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Meili, Kaspar WalterORCID iD iconorcid.org/0000-0002-9889-4406
Biografi [eng]

Health economics, outcome research, scripting language R, systematic reviews

Biografi [swe]

Hälsoekonomi, utfallsforkskning, programspråk R, systematiska översiktsarbeten

Publikationer (9 of 9) Visa alla publikationer
Meili, K. W. (2024). Capability for broader cost-effectiveness in public health and social welfare: developing, valuing, and applyingcapability-adjusted life years Sweden (CALY-SWE). (Doctoral dissertation). Umeå: Umeå University
Öppna denna publikation i ny flik eller fönster >>Capability for broader cost-effectiveness in public health and social welfare: developing, valuing, and applyingcapability-adjusted life years Sweden (CALY-SWE)
2024 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Alternativ titel[sv]
Ett steg mot att bättre bedöma kostnadseffektivitet inom folkhälsa och välfärd : att utveckla och använda Goda år
Abstract [en]

Spending in social welfare areas such as healthcare, wider public health, education, and social care consumes a major part of the public budget. Cost-effective resource allocation is a moral obligation towards both taxpayers and beneficiaries: tax money should be used efficiently, and it should be transparently accounted for. After all, economical management of resources is important for sustaining future prosperity and for addressing fundamental challenges such as climate change and demographic shift. 

In healthcare, cost‐effectiveness using quality-adjusted life years (QALYs) is a well-established tool to inform policymakers. Using cost per QALY implies that health-related quality of life (QoL), and not money, is an end on its own. Moreover, cost per QALY allows one to compare unrelated interventions by measuring the effects on the common QALY scale. However, for actors concerned with broader social welfare, such as the Swedish municipalities, QALYs may be less useful because their measurement focus is largely limited to health. Comparable outcome measures for broader social welfare are still sparsely available and employed, and a context-specific measure for Sweden is lacking. 

The aim of this thesis was to develop, value, and apply capability-adjusted life years Sweden (CALY‐SWE), a QoL outcome measure conceptually based on the capability approach, for broader social welfare and specific for Sweden.

Within study 1, we organized a Delphi panel to select relevant capability attributes and then developed the phrasing for the questionnaire. The resulting questionnaire contains six attributes –health, social relations, financial situation & housing, security, occupation, and political & civil rights – each with three answer levels. The phrasing integrates an implicit threshold so that the sensitivity is focused on the lower range of the scale, thus incorporating equity considerations that relate to sufficientarianism and prioritarianism. 

In study 2, we developed a value set consisting of all quality weights for the 729 possible CALY-SWE states. We relied on health economic outcome methodology, namely hybrid modelling of discrete choice and time trade-off data that we collected in a cross-sectional web survey with representative sampling. This value set allows to aggregate the CALY-SWE answers into a single quality weight that can be used in cost‐effectiveness analysis to calculate CALYs. 

In study 3, we applied the CALY-SWE questionnaire and value set to describe the capability distribution in a cross-sectional representative sample of the Swedish population. In a framework of group comparisons, we estimated capability inequalities and shortfalls for different population groups. The results showed that there are capability inequalities for *disadvantage groups* as well as for groups with discriminative inequalities – *plurality groups*, for example between lower and higher education. 

For study 4, we applied CALY‐SWE in a cost‐effectiveness application to model the effects of a payroll tax reduction in Sweden from 2007 to 2016 (during the financial crisis) on young people not in employment, education, or training (NEET). The intervention was likely cost-effective from a societal perspective, but only with limited probability from a fiscal perspective, although definite statements regarding cost-effectiveness are challenging because a threshold value for a CALY is still lacking. 

The final chapter discusses the measure’s development, including normative choices, in relation to the Swedish social welfare and policy context, the capability framework as suggested by Amartya Sen, distributive justice, and other outcome measures in cost‐effectiveness evaluations. 

Important work remains – for example, assessing psychometric properties, developing the conceptualization of the 0 to 1 anchor scale for capability weights, and assessing a threshold value for a CALY. In conclusion, with the questionnaire development, value set elicitation, and demonstration of applications, important steps for CALY‐SWE were accomplished. Cost‐effectiveness evaluations in wider social welfare and public health using CALY-SWE are now possible. 

Abstract [sv]

Kostnader inom välfärdsområden som hälso- och sjukvård, socialt arbete, folkhälsa, utbildning och arbetsmarknad utgör en stor andel av den offentliga budgeten. En kostnadseffektiv resursallokering är en moralisk plikt mot både skattebetalare och de som använder välfärden. Skattepengar ska användas effektivt, och nyttan borde redovisas mer transparent. Till syvende och sist är ekonomisk hushållning viktigt för ett hållbart framtida välstånd och för att kunna möta grundläggande utmaningar som klimatpåverkan och demografiska förändringar. 

I hälso- och sjukvården är kostnadseffektivitetsanalyser med kvalitetsjusterade levnadsår (QALY) ett etablerat verktyg för beslutsfattande. Med kostnader i förhållande till vunna QALYs blir hälsorelaterad livskvalitet ‐ inte pengar ‐ ett explicit självändamål. Dessutom möjliggör kostnad per QALY jämförelser av olika interventioner genom att effekterna mäts på en gemensam QALY skala. 

För aktörer med verksamhet som berör välfärd i allmänhet, som svenska kommuner, är dock QALYs ett mindre användbart mått eftersom QALYs fokuserar på hälsa. Användbara mått, som beaktar bredare konsekvenser för livskvalitet och  som liknar QALYs till konstruktionen, saknas i nuläget. Syftet med avhandlingen var att utveckla, värdera och tillämpa Goda år (CALY-SWE), ett mått som konceptuellt bygger på handlingsfrihetsansatsen (capability approach), för beskrivning och analys av välfärd i Sverige. 

I delstudie 1 genomförde vi en Delfi-panel i syfte att välja ut relevanta handlingsfriheter för det nya måttet (capability-adjusted life years Sweden, CALY-SWE).  Det resulterade i sex attribut – hälsa, nära relationer, ekonomi och boende, sysselsättning, säkerhet, politiska och medborgerliga rättigheter – som vardera har tre svarsnivåer. Formuleringarna inbegriper ett implicit tröskelvärde med syfte att fokusera sensitiviteten på nedre delen av skalan. På så sätt integreras effektivitets- och jämlikhetaspekter i samhällets prioriteringar. 

I delstudie 2 utvecklade vi vikter för de 729 möjliga CALY-SWE tillstånden. Vi använde hälsoekonomiska metoder utvecklade i QALY-studier, nämligen hybridmodellering av DCE- och TTO-svar som vi samlade in genom en tvärsnittsenkät i ett representativt urval. På så vis kan CALY-SWE enkätsvar översättas i en enda  *livskvalitetsvikt* som kan användas i kostnadseffektivitetsanalyser för att beräkna Goda År (capability-adjusted life years, CALYs). 

I delstudie 3 använde vi CALY-SWE frågor (studie 1) och vikter (studie 2) för att beskriva fördelningen av handlingsfrihet i ett representativt tvärsnittsurval av den svenska befolkningen. I ett ramverk inspirerat av sjukvårdens etiska plattform jämfördes graden av handlingsfrihet och CALYs för olika befolkningsgrupper. Resultaten visade att det finns brister i handlingsfrihet för grupper som har sämre objektiva förutsättningar för livskvalitet (*nackdelsgrupper*, t.ex. sjukskrivna och arbetslösa) samt för grupper som har ökad risk för diskriminering (*mångfaldsgrupper*, t.ex. kön och födelseland). 

I delstudie 4 använde vi CALY-SWE i en kostnadseffektivitetsanalys för att modellera effekterna av sänkta arbetsgivaravgifter under finanskrisen från 2007 till 2016 bland unga som varken arbetar eller studerar (UVAS). Interventionen var säkerligen kostnadseffektiv från ett samhällsperspektiv men med mindre sannolikhet från ett fiskalt perspektiv. Resultaten bör dock tolkas med försiktighet då tröskelvärdet för en CALY ännu inte har beräknats. 

Avslutningsvis förs ett resonemang om måttets utveckling i förhållande till normativa frågor som fördelningsrättvisa, det svenska välfärdssystemet inklusive beslutsfattande, samt till andra utfallsmått för ekonomisk utvärdering. Den sammantagna bedömningen är att CALY-SWE förhåller sig väl till handlingsfrihetsansatsen så som den ursprungligen föreslogs av Amartya Sen. 

Det krävs fortsatt forskning om CALY-SWE som att utforska psykometriska egenskaper, utveckla konceptualiseringen av ankringsvärdena 1 och 0 för kapabilitetsvikter, och uppskatta ett tröskelvärde för en CALY. Denna avhandling utgör dock ett viktigt steg och kostnadseffektivitetsanalyser inom välfärd och folkhälsa med CALY-SWE är nu genomförbara. 

Abstract [de]

Ausgaben im Zusammenhang mit sozialer Wohlfahrt, zum Beispiel für öffentliche Gesundheit, für Ausbildung und im Sozialwesen, beanspruchen einen großen Teil des öffentlichen Haushalts. Eine kosteneffektive Mittelverteilung ist eine moralische Verpflichtung sowohl gegenüber dem Steuerzahler als auch gegenüber den Begünstigten. Steuergelder sollten effizient und transparent genutzt werden. Letztendlich ist ein wirtschaftlicher Umgang mit Ressourcen wichtig, um zukünftig den Wohlstand aufrechtzuerhalten und um grundlegende Herausforderungen wie den Klimaschutz oder den demografischen Wandel anzugehen. 

Im Gesundheitswesen ist Kosteneffizienz mittels qualitätskorrigierter Lebensjahre (quality-adjusted life years, QALYs) ein anerkanntes Werkzeug, um politische Entscheidungsträger zu informieren. Die Anwendung von QALYs impliziert, verglichen mit ausschließlich finanziellen Überlegungen, dass die Förderung gesundheitsbezogener Lebensqualität einen Selbstwert hat. Außerdem erlauben Kosten per QALY den Vergleich unterschiedlicher Interventionen, da die Effekte auf der gemeinsamen QALY-Skala gemessen werden. Für Akteure, die sich mit sozialer Wohlfahrt im weiteren Sinne befassen, wie zum Beispiel die schwedischen Gemeinden, sind QALYs hingegen weniger anwendbar, da der Messfokus mehrheitlich auf Gesundheit gerichtet ist. Vergleichbare Messinstrumente für breitere soziale Wohlfahrt sind noch relativ wenig verfügbar und ein kontextspezifisches Instrument für Schweden ist nicht vorhanden. 

Die Zielsetzung dieser Doktorarbeit war die Entwicklung, Wertung, und Anwendung von befähigungskorrigierten Lebensjahren Schweden (capability-adjusted life years Sweden, CALY-SWE) für die weitere soziale Wohlfahrt und spezifisch für Schweden. 

In Teilstudie 1 organisierten wir ein Delphi-Panel, um relevante Befähigungsattribute auszuwählen. Im Anschluss entwickelten wir die Formulierungen für den Fragebogen. Der resultierende Fragebogen enthält sechs Attribute: Gesundheit, soziale Beziehungen, finanzielle Situation und Wohnen, Sicherheit, Beschäftigung und politische und zivile Rechte, jeweils mit drei Antwortstufen. In die Frageformulierungen integriert sind implizite Schwellen, so dass die Empfindlichkeit auf den unteren Teil der Skala fokussiert ist. Auf diese Weise sind Verteilungsgerechtigkeitsaspekte im Sinne von Suffizientarismus und Prioritärianismus eingebaut. 

In Teilstudie 2 entwickelten wir eine Wertemenge für die Gewichtungsfaktoren aller 729 CALY-SWE-Zustände. Wir haben gesundheitsökonomische Berechnungsmethoden angewendet, namentlich Hybridmodellierung von DCE- und TTO-Daten, die wir in einer Querschnittstudie mit einer repräsentativen Stichprobe gesammelt haben. Diese Wertemenge erlaubt es, CALY-SWE-Antworten in einem einzelnen Gewichtungsfaktor zusammenzufassen, der dann in Kosteneffektivitätsanalysen angewendet werden kann, um befähigungskorrigierte Lebensjahre (CALYs) zu berechnen. 

In Teilstudie 3 wandten wir den CALY-SWE-Fragebogen und die Wertemenge in einer querschnittlichen Bevölkerungsstichprobe an, um die Befähigungsverteilung zu untersuchen. Innerhalb eines Rahmenwerks von Gruppenvergleichen schätzten wir Befähigungsunterschiede und Mankos zwischen verschiedenen Gruppen. Die Resultate ließen auf Befähigungsunterschiede für Benachteiligungsgruppen und auch für Pluralitätsgruppen schließen, zum Beispiel zwischen niedriger und höherer Ausbildung. 

In Teilstudie 4 wandten wir CALY-SWE an, um die Auswirkungen einer Ermäßigung der Sozialabgaben für Arbeitgeber während der Finanzkrise von 2007 bis 2016 auf das Vorkommen von NEET (junge Erwachsene, die weder arbeiten noch studieren oder in Ausbildung sind) in einer Kosteneffektivitätsanalyse zu untersuchen. Die Steuerermäßigung war wahrscheinlich kosteneffektiv in der Gesellschaftsperspektive, aber nur mit einer gewissen Wahrscheinlichkeit in der Fiskalperspektive, obwohl die Beurteilung wegen des fehlenden Kosteneffektivitäts-Schwellenwertes eines CALY schwierig ist. 

Das letzte Kapitel diskutiert die CALY-SWE-Entwicklung und normative Entscheide im Zusammenhang mit dem schwedischen Wohlfahrts- und Entscheidungskontext, dem Befähigungsansatz wie vorgeschlagen von Amartya Sen, Verteilungsgerechtigkeit und anderen Messinstrumenten für Kosteneffektivitätsauswertungen. 

Wichtige verbleibende Forschungsarbeit umfasst zum Beispiel die psychometrischen Eigenschaften, die weitere Konzeptualisierung der Ankerwerte 0 und 1 für Befähigungsgewichte und die Festlegung eines Schwellenwertes für ein CALY. Zusammenfassend sind mit der Entwicklung des Fragebogens, mit der Wertemenge und den dargestellten Anwendungen wichtige Entwicklungsschritte für CALY-SWE vollendet. Kosteneffektivitätsanalysen in breiter sozialer Wohlfahrt und öffentlicher Gesundheit mittels CALY-SWE sind nun möglich.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå University, 2024. s. 127
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 2280
Nyckelord
CALY-SWE, Cost-effectiveness, Social-welfare, Capability approach, Public health, Health economics, Delfi panel, TTO, DCE, NEET, Priority setting, Outcome measure, Delphi
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi Socialt arbete
Forskningsämne
nationalekonomi; medicinsk humaniora
Identifikatorer
urn:nbn:se:umu:diva-220076 (URN)978-91-8070-257-7 (ISBN)978-91-8070-258-4 (ISBN)
Disputation
2024-02-23, NAT.D.380, Naturvetarhuset, plan 3, Umeå, 09:00 (Engelska)
Opponent
Handledare
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd
Tillgänglig från: 2024-02-02 Skapad: 2024-01-27 Senast uppdaterad: 2024-01-29Bibliografiskt granskad
Meili, K. W., Mulhern, B., Ssegonja, R., Norström, F., Feldman, I., Månsdotter, A., . . . Lindholm, L. (2024). Eliciting a value set for the Swedish capability-adjusted life years instrument (CALY-SWE). Quality of Life Research, 33(1), 59-72
Öppna denna publikation i ny flik eller fönster >>Eliciting a value set for the Swedish capability-adjusted life years instrument (CALY-SWE)
Visa övriga...
2024 (Engelska)Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 33, nr 1, s. 59-72Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

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.

Ort, förlag, år, upplaga, sidor
Springer Nature, 2024
Nyckelord
Quality-adjusted life year, Time trade-off, Discrete choice experiment, Capability approach, Hybrid modeling, Economic evaluation
Nationell ämneskategori
Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
Identifikatorer
urn:nbn:se:umu:diva-214379 (URN)10.1007/s11136-023-03507-w (DOI)001064459600002 ()37695477 (PubMedID)2-s2.0-85170367443 (Scopus ID)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2018-00143Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2018-00143
Tillgänglig från: 2023-09-13 Skapad: 2023-09-13 Senast uppdaterad: 2024-04-29Bibliografiskt granskad
Meili, K. W., Månsdotter, A., Richter Sundberg, L., Hjelte, J. & Lindholm, L. (2022). An initiative to develop capability-adjusted life years in Sweden (CALY-SWE): Selecting capabilities with a Delphi panel and developing the questionnaire. PLOS ONE, 17(2), Article ID e0263231.
Öppna denna publikation i ny flik eller fönster >>An initiative to develop capability-adjusted life years in Sweden (CALY-SWE): Selecting capabilities with a Delphi panel and developing the questionnaire
Visa övriga...
2022 (Engelska)Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 17, nr 2, artikel-id e0263231Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Introduction: Capability-adjusted life years Sweden (CALY-SWE) are a new Swedish questionnaire-based measure for quality of life based on the capability approach. CALY-SWE are targeted towards use in cost-effectiveness evaluations of social welfare consequences. Here, we first motivate the measure both from a theoretical and from a Swedish policy-making perspective. Then, we outline the core principles of the measure, namely the relation to the capability approach, embedded equity considerations inspired by the fair-innings approach, and the bases for which capabilities should be considered. The aims were to 1) the most vital capabilities for individuals in Sweden, 2) to define a sufficient level of each identified capability to lead a flourishing life, and to 3) develop a complete questionnaire for the measurement of the identified capabilities.

Material and methods: For the selection of capabilities, we used a Delphi process with Swedish civil society representants. To inform the questionnaire development, we conducted a web survey in three versions, with each Swedish 500 participants, to assess the distribution of capabilities that resulted from the Delphi process in the Swedish population. Each version was formulated with different strictness so that less strict wordings of a capability level would apply to a larger share of participants. All versions also included questions on inequality aversion regarding financial, educational, and health capabilities.

Results: The Delphi process resulted in the following six capabilities: Financial situation & housing, health, social relations, occupations, security, and political & civil rights. We formulated the final phrasing for the questionnaire based on normative reasons and the distribution of capabilities in the population while taking into account inequality aversion.

Conclusion: We developed a capability-based model for cost effectiveness economic evaluations of broader social consequences, specific to the Swedish context.

Ort, förlag, år, upplaga, sidor
Public Library of Science (PLoS), 2022
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
hälso- och sjukvårdsforskning; folkhälsa
Identifikatorer
urn:nbn:se:umu:diva-192308 (URN)10.1371/journal.pone.0263231 (DOI)000798968600010 ()35134053 (PubMedID)2-s2.0-85124191312 (Scopus ID)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2018-00143
Tillgänglig från: 2022-02-08 Skapad: 2022-02-08 Senast uppdaterad: 2024-01-27Bibliografiskt granskad
Buitrago-Garcia, D., Ipekci, A. M., Heron, L., Imeri, H., Araujo-Chaveron, L., Arevalo-Rodriguez, I., . . . Low, N. (2022). Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: Update of a living systematic review and meta-analysis. PLoS Medicine, 19(5), Article ID e1003987.
Öppna denna publikation i ny flik eller fönster >>Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: Update of a living systematic review and meta-analysis
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2022 (Engelska)Ingår i: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 19, nr 5, artikel-id e1003987Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Debate about the level of asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection continues. The amount of evidence is increasing and study designs have changed over time. We updated a living systematic review to address 3 questions: (1) Among people who become infected with SARS-CoV-2, what proportion does not experience symptoms at all during their infection? (2) What is the infectiousness of asymptomatic and presymptomatic, compared with symptomatic, SARS-CoV-2 infection? (3) What proportion of SARS-CoV-2 transmission in a population is accounted for by people who are asymptomatic or presymptomatic?

Methods and findings: The protocol was first published on 1 April 2020 and last updated on 18 June 2021. We searched PubMed, Embase, bioRxiv, and medRxiv, aggregated in a database of SARS-CoV-2 literature, most recently on 6 July 2021. Studies of people with PCR-diagnosed SARS-CoV-2, which documented symptom status at the beginning and end of follow-up, or mathematical modelling studies were included. Studies restricted to people already diagnosed, of single individuals or families, or without sufficient follow-up were excluded. One reviewer extracted data and a second verified the extraction, with disagreement resolved by discussion or a third reviewer. Risk of bias in empirical studies was assessed with a bespoke checklist and modelling studies with a published checklist. All data syntheses were done using random effects models. Review question (1): We included 130 studies. Heterogeneity was high so we did not estimate a mean proportion of asymptomatic infections overall (interquartile range (IQR) 14% to 50%, prediction interval 2% to 90%), or in 84 studies based on screening of defined populations (IQR 20% to 65%, prediction interval 4% to 94%). In 46 studies based on contact or outbreak investigations, the summary proportion asymptomatic was 19% (95% confidence interval (CI) 15% to 25%, prediction interval 2% to 70%). (2) The secondary attack rate in contacts of people with asymptomatic infection compared with symptomatic infection was 0.32 (95% CI 0.16 to 0.64, prediction interval 0.11 to 0.95, 8 studies). (3) In 13 modelling studies fit to data, the proportion of all SARS-CoV-2 transmission from presymptomatic individuals was higher than from asymptomatic individuals. Limitations of the evidence include high heterogeneity and high risks of selection and information bias in studies that were not designed to measure persistently asymptomatic infection, and limited information about variants of concern or in people who have been vaccinated.

Conclusions: Based on studies published up to July 2021, most SARS-CoV-2 infections were not persistently asymptomatic, and asymptomatic infections were less infectious than symptomatic infections. Summary estimates from meta-analysis may be misleading when variability between studies is extreme and prediction intervals should be presented. Future studies should determine the asymptomatic proportion of SARS-CoV-2 infections caused by variants of concern and in people with immunity following vaccination or previous infection. Without prospective longitudinal studies with methods that minimise selection and measurement biases, further updates with the study types included in this living systematic review are unlikely to be able to provide a reliable summary estimate of the proportion of asymptomatic infections caused by SARS-CoV-2.

Ort, förlag, år, upplaga, sidor
Public Library of Science (PLoS), 2022
Nationell ämneskategori
Infektionsmedicin
Identifikatorer
urn:nbn:se:umu:diva-201019 (URN)10.1371/journal.pmed.1003987 (DOI)000944355600010 ()35617363 (PubMedID)2-s2.0-85130949778 (Scopus ID)
Forskningsfinansiär
EU, Horisont 2020, 101003688
Tillgänglig från: 2022-11-15 Skapad: 2022-11-15 Senast uppdaterad: 2023-09-05Bibliografiskt granskad
Meili, K. W., Jonsson, H., Lindholm, L. & Månsdotter, A. (2022). Perceived changes in capability during the COVID-19 pandemic: A Swedish cross-sectional study from June 2020. Scandinavian Journal of Public Health, 50(1), 102-110
Öppna denna publikation i ny flik eller fönster >>Perceived changes in capability during the COVID-19 pandemic: A Swedish cross-sectional study from June 2020
2022 (Engelska)Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 50, nr 1, s. 102-110Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aims: Measures against COVID-19 potentially impact quality of life in different ways. The capability approach by Amartya Sen with a broad and consistent framework for measuring quality of life is suited to capture the various consequences. We aimed to examine (a) whether individuals experienced change in 10 capability dimensions during the first half of 2020, (b) which dimensions were affected most, and (c) whether changes were unequally distributed in terms of gender, education, income, geography, housing, living situation and place of birth.

Methods: We assessed self-reported capability change in Sweden in 10 capability dimensions in a cross-sectional online survey among 500 participants on a five-item Likert scale. We analysed the distribution of answers by comparing the balance of positive and negative perceived changes and used mixed effects logistic regression to examine associations with background characteristics of the participants.

Results: Reported perceived negative changes outweighed positive changes, and a higher proportion stated negative perceived changes if they also stated having low capability in the same dimension. In the capabilities of financial situation, political resources and health, the proportions of perceived negative change were highest. Odds for perceived negative change compared to no or positive change were higher for higher incomes, living in medium-sized municipalities, being born outside Europe, living in the south of Sweden, and renting instead of owning housing.

Conclusions: Self-reported negative capability change, and associated inequalities related to socioeconomic position, place of birth and regional residence should be of concern for policymakers.

Ort, förlag, år, upplaga, sidor
Sage Publications, 2022
Nyckelord
Quality of life, capability approach, COVID-19, cross-sectional survey
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Forskningsämne
folkhälsa
Identifikatorer
urn:nbn:se:umu:diva-185846 (URN)10.1177/14034948211023633 (DOI)000672123300001 ()34213363 (PubMedID)2-s2.0-85109165611 (Scopus ID)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2018-00143
Tillgänglig från: 2021-07-08 Skapad: 2021-07-08 Senast uppdaterad: 2022-07-13Bibliografiskt granskad
Ipekci, A. M., Buitrago-Garcia, D., Meili, K. W., Krauer, F., Prajapati, N., Thapa, S., . . . Counotte, M. J. (2021). Outbreaks of publications about emerging infectious diseases: the case of SARS-CoV-2 and Zika virus. BMC Medical Research Methodology, 21(1), Article ID 50.
Öppna denna publikation i ny flik eller fönster >>Outbreaks of publications about emerging infectious diseases: the case of SARS-CoV-2 and Zika virus
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2021 (Engelska)Ingår i: BMC Medical Research Methodology, E-ISSN 1471-2288, Vol. 21, nr 1, artikel-id 50Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Outbreaks of infectious diseases generate outbreaks of scientific evidence. In 2016 epidemics of Zika virus emerged, and in 2020, a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a pandemic of coronavirus disease 2019 (COVID-19). We compared patterns of scientific publications for the two infections to analyse the evolution of the evidence. Methods: We annotated publications on Zika virus and SARS-CoV-2 that we collected using living evidence databases according to study design. We used descriptive statistics to categorise and compare study designs over time. Results: We found 2286 publications about Zika virus in 2016 and 21,990 about SARS-CoV-2 up to 24 May 2020, of which we analysed a random sample of 5294 (24%). For both infections, there were more epidemiological than laboratory science studies. Amongst epidemiological studies for both infections, case reports, case series and cross-sectional studies emerged first, cohort and case-control studies were published later. Trials were the last to emerge. The number of preprints was much higher for SARS-CoV-2 than for Zika virus. Conclusions: Similarities in the overall pattern of publications might be generalizable, whereas differences are compatible with differences in the characteristics of a disease. Understanding how evidence accumulates during disease outbreaks helps us understand which types of public health questions we can answer and when.

Ort, förlag, år, upplaga, sidor
BioMed Central, 2021
Nationell ämneskategori
Infektionsmedicin
Identifikatorer
urn:nbn:se:umu:diva-181796 (URN)10.1186/s12874-021-01244-7 (DOI)000628993600002 ()2-s2.0-85102468585 (Scopus ID)
Forskningsfinansiär
EU, Horisont 2020
Tillgänglig från: 2021-04-01 Skapad: 2021-04-01 Senast uppdaterad: 2024-01-17Bibliografiskt granskad
Månsdotter, A., Ekman, B., Meili, K. W., Feldman, I., Hagberg, L., Hurtig, A.-K. & Lindholm, L. (2020). Towards capability-adjusted life years in public health and social welfare: results from a Swedish survey on ranking capabilities. PLOS ONE, 15(12), Article ID e0242699.
Öppna denna publikation i ny flik eller fönster >>Towards capability-adjusted life years in public health and social welfare: results from a Swedish survey on ranking capabilities
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2020 (Engelska)Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 15, nr 12, artikel-id e0242699Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

INTRODUCTION: The aim of this study was to rank capabilities and suggest a relevant set of capabilities for the Swedish context to inform the development of capability-adjusted life years (CALYs). CALYs is a quality of life measure for policy making based on the capability approach by Amartya Sen.

MATERIALS AND METHODS: A Swedish governmental review proposed the following 10 relevant capabilities: time, financial situation, mental/physical health, political resources, knowledge, living environment, occupation, social relations, security, and housing. Researchers in health-related disciplines from 5 universities ranked these capabilities from 1 to 10 (most to least important) in a web-based cross-sectional survey; 115 of 171 responses were eligible.

RESULTS: Health, social relations, and financial situation were deemed most important. Stratification by gender, research field, and age group revealed few differences. We found that it was possible to rank capabilities and that health, social relations, and financial situation were ranked highest by a non-representative sample of researchers and doctoral students from health-related disciplines at five Swedish universities.

CONCLUSIONS: The revealed ranking is dependent on the metric and must be further explored. The findings support continued development of CALYs for monitoring and evaluating outcomes in public health and social-welfare interventions.

Ort, förlag, år, upplaga, sidor
San Francisco: Public Library of Science, 2020
Nationell ämneskategori
Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-177334 (URN)10.1371/journal.pone.0242699 (DOI)000596503200010 ()33259528 (PubMedID)2-s2.0-85097035100 (Scopus ID)
Tillgänglig från: 2020-12-07 Skapad: 2020-12-07 Senast uppdaterad: 2021-11-25Bibliografiskt granskad
Meili, K. W., Hjelte, J., Lindholm, L. & Månsdotter, A.Capability inequality: Does disadvantage or plurality matter more for policy?: A Swedish cross-sectional study on the population distribution and group differences of capability using CALY-SWE.
Öppna denna publikation i ny flik eller fönster >>Capability inequality: Does disadvantage or plurality matter more for policy?: A Swedish cross-sectional study on the population distribution and group differences of capability using CALY-SWE
(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Nyckelord
CALY-SWE, Capability approach, Inequality, Sweden, Distributive justice, Prioritization, Welfare, Wellbeing, Quality of life
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Nationalekonomi Filosofi Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi Socialt arbete
Forskningsämne
nationalekonomi; folkhälsa
Identifikatorer
urn:nbn:se:umu:diva-220063 (URN)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd
Tillgänglig från: 2024-01-26 Skapad: 2024-01-26 Senast uppdaterad: 2024-01-29
Meili, K. W., Hjelte, J., Jonsson, F., Löfgren, C., Månsdotter, A. & Lindholm, L.NEET prevention through Sweden’s youth payroll tax cut: Evaluating cost-effectiveness using CALY-SWE.
Öppna denna publikation i ny flik eller fönster >>NEET prevention through Sweden’s youth payroll tax cut: Evaluating cost-effectiveness using CALY-SWE
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(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Nyckelord
CALY-SWE, Capability approach, Sweden, Welfare, Wellbeing, Quality of life, NEET, Quality of Life, Labour market, Public economics
Nationell ämneskategori
Nationalekonomi Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
Forskningsämne
nationalekonomi; folkhälsa
Identifikatorer
urn:nbn:se:umu:diva-220066 (URN)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd
Anmärkning

Alternative title: Taking cost-effectiveness to socialwelfare - Evaluating NEETprevention through Sweden’syouth payroll tax cut using CALY-SWE

Tillgänglig från: 2024-01-26 Skapad: 2024-01-26 Senast uppdaterad: 2024-01-27
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-9889-4406

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