Disability Weights for Visual Impairment and Blindness Jill Keeffe Centre for Eye Research Australia...
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Transcript of Disability Weights for Visual Impairment and Blindness Jill Keeffe Centre for Eye Research Australia...
Disability Weights for Visual Impairment and Blindness
Jill KeeffeCentre for Eye Research Australia (CERA)
Terminology
• Disability weights – 0 to 1 ratio scale• YLL and YLD• Disease• Health states• Activities• Participation• Well-being, quality of life
GBD Methods for DW
• 1990 GBD disability classes for ADL– Eating and personal hygiene– ADL such as meal planning– procreation– Occupation– Education– Recreation
• Panel of experts assigned weights deriving average weights
1996 Revision
• Person trade-off method• DALY• Suitable for adults but not replicable• Not sensitive to mild levels of health states
GBD 2000-2002
• Based on 1990 weights• Panel of experts• Proportion of time in a class• If weights not available results for Dutch or
Australian studies used• Dutch study added health state distributions
for sequelae from EQ-5D• Vision 4.2% of GBD; in top 7 diseases
New GBD
• Diseases • Health states in 0 to 1 scale• Not utility, contribution to health and welfare,
activities or participation• Departure from ideal health on ratio scale so
makes comparison possible• Homogenous health experience
Disease
• Dysfunctions of the body system• Discrete list under groups• Sense organs: glaucoma, cataracts, AMD, RE• CVD and Circulatory: Ophtalmia neonatorum,
corneal scar in LBW children• Nutritional: VAD• NTD: onchocerciasis, trachoma• Diabetes: retinopathy
Health States
• Core domains of body functions• Ambulation, cognition• Senses such as vision and hearing• Functional health domains, not well-being• GBD uses disability as a proxy for loss of
health in the terminology YLD and DALY• “what can be seen”, ie vision loss, not
performance
Disability Weight
• Loss of health measured in decrements of health capacity
• Quantification of the level severity of health of each domain – low vision or blindness
• Average health state valuation across the entire distribution experienced by all individuals
• Same across countries
YLD
• For each case or sequela YLD = incidence, average duration until remission or death and average disability weight
• Community survey of chronic health states• Checklist and cognitive interviews• Rating of health states• Surveys in 3 countries• Health professionals ranking and VA scale 0-1
Implications
• Impact of vision on physical function can be quite limited
• Corrected vision not loss of function• Use in cost effectiveness analysis
Global blindness by etiology
Source: GBD 2010 Estimation Strategy Report for Vision Loss
Global Low Vision Loss by etiology
Source: GBD 2010 Estimation Strategy Report for Vision Loss
Global prediction of blindness for females by etiology and age
Source: GBD 2010 Estimation Strategy Report for Vision Loss
Global prediction from low vision for females by etiology and age
Source: GBD 2010 Estimation Strategy Report for Vision Loss
Predicted number from blindness in North America males by etiology and age
Source: GBD 2010 Estimation Strategy Report for Vision Loss
Blindness 1990
Source: GBD 2010 Estimation Strategy Report for Vision Loss
Blindness 2010
Source: GBD 2010 Estimation Strategy Report for Vision Loss
Near vision loss 2005
Source: GBD 2010 Estimation Strategy Report for Vision Loss
Low vision 2005
Source: GBD 2010 Estimation Strategy Report for Vision Loss
Blindness 2005
Source: GBD 2010 Estimation Strategy Report for Vision Loss