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Comparing disability weights between a Swedish and a Chinese context: Using the methods in Global Burden of Disease 2013 - A pilot study
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
2016 (English)Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Introduction: Disability Adjusted Life Years (DALY) in the Global Burden of Diseasestudies (GBD) are a measure to describe the worldwide distribution of disability. Disabilityweights are a major part in calculating DALY. It has been discussed whether the samedisability weights can be used in different contexts.

Aim: we aim to operationalize the methods for disability weights calculation based on theGBD 2013 study, conduct a pilot survey with Chinese and Swedish target groups, and tocheck if the disability weights are affected by the cultural contexts of China and Sweden.

Methods: We applied procedures from the GBD 2010 and 2013 studies and chose five healthstates according to a Years Lived with Disability (YLD) ranking based on data from the GBD2013 study. We conducted a web survey with university students aged 18 to 30 from bothChina and Sweden. The survey contained eight paired comparison questions and threepopulation health equivalence questions. Probit regression was used to assess the relativedifferences between each pair of health states from paired comparison questions. To locatethe disability weight on a zero to one scale, we used the results of censored regression of thedata from the population health equivalence questions.

Results: Of the 119 students that participated in the web survey, 58 were from China and 61from Sweden. The estimates of the regressions and the disability weights showed highvariance and inconsistencies. Although some differences of health state selection probabilitiesbetween the two groups could be indicators for different perceptions of disabilities, we cannotdraw clear conclusion on any cultural influences to disability weights between the two groups.

Discussion: Within the half semester time, we have figured out the statistical method andused it to calculate the disability weights based on paired question surveys. We learned howto conduct survey questionnaire among students from two countries with totally differentcultures. To reach a larger sample size requires a different approach to recruit participantsthan what we used in this study. The main issue in this pilot study proofed to be theinsufficient sample size and difficulties in anchoring the disability weights on the 0 to 1 scale.Any future studies of this kind need to reach an adequate sample size, which is determined bythe required minimum differences in disability weights to differential the two groups.

Conclusion: In this pilot study, we operationalized methods to calculate disability weights,similar to the ones used in GBD 2013 study. We conducted pilot surveys between two studentgroups in China and Sweden. The results show that in order to assess differences betweengroups, we need larger sample size than 119 to reach required precision of the disabilityweights due to its anchoring process on a 0-1 scale. Further study is needed to confirm thepossible indicator for different perceptions of disabilities found in this study. Due to thecomplexity of the statistical method, it is important to validate this method to ensure theirapplicability and accuracy in any future study. This study has fulfilled its three specificobjectives, although not the final aim of confirming the disability weights used in GBD2013study.

Place, publisher, year, edition, pages
2016. , 62 p.
Centre for Public Health Report Series, ISSN 1651-341x ; 2016:5
Keyword [en]
Public Health, Global Burden of Disease, GBD, Disability Weight, Paired Comparison, Population Health Equivalence, Web Survey, Probit, Logit, Censored Regression, Intervall Regression
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
URN: urn:nbn:se:umu:diva-124087OAI: diva2:948951
Educational program
Master's Programme in Public Health
2016-05-23, Umeå, 13:25 (English)
Available from: 2016-10-18 Created: 2016-07-14 Last updated: 2016-10-18Bibliographically approved

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