Staff Publications

Staff Publications

  • external user (warningwarning)
  • Log in as
  • language uk
  • About

    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

    We have a manual that explains all the features 

Record number 477088
Title Dynamic-HIA-2: a tool to calculate the complete counterfactual disability-adjusted life-years (DALYs) of risk factor exposure
Author(s) Boshuizen, H.C.; Gool, C.H.; Nusselder, W.J.
Source The Lancet 381 (2013)Suppl.2. - ISSN 0140-6736 - p. S21 - S21.
Department(s) Biometris (WU MAT)
Chair Nutrition and Disease
ASG Facilities & Services (WU)
Publication type Abstract in scientific journal or proceedings
Publication year 2013
Abstract Background Many risk factors, such as smoking, affect multiple diseases. Calculating a disability-adjusted life-year (DALY) for such risk factors should take comorbidity into account. We aim to provide a tool for such calculations, using a counterfactual approach. Methods We defined a DALY in the original terms as a metric “to quantify loss of healthy years of life due to dying prematurely or to living with the health consequences of diseases, injuries or risk factors”, rather than use its operational form (the sum of healthy years lost through mortality and through disease). As a DALY reflects the effect of risk factor exposure in a particular year only, we calculate this by comparing future population health in the current situation and in the situation where the risk factor is absent in the particular year but returns to the value it would have had in the current situation after 1 year. We derived disability weights for comorbidity by multiplying (1 — disability weight) of the separate diseases. We also included disability weights greater than 0 for those without risk-factor-related disease, reflecting disability from all other diseases. We incorporated the calculation in the DYNAMO-HIA-2 programme, which implements a risk factor—disease Markov model. This reduces the computational burden on the user from entering the data. Findings Our method delivers a lower DALY than the WHO burden of disease approach, as the latter assumes that the years gained by elimination of the risk factor would all have been healthy years, while our method takes into account that part of these years would have been spent with disease. Interpretation The proposed method delivers a straightforward metric in terms of interpretation, fully taking competing mortality, morbidity, and comorbidity into account. However, handling of interaction effects (that is, those spared in one year are at risk in later years) needs further discussion. Funding This research was funded by the National Institute for Public Health and the Environment (RIVM) and partly by the Netherlands Organisation for Health Research and Development. The first version of DYNAMO-HIA was partly funded by the Directorate General for Health and Consumers of the European Commission.
There are no comments yet. You can post the first one!
Post a comment
Please log in to use this service. Login as Wageningen University & Research user or guest user in upper right hand corner of this page.