| | - Wenling Zhong
- Institute for Endemic and Chronic and Non-communicable Diseases, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian350012, China
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Huang Z, Kijko G, Scanlon K, Lloyd S, Henderson A, Fantke P, Jolliet O, Li S. System Approach for Characterizing and Evaluating Factors for Occupational Health Impacts Due to Nonfatal Injuries and Illnesses for the Use in Life Cycle Assessment. Environ Sci Technol 2023; 57:11738-11749. [PMID: 37490771 PMCID: PMC10433530 DOI: 10.1021/acs.est.3c00188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
Occupational injuries and illnesses are major risk factors for human health impacts worldwide, but they have not been consistently nor comprehensively considered in life cycle impact assessment (LCIA) methods. In this study, we quantified occupational health impacts as disability-adjusted life years (DALYs) for nonfatal injuries and illnesses in all US industries. We further applied an economic input-output model of the US economy to develop a new data set of characterization factors (CFs) that links direct and indirect occupational health impacts to product life cycle final demand. We found that the CF data set varies significantly by industry, ranging from 6.1 to 298 DALYs per billion dollars. About 20% of final demand in the US economic system contributes nearly 50% of the total impacts of occupational health, suggesting occupational health impacts are concentrated in a small portion of industries. To verify the feasibility of the CFs and demonstrate their importance, we included a case of an office chair. The occupational health impacts caused by nonfatal injuries and illnesses during the production of an office chair are of the same order of magnitude as those caused by chemical emissions across the chair's life cycle, with 1.1 × 10-5 and 1.4 × 10-5 DALYs per chair, respectively. Results and data sets derived from this study support the integration of occupational health impacts with LCIA methods.
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Affiliation(s)
- Zhehan Huang
- College
of the Environment and Ecology, Xiamen University, Xiamen, Fujian 361102, China
| | - Gaël Kijko
- École
Polytechnique de Montréal, Montreal, Quebec H3C 3A7, Canada
| | - Kelly Scanlon
- Independent
Researcher, Washington, District of Columbia 20008, United States
| | - Shannon Lloyd
- John
Molson School of Business, Concordia University, Montréal, Quebec H3G 2J1, Canada
| | - Andrew Henderson
- School
of Public Health, University of Texas Health
Science Center, Austin, Texas 77030, United States
- Eastern
Research Group, Concord, Massachusetts 01742, United States
| | - Peter Fantke
- Quantitative
Sustainability Assessment, Department of Environmental and Resource
Engineering, Technical University of Denmark, Kongens Lyngby 2800, Denmark
| | - Olivier Jolliet
- Quantitative
Sustainability Assessment, Department of Environmental and Resource
Engineering, Technical University of Denmark, Kongens Lyngby 2800, Denmark
- Department
of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Shaobin Li
- College
of the Environment and Ecology, Xiamen University, Xiamen, Fujian 361102, China
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Qiu P, He H, Zhao Y, Yang Z, Li S, Ni P, Guo Y, Ji C, Zhang C, Zhang H, Zhou C, Wang B. Global disease burden attributed to unsafe sex in 204 countries and territories from 1990 to 2019: results from the Global Burden of Disease Study 2019. Sci Rep 2023; 13:12900. [PMID: 37558737 PMCID: PMC10412620 DOI: 10.1038/s41598-023-40001-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023] Open
Abstract
Unsafe sex has become a public safety problem that endangers society, and research on deaths and disability-adjusted life years (DALYs) related to unsafe sex is valuable for global policy-making. We aimed to estimate the deaths and DALYs attributable to unsafe sex by country, gender, age group, and sociodemographic status from 1990 to 2019. We extracted data on disease burden from the Global Disease Burden 2019 (GBD 2019) database for unsafe sex, including deaths, DALYs and age-standardized rates (ASRs). Comparative analyses were performed on data about deaths, DALYs and the responding ASRs attributable to unsafe sex in different countries and regions using the Social Demographic Index (SDI). The global age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) attributable to unsafe sex were 11.98 (95% uncertainty intervals (UI): 10.97-13.52) per 100,000 people and 570.78 (95% UI: 510.24-658.10) per 100,000 people, respectively. Both the ASMRs and ASDRs were the highest in southern sub-Saharan Africa and lowest in Australasia and decreased with increasing SDI levels. About unsafe-sex-related disease, HIV/AIDS has the highest ASMR [8.48 (95% UI: 7.62-9.95)/100,000 people] and ASDR [447.44 (95% UI: 394.82-533.10)/100,000 people], followed by Cervical cancer [ASMR: 3.40 (95% UI: 2.90-3.81)/100,000 people and ASDR: 107.2 (95% UI: 90.52-119.43)/100,000 people] and sexually transmitted infections excluding HIV [ASMR: 0.10 (95% UI: 0.08-0.11)/100,000 people and ASDR: 16.14 (95% UI: 10.51-25.83)/100,000 people]. The death and DALY burden caused by these three diseases were more serious in the over 75 years old age group. The 40-44 age group for men and the 35-39 age group for women had the highest population of unsafe sex-related deaths and DALYs, respectively. In addition, the burden of unsafe sex in women was more serious than those in men. Unsafe sex is an important risk factor for global disease burden and a leading cause of substantial health loss. We found that the risk of ASMRs and ASDRs attributable to unsafe sex had negative correlation with SDI levels. These results demonstrate that the need for revised policies that focus on efforts to reduce overall unsafe sex worldwide.
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Affiliation(s)
- Pei Qiu
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yuting Zhao
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zejian Yang
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shouyu Li
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Peng Ni
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yujie Guo
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chao Ji
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chenchen Zhang
- Department of Clinical Laboratory, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China
| | - Huimin Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
| | - Can Zhou
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China.
| | - Bo Wang
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China.
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province, Xi'an, China.
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Lei S, Zheng R, Zhang S, Huang Y, Qiao L, Song B, He Y, Du L, Wang N, Xi Y, Liu Y, Zhou J, Zhang M, Zheng Y, Zhang Y, Ju W, Wei W. Years lived with disability of cancer in China: findings from disability weights measurement with a focus on the effect of disease burden. Sci Bull (Beijing) 2023; 68:1430-1438. [PMID: 37349162 DOI: 10.1016/j.scib.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/25/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023]
Abstract
Disability weights are crucial for quantifying health loss associated with non-fatal outcomes and were not well assessed in different countries, especially for specific cancer. Therefore, this study aimed to identify disability weights with a focus on specific cancer in a large Chinese population. Two types of web surveys were conducted, and 254 health states, including 30 new states for specific cancer, were investigated using paired comparison methods. The years lived with disability (YLDs) of cancer were calculated as the sum of the prevalence of each sequela of cancer multiplied by its relative disability weight. In total, 44,069 participants were eligible for the disability weights study. The disability weights of 254 health states were estimated. Among those, the disability weights of 18 specific cancer types varied greatly at diagnosis and primary treatment stage, with the value ranging from 0.619 (95% uncertainty interval (UI) 0.606-0.632) for brain cancer to 0.167 (95% UI 0.158-0.176) for oropharyngeal cancer. The discrepancy in YLDs calculated by different disability weights was high, and the largest gap for all cancer combined was approximately 30.14%. When calculated using the cancer-specific disability weights, a total of 1,967,830 (95% UI 1,928,880-2,008,060) YLDs of cancer were recorded in China. The disability weights of cancer varied greatly among cancer types and populations, which had considerable influence on the estimation of the disease burden. Cancer-specific disability weights could provide a more accurate evaluation of the cancer burden.
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Affiliation(s)
- Shaoyuan Lei
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; Department of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Rongshou Zheng
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Shaokai Zhang
- Department of Cancer Epidemiology and Prevention, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China
| | - Yunchao Huang
- Yunnan Cancer Center/Yunnan Cancer Hospital, Kunming 650118, China
| | - Liang Qiao
- Department of Cancer Prevention and Control, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610042, China
| | - Bingbing Song
- Institute of Cancer Prevention and Treatment, Harbin Medical University/Institute of Cancer Prevention and Treatment, Heilongjiang Academy of Medical Sciences, Heilongjiang Cancer Centre, Harbin 150081, China
| | - Yutong He
- Department of Cancer Prevention and Control, Hebei Medical University Fourth Hospital, Shijiazhuang 050000, China
| | - Lingbin Du
- Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Hangzhou 310005, China
| | - Ning Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Yunfeng Xi
- The Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention, Hohhot 750306, China
| | - Yuqin Liu
- Cancer Epidemiology Research Center, Gansu Cancer Hospital, Lanzhou 730050, China
| | - Jinyi Zhou
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Min Zhang
- Office of Cancer Prevention and Treatment, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, China
| | - Ying Zheng
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yongzhen Zhang
- Department of Epidemiology, Shanxi Cancer Hospital, Taiyuan 030013, China
| | - Wen Ju
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wenqiang Wei
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
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Li Y, Luo R, Wang D, Zhang X. Association between Empathy and Clinical Symptoms among Overweight and Non-Overweight Chinese Chronic Schizophrenia Patients. Brain Sci 2023; 13:1075. [PMID: 37509007 PMCID: PMC10377734 DOI: 10.3390/brainsci13071075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Patients with schizophrenia are afflicted by severe clinical symptoms and serious cognitive dysfunction. The aim of this study is to investigate the potential relationships between clinical symptoms and empathy and their variations between overweight and non-overweight schizophrenia patients. To address this problem, a group of 776 inpatients diagnosed with chronic schizophrenia (504 overweight patients and 272 non-overweight patients) was recruited. The Positive and Negative Syndrome Scale (PANSS) and its five-factor model were employed to assess clinical symptoms, while empathy levels were measured using the Interpersonal Reactivity Index (IRI). The overweight patients had lower education levels but higher positive symptoms than the non-overweight patients (all p < 0.05). In addition, the overweight patients performed significantly better with respect to empathy (FDR-corrected p < 0.05). Additional multiple regression analyses indicated significant associations between the total score of the IRI and PANSS negative symptoms, gender, and family history of psychiatric disorders among the overweight group; among non-overweight patients, there was a significant correlation between suicide and the total score of the IRI. This study provides evidence suggesting that chronic schizophrenia patients who are overweight may have distinct clinical characteristics, particularly with respect to their empathy, compared with non-overweight patients. Moreover, different variables are associated with empathy in different groups.
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Affiliation(s)
- Yuchen Li
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
| | - Ruichenxi Luo
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
| | - Dongmei Wang
- Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Xiangyang Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
- Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China
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40
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Fan L, Wu Y, Wei J, Xia F, Cai Y, Zhang S, Miao J, Zhou Y, Liu C, Yan W, Liu D, Chen L, Wang T. Global, regional, and national time trends in incidence for migraine, from 1990 to 2019: an age-period-cohort analysis for the GBD 2019. J Headache Pain 2023; 24:79. [PMID: 37391721 DOI: 10.1186/s10194-023-01619-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/21/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND The majority of epidemiological studies on migraine have been conducted in a specific country or region, and there is a lack of globally comparable data. We aim to report the latest information on global migraine incidence overview trends from 1990 to 2019. METHODS In this study, the available data were obtained from the Global Burden of Disease 2019. We present temporal trends in migraine for the world and its 204 countries and territories over the past 30 years. Meanwhile, an age-period-cohort model be used to estimate net drifts (overall annual percentage change), local drifts (annual percentage change in each age group), longitudinal age curves (expected longitudinal age-specific rate), and period (cohort) relative risks. RESULTS In 2019, the global incidence of migraine increased to 87.6 million (95% UI: 76.6, 98.7), with an increase of 40.1% compared to 1990. India, China, United States of America, and Indonesia had the highest number of incidences, accounting for 43.6% of incidences globally. Females experienced a higher incidence than males, the highest incidence rate was observed in the 10-14 age group. However, there was a gradual transition in the age distribution of incidence from teenagers to middle-aged populations. The net drift of incidence rate ranged from 3.45% (95% CI: 2.38, 4.54) in high-middle Socio-demographic Index (SDI) regions to -4.02% (95% CI: -4.79, -3.18) in low SDI regions, 9 of 204 countries showed increasing trends (net drifts and its 95% CI were > 0) in incidence rate. The age-period-cohort analysis results showed that the relative risk of incidence rate generally showed unfavorable trends over time and in successively birth cohorts among high-, high-middle-, and middle SDI regions, but low-middle- and low-SDI regions keep stable. CONCLUSIONS Migraine is still an important contributor to the global burden of neurological disorders worldwide. Temporal trends in migraine incidence are not commensurate with socioeconomic development and vary widely across countries. Both sexes and all age groups should get healthcare to address the growing migraine population, especially adolescents and females.
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Affiliation(s)
- Luying Fan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Yuhang Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Jiehua Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Fan Xia
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Yufeng Cai
- Department of Biomedical Informatics, School of Life Sciences, Central South University, Changsha, China
| | - Senmao Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Junxiang Miao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Yunzhe Zhou
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Chu Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Wei Yan
- Jiangxi Center for Disease Control and Prevention Institute of Chronic Non-Communicable Diseases, Nanchang, China
| | - Dan Liu
- Prehospital Emergency Department of Xiangtan Central Hospital, Xiangtan, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China.
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, Hunan, 410078, China.
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China.
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China.
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41
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Johnsen DC, Marchini L, Ettinger RL. How can dental research deliver better outcomes to frail older adults? Essay on considerations. Spec Care Dentist 2023; 43:375-379. [PMID: 36715103 DOI: 10.1111/scd.12802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 01/31/2023]
Affiliation(s)
- David C Johnsen
- Department of Pediatric Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Leonardo Marchini
- Department of Comprehensive Care, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
| | - Ronald L Ettinger
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
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42
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Neppelenbroek NJM, de Wit GA, Dalziel K, Devlin N, Carvalho NI. Use of Utility and Disability Weights in Economic Evaluation of Pediatric Vaccines. Value Health 2023; 26:1098-1106. [PMID: 36967026 DOI: 10.1016/j.jval.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 02/21/2023] [Accepted: 04/18/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To describe how utility weights and disability weights have been used in the context of quality-adjusted life-years (QALYs) and disability-adjusted life-years (DALYs)-based cost-effectiveness analysis (CEA) of pediatric vaccines for infectious diseases and assess the comparability between weights. METHODS A systematic review was conducted of CEAs of pediatric vaccines for 16 infectious diseases, published between January 2013 and December 2020 and using QALYs or DALYs as outcome measure. Data on values and sources of weights for the estimation of QALYs and DALYs were extracted from studies and compared across similar health states. Reporting was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULTS Out of 2154 articles identified, 216 CEAs met our inclusion criteria. Of the included studies, 157 used utility weights and 59 used disability weights in their valuation of health states. In QALY studies, the source, background, who's preferences (adults'/children's) were applied and adjustments made to utility weights were poorly reported. In DALY studies, the Global Burden of Disease study was most often referenced. Valuation weights for similar health states varied within QALY studies and between DALY and QALY studies, but no systematic differences were identified. CONCLUSIONS This review identified considerable gaps in the way valuation weights are used and reported on in CEA. The nonstandardized use of weights may lead to different conclusions about cost-effectiveness of vaccines and policy decisions.
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Affiliation(s)
- Nienke J M Neppelenbroek
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia; MSc Epidemiology Student, Utrecht University, Utrecht, The Netherlands.
| | - G Ardine de Wit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands; Centre for Nutrition, Prevention, and Health services, National Institute of Public Health and the Environment, Bilthoven, The Netherlands; Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kim Dalziel
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Nancy Devlin
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Natalie I Carvalho
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
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Nguyen P, Ananthapavan J, Gao L, Dunstan DW, Moodie M. Cost-effectiveness analysis of sedentary behaviour interventions in offices to reduce sitting time in Australian desk-based workers: A modelling study. PLoS One 2023; 18:e0287710. [PMID: 37384626 PMCID: PMC10309613 DOI: 10.1371/journal.pone.0287710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 06/09/2023] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVES Sedentary behaviour (SB) is associated with increased incidence of chronic diseases such as type 2 diabetes (T2D), cardiovascular disease, cancers, and premature mortality. SB interventions in workplaces are effective in reducing sitting time. Previous economic evaluations have not specifically used changes in sitting time to estimate the long-term impact of SB on chronic disease-related health and cost outcomes. This research evaluated the cost-effectiveness of three hypothetical SB interventions: behavioural (BI), environmental (EI) and multi-component intervention (MI), implemented in the Australian context, using a newly developed epidemiological model that estimates the impact of SB as a risk factor on long-term population health and associated cost outcomes. METHOD Pathway analysis was used to identify the resource items associated with implementing each of the three interventions using a limited societal perspective (included costs: health sector, individuals and industry; excluded costs: productivity). The effectiveness of the modelled interventions in reducing daily sitting time (informed by published meta-analyses) was modelled for the Australian working population aged 20-65 years. A multi-cohort Markov model was developed to simulate the 2019 Australian population and estimate the incidence, prevalence and mortality of five diseases causally related to excessive sitting time, over the life course. Monte-Carlo simulations were used to calculate each intervention's mean incremental costs and benefits (quantified as health adjusted life years HALYs) compared to a do-nothing comparator. RESULTS When implemented at the national level, the interventions were estimated to reach 1,018 organisations with 1,619,239 employees. The estimated incremental cost of SB interventions was A$159M (BI), A$688M (EI) and A$438M (MI) over a year. Incremental health-adjusted life years (HALYs) gained by BI, EI and MI were 604, 919 and 349, respectively. The mean ICER for BI was A$251,863 per HALY gained, A$737,307 for EI and A$1,250,426 for MI. Only BI had any probability (2%) of being cost-effective at a willingness-to-pay threshold of A$50,000 per HALY gained from a societal perspective. CONCLUSION SB interventions are not cost-effective when a reduction in sitting time is the outcome measure of interest. The cost-effectiveness results are heavily driven by the cost of the sit-stand desks and the small HALYs gained from reducing sitting time. Future research should focus on capturing non-health-benefits of these interventions, such as productivity, work satisfaction, and other health benefits: metabolic, physical, and musculoskeletal outcomes. Importantly, the health benefits of simultaneously reducing sitting time and increasing standing time for such interventions should be captured with the joint effects of these risk factors appropriately considered.
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Affiliation(s)
- Phuong Nguyen
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Jaithri Ananthapavan
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Lan Gao
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - David W. Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Vitoria, Australia
| | - Marj Moodie
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Australia
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Messina A, Cuccì G, Crescimanno C, Signorelli MS. Clinical anatomy of the precuneus and pathogenesis of the schizophrenia. Anat Sci Int 2023:10.1007/s12565-023-00730-w. [PMID: 37340095 DOI: 10.1007/s12565-023-00730-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/12/2023] [Indexed: 06/22/2023]
Abstract
Recent evidence has shown that the precuneus plays a role in the pathogenesis of schizophrenia. The precuneus is a structure of the parietal lobe's medial and posterior cortex, representing a central hub involved in multimodal integration processes. Although neglected for several years, the precuneus is highly complex and crucial for multimodal integration. It has extensive connections with different cerebral areas and is an interface between external stimuli and internal representations. In human evolution, the precuneus has increased in size and complexity, allowing the development of higher cognitive functions, such as visual-spatial ability, mental imagery, episodic memory, and other tasks involved in emotional processing and mentalization. This paper reviews the functions of the precuneus and discusses them concerning the psychopathological aspects of schizophrenia. The different neuronal circuits, such as the default mode network (DMN), in which the precuneus is involved and its alterations in the structure (grey matter) and the disconnection of pathways (white matter) are described.
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Affiliation(s)
- Antonino Messina
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy.
| | | | | | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
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Darker CD, Nicolson G, Reddon H, O'Connor K, Jennings R, O'Connell N. Barriers and facilitators to the implementation of an early intervention in psychosis service in three demonstration sites in Ireland. BMC Health Serv Res 2023; 23:653. [PMID: 37337176 DOI: 10.1186/s12913-023-09585-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/20/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Programmes for early intervention (EIP) in psychosis for people experiencing a first episode of psychosis (FEP) have been found to be both clinically and cost effective. Following the publication of a new EIP model of care (MoC) in Ireland, the aim of this research is to describe how people participated in and responded to the MoC including service users, family members, HSE clinical staff and HSE management. METHODS Qualitative design using the UK Medical Research Council's process evaluation framework. Purposive sampling techniques were used. A total of N = 40 key informant semi-structured interviews were completed which included clinical staff (N = 22), health service managers and administrators (N = 9), service users (N = 8) and a family member (N = 1). Thematic analyses were conducted. RESULTS Unique features of the EIP service (e.g., speed of referral/assessment, multidisciplinary approach, a range of evidence-based interventions and assertive MDT follow up) and enthusiasm for EIP were identified as two key factors that facilitated implementation. In contrast, obstacles to staff recruitment and budget challenges emerged as two primary barriers to implementation. CONCLUSIONS The findings from this research provide real world insights into the complexity of implementing an innovative service within an existing health system. Clear and committed financial and human resource processes which allow new innovations to thrive and be protected during their initiation and early implementation phase are paramount. These elements should be considered in the planning and implementation of EIP services both nationally in Ireland and internationally.
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Affiliation(s)
- C D Darker
- Discipline of Public Health and Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - G Nicolson
- Health Promotion and Improvement Department, HSE Health and Wellbeing, 1st Floor Old National Ambulance Training Building, St Marys Hospital Campus, Phoenix Park, Dublin 20, Chapelizod, D20 TY72, Ireland
| | - H Reddon
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - K O'Connor
- National Clinical Programme for Early Intervention in Psychosis, Health Service Executive Dublin, Dublin, Ireland
- Rise, South Lee Mental Health Services, Cork & Department of Psychiatry, University College Cork, Cork, Ireland
| | - R Jennings
- National Clinical Programme for Early Intervention in Psychosis, Health Service Executive Dublin, Dublin, Ireland
| | - N O'Connell
- Sexual Health and Crisis Pregnancy Programme, HSE Health and Wellbeing, Strategy and Research, 89-94 Capel St, Dublin 1, Dublin, D01 P281, Ireland
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Johnsen DC. A paradox for the essential activity of interprofessional practice: Sectors designed by professions and not patients-how do we retrofit the system for patient health? J Am Dent Assoc 2023:S0002-8177(23)00257-X. [PMID: 37204375 DOI: 10.1016/j.adaj.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/20/2023]
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Catalán JM, Trigili E, Nann M, Blanco-Ivorra A, Lauretti C, Cordella F, Ivorra E, Armstrong E, Crea S, Alcañiz M, Zollo L, Soekadar SR, Vitiello N, García-Aracil N. Hybrid brain/neural interface and autonomous vision-guided whole-arm exoskeleton control to perform activities of daily living (ADLs). J Neuroeng Rehabil 2023; 20:61. [PMID: 37149621 PMCID: PMC10164333 DOI: 10.1186/s12984-023-01185-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 04/26/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND The aging of the population and the progressive increase of life expectancy in developed countries is leading to a high incidence of age-related cerebrovascular diseases, which affect people's motor and cognitive capabilities and might result in the loss of arm and hand functions. Such conditions have a detrimental impact on people's quality of life. Assistive robots have been developed to help people with motor or cognitive disabilities to perform activities of daily living (ADLs) independently. Most of the robotic systems for assisting on ADLs proposed in the state of the art are mainly external manipulators and exoskeletal devices. The main objective of this study is to compare the performance of an hybrid EEG/EOG interface to perform ADLs when the user is controlling an exoskeleton rather than using an external manipulator. METHODS Ten impaired participants (5 males and 5 females, mean age 52 ± 16 years) were instructed to use both systems to perform a drinking task and a pouring task comprising multiple subtasks. For each device, two modes of operation were studied: synchronous mode (the user received a visual cue indicating the sub-tasks to be performed at each time) and asynchronous mode (the user started and finished each of the sub-tasks independently). Fluent control was assumed when the time for successful initializations ranged below 3 s and a reliable control in case it remained below 5 s. NASA-TLX questionnaire was used to evaluate the task workload. For the trials involving the use of the exoskeleton, a custom Likert-Scale questionnaire was used to evaluate the user's experience in terms of perceived comfort, safety, and reliability. RESULTS All participants were able to control both systems fluently and reliably. However, results suggest better performances of the exoskeleton over the external manipulator (75% successful initializations remain below 3 s in case of the exoskeleton and bellow 5s in case of the external manipulator). CONCLUSIONS Although the results of our study in terms of fluency and reliability of EEG control suggest better performances of the exoskeleton over the external manipulator, such results cannot be considered conclusive, due to the heterogeneity of the population under test and the relatively limited number of participants.
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Affiliation(s)
- José M Catalán
- Robotics and Artificial Intelligence Group of the Bioengineering Institute, Miguel Hernandez University, 03202, Elche, Spain.
| | - Emilio Trigili
- BioRobotics Institute, Scuola Superiore Sant'Anna, 56025, Pontedera, Italy.
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy.
| | - Marius Nann
- Clinical Neurotechnology Laboratory, Charité, Universitätsmedizin Berlin, 10117, Belin, Germany
| | - Andrea Blanco-Ivorra
- Robotics and Artificial Intelligence Group of the Bioengineering Institute, Miguel Hernandez University, 03202, Elche, Spain
| | - Clemente Lauretti
- Laboratory of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma, 00128, Rome, Italy
| | - Francesca Cordella
- Laboratory of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma, 00128, Rome, Italy
| | - Eugenio Ivorra
- University Institute for Human-Centered Technology Research (Human-Tech), Universitat Politècnica de València, 46022, Valencia, Spain
| | | | - Simona Crea
- BioRobotics Institute, Scuola Superiore Sant'Anna, 56025, Pontedera, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
- IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Mariano Alcañiz
- University Institute for Human-Centered Technology Research (Human-Tech), Universitat Politècnica de València, 46022, Valencia, Spain
| | - Loredana Zollo
- Laboratory of Biomedical Robotics and Biomicrosystems, Università Campus Bio-Medico di Roma, 00128, Rome, Italy
| | - Surjo R Soekadar
- Clinical Neurotechnology Laboratory, Charité, Universitätsmedizin Berlin, 10117, Belin, Germany
| | - Nicola Vitiello
- BioRobotics Institute, Scuola Superiore Sant'Anna, 56025, Pontedera, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
- IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Nicolás García-Aracil
- Robotics and Artificial Intelligence Group of the Bioengineering Institute, Miguel Hernandez University, 03202, Elche, Spain
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Liu X, Guo Y, Wang F, Yu Y, Yan Y, Wen H, Shi F, Wang Y, Wang X, Shen H, Li S, Gong Y, Ke S, Zhang W, Jin Q, Zhang G, Wu Y, Zhou M, Yu C. Disability weight measurement for the severity of different diseases in Wuhan, China. Popul Health Metr 2023; 21:5. [PMID: 37143047 PMCID: PMC10157574 DOI: 10.1186/s12963-023-00304-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/16/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Measurement of the Chinese burden of disease with disability-adjusted life-years (DALYs) requires disability weight (DW) that quantify health losses for all non-fatal consequences of disease and injury. The Global Burden of Disease (GBD) 2013 DW study indicates that it is limited by lack of geographic variation in DW data and by the current measurement methodology. We aim to estimate DW for a set of health states from major diseases in the Wuhan population. METHODS We conducted the DW measurement study for 206 health states through a household survey with computer-assisted face-to-face interviews and a web-based survey. Based on GBD 2013 DW study, paired comparison (PC) and Population health equivalence (PHE) method was used and different PC/PHE questions were randomly assigned to each respondent. In statistical analysis, the PC data was analyzed by probit regression. The probit regression results will be anchored by results from the PHE data analyzed by interval regression on the DW scale units between 0 (no loss of health) and 1 (loss equivalent to death). RESULTS A total of 2610 and 3140 individuals were included in the household and web-based survey, respectively. The results from the total pooled data showed health state "mild anemia" (DW = 0.005, 95% UI 0.000-0.027) or "allergic rhinitis (hay fever)" (0.005, 95% UI 0.000-0.029) had the lowest DW and "heroin and other opioid dependence, severe" had the highest DW (0.699, 95% UI 0.579-0.827). A high correlation coefficient (Pearson's r = 0.876; P < 0.001) for DWs of same health states was observed between Wuhan's survey and GBD 2013 DW survey. Health states referred to mental symptom, fatigue, and the residual category of other physical symptoms were statistically significantly associated with a lower Wuhan's DWs than the GBD's DWs. Health states with disfigurement and substance use symptom had a higher DW in Wuhan population than the GBD 2013 study. CONCLUSIONS This set of DWs could be used to calculate local diseases burden for health policy-decision in Wuhan population. The DW differences between the GBD's survey and Wuhan's survey suggest that there might be some contextual or culture factors influencing assessment on the severity of diseases.
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Affiliation(s)
- Xiaoxue Liu
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
- Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Yan Guo
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Fang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, China
| | - Yong Yu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, 442000, Hubei, China
| | - Yaqiong Yan
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Haoyu Wen
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Fang Shi
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Yafeng Wang
- Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Xuyan Wang
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Hui Shen
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Shiyang Li
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Yanyun Gong
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China
| | - Sisi Ke
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Wei Zhang
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Qiman Jin
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Gang Zhang
- Wuhan Centers for Disease Control and Prevention, Wuhan, 430024, Hubei, China
| | - Yu Wu
- Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Nanwei Road 27, Xicheng District, Beijing, 100050, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Pubic Health, Wuhan University, 115 Donghu Road, Wuchang District, Wuhan, 430071, Hubei, China.
- Global Health Institute, Wuhan University, Wuhan, 430072, Hubei, China.
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Dyląg KA, Anunziata F, Bandoli G, Chambers C. Birth Defects Associated with Prenatal Alcohol Exposure-A Review. Children (Basel) 2023; 10:children10050811. [PMID: 37238358 DOI: 10.3390/children10050811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/20/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023]
Abstract
Since the recognition of fetal alcohol syndrome, alcohol has been accepted as a human teratogen. However, little is known about the relation between prenatal alcohol exposure and the spectrum of associated major birth defects. The objective of this review was to summarize data on the association of major congenital abnormalities and prenatal alcohol exposure. We included all major birth defects according to ICD-10 classification. We found that the strongest evidence to date lies in the research examining herniation (gastroschisis and omphalocele), oral clefts (cleft lip with or without palate and cleft palate) and cardiac defects. There is less consistent evidence supporting the association between prenatal alcohol exposure and anomalies of gastrointestinal system, diaphragmatic hernia, genitourinary system and neural tube defects. We found no material support for PAE and choanal atresia, biliary atresia or clubfoot.
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Affiliation(s)
- Katarzyna Anna Dyląg
- Department of Pathophysiology, Jagiellonian University Medical College, Czysta 18, 31-121 Krakow, Poland
- St. Louis Children Hospital, ul. Strzelecka 2, 31-503 Krakow, Poland
| | - Florencia Anunziata
- Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, MC0828, La Jolla, CA 92093-0412, USA
| | - Gretchen Bandoli
- Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, MC0828, La Jolla, CA 92093-0412, USA
| | - Christina Chambers
- Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, MC0828, La Jolla, CA 92093-0412, USA
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Santomauro DF, Purcell C, Whiteford HA, Ferrari AJ, Vos T. Grading disorder severity and averted burden by access to treatment within the GBD framework: a case study with anxiety disorders. Lancet Psychiatry 2023; 10:272-281. [PMID: 36931778 PMCID: PMC10017349 DOI: 10.1016/s2215-0366(23)00037-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/08/2022] [Accepted: 01/17/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND The Global Burden of Disease Study (GBD) estimates burden by cause with major relevance for resource allocators globally. Non-fatal burden estimates are influenced by disorder severity. However, for many disorders, global severity is sourced from a single high-income country survey. We aimed to estimate severity distributions that vary by Healthcare Access Quality Index (HAQI) using anxiety disorders as a case study and present the usefulness of this method in simulating averted and avoidable burden globally. METHODS In this case study, we estimated treatment use among respondents with anxiety disorder in the 1997 Australian National Survey of Mental Health and Wellbeing (NSMHWB), the source used to estimate severity of anxiety disorders in GBD. Treatment effects were sourced from the Cochrane Database of Systematic Reviews and pooled via network meta-analysis. Severity distribution was established via a meta-regression of their disability weights, derived from 12-item short form survey scores. We simulated the shift in severity across scenarios without access to treatment and with full access to optimal treatment (cognitive behavioural therapy and antidepressants). We interpolated this shift linearly along the HAQI, extrapolated country-specific severity from HAQI scores, and calculated averted and avoidable burden. FINDINGS The database review sourced 56 reviews, of which eight were eligible for inclusion. These eight reviews reported on 156 randomised controlled trials, with 194 treatment effects. Respondents to the 1997 NSMHWB consisted of 5936 women (55·8%) and 4705 (44·2%) men aged 18 years or older (mean age and ethnicity data not available). The survey-weighted treatment effect size was -0·28 (95% uncertainty interval -0·45 to -0·12). The pooled treatment effect for full coverage optimal treatment was -1·07 (-1·47 to -0·64). The sequela-weighted disability weight among people with anxiety disorder in the NSMHWB was 0·141 (0·042 to 0·275). The estimated disability weight was 0·188 (0·070 to 0·341) after removing the benefits of treatment and 0·056 (0·013 to 0·140) after providing all people with anxiety disorder access to optimal treatment. Globally, 12·5% (4·6 to 21·5) of anxiety disorder burden was averted because of available treatment. However, 71·1% (46·2 to 87·6) of global anxiety disorder burden could be averted if all people with anxiety disorders had access to optimal treatment. INTERPRETATION Because it is based on guidance from a single survey done in one high-income country, the burden of anxiety disorders in low-income and middle-income countries is probably underestimated by GBD. Despite the availability of effective treatments, low use of these treatments means that most burden is still avoidable. Most of the burden could be averted if all people with anxiety disorders had access to optimal treatment, highlighting the importance of public promotion and referral pathways of treatment for anxiety disorders. Location-specific severity distributions in GBD would greatly increase precision in burden estimates and highlight avertable burden to clinicians, public health practitioners, and policy makers. FUNDING Queensland Health and Bill & Melinda Gates Foundation.
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Affiliation(s)
- Damian F Santomauro
- School of Public Health, University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.
| | - Caroline Purcell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Harvey A Whiteford
- School of Public Health, University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Alize J Ferrari
- School of Public Health, University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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