In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and quali...In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.展开更多
目的了解1990-2019年中国慢性阻塞性肺疾病发病、患病、死亡情况及疾病负担情况,预测2020-2030年中国慢性阻塞性肺疾病发病情况,为评估和制定慢性阻塞性肺疾病相关预防治疗政策和措施提供数据支持。方法利用2019年全球疾病负担研究数据...目的了解1990-2019年中国慢性阻塞性肺疾病发病、患病、死亡情况及疾病负担情况,预测2020-2030年中国慢性阻塞性肺疾病发病情况,为评估和制定慢性阻塞性肺疾病相关预防治疗政策和措施提供数据支持。方法利用2019年全球疾病负担研究数据库(Global burden of disease study,GBD),研究分析1990-2019年中国慢性阻塞性肺疾病的发病、患病、死亡、伤残调整寿命年(DALY)、早死寿命损失年(YLL)、伤残寿命损失年(YLD)等情况。采用贝叶斯-时期-队列分析(BAPC)方法,预测2020-2030年中国慢性阻塞性肺疾病发病率。结果相对于1990年,2019年中国慢性阻塞性肺疾病粗患病率增长35.44%,标化患病率减少27.16%,粗发病率增长38.31%,标化发病率减少28.52%,粗死亡率减少30.59%,标化死亡率减少70.08%。1990-2019年中国人群因慢性阻塞性肺疾病导致的YLL率由3281.48/10万降至862.37/10万,YLD率由330.33/10万降至240.40/10万,DALY率由3611.81/10万降至1102.77/10万。2019年男性慢性阻塞性肺疾病DALY率相比于1990年降低66.56%,女性DALY率相比于1990年降低71.87%。2020-2030年中国慢性阻塞性肺疾病标化发病率预计呈下降趋势,2030年男性标化发病率预计比2020年降低31.97%,女性标化发病率预计比2020年降低27.69%。结论1990-2019年,慢性阻塞性肺疾病对中国人口造成的疾病负担总体呈下降趋势。但从患病情况和死亡情况来看,发病及死亡人数较多,中国慢性阻塞性肺疾病的疾病负担仍处于较高水平。同时预测结果显示,未来10年中国慢性阻塞性肺疾病标化发病率在下降,但是仍处于较高水平,因此进行早筛查、早预防和早治疗,及广泛开展慢阻肺相关知识普及,对于做好COPD疾病管理具有重要意义。展开更多
目的分析1990—2019年中国喉癌疾病负担的变化趋势。方法基于全球疾病负担研究数据库对比分析1990—2019年我国和全球喉癌的发病率、死亡率、伤残调整寿命年(disability adjusted life years,DALYs)、过早死亡损失寿命年、伤残损失寿命...目的分析1990—2019年中国喉癌疾病负担的变化趋势。方法基于全球疾病负担研究数据库对比分析1990—2019年我国和全球喉癌的发病率、死亡率、伤残调整寿命年(disability adjusted life years,DALYs)、过早死亡损失寿命年、伤残损失寿命年及年估计变化百分比(estimated annual percentage change,EAPC),并进一步分析我国不同年龄、性别及喉癌归因危险因素的疾病负担情况。结果2019年中国喉癌发病例数、死亡例数和DALYs分别为4.54万、2.03万和49.79万人年,比1990年分别增加了221.98%、76.20%和56.72%。1990—2019年中国喉癌标化发病率呈上升趋势(EAPC=1.32),而标化死亡率(EAPC=-0.96)和标化DALYs率(EAPC=-1.21)均呈下降趋势。我国喉癌的发病、死亡和疾病负担在50~69岁年龄组开始明显上升,≥70岁达到最高,且男性显著高于女性。与1990年相比,2019年我国可归因于吸烟、饮酒和石棉暴露的喉癌死亡比例和DALYs比例均有所增加;可归因于硫酸暴露的喉癌死亡比例和DALYs比例均有所下降。结论1990—2019年我国喉癌的标化发病率呈上升趋势,而标化死亡率和标化DALYs率均呈下降趋势,疾病负担在男性中明显高于女性,中老年人群的疾病负担仍较为沉重,提示仍需进一步加强喉癌的防治工作。展开更多
文摘In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.
文摘目的了解1990-2019年中国慢性阻塞性肺疾病发病、患病、死亡情况及疾病负担情况,预测2020-2030年中国慢性阻塞性肺疾病发病情况,为评估和制定慢性阻塞性肺疾病相关预防治疗政策和措施提供数据支持。方法利用2019年全球疾病负担研究数据库(Global burden of disease study,GBD),研究分析1990-2019年中国慢性阻塞性肺疾病的发病、患病、死亡、伤残调整寿命年(DALY)、早死寿命损失年(YLL)、伤残寿命损失年(YLD)等情况。采用贝叶斯-时期-队列分析(BAPC)方法,预测2020-2030年中国慢性阻塞性肺疾病发病率。结果相对于1990年,2019年中国慢性阻塞性肺疾病粗患病率增长35.44%,标化患病率减少27.16%,粗发病率增长38.31%,标化发病率减少28.52%,粗死亡率减少30.59%,标化死亡率减少70.08%。1990-2019年中国人群因慢性阻塞性肺疾病导致的YLL率由3281.48/10万降至862.37/10万,YLD率由330.33/10万降至240.40/10万,DALY率由3611.81/10万降至1102.77/10万。2019年男性慢性阻塞性肺疾病DALY率相比于1990年降低66.56%,女性DALY率相比于1990年降低71.87%。2020-2030年中国慢性阻塞性肺疾病标化发病率预计呈下降趋势,2030年男性标化发病率预计比2020年降低31.97%,女性标化发病率预计比2020年降低27.69%。结论1990-2019年,慢性阻塞性肺疾病对中国人口造成的疾病负担总体呈下降趋势。但从患病情况和死亡情况来看,发病及死亡人数较多,中国慢性阻塞性肺疾病的疾病负担仍处于较高水平。同时预测结果显示,未来10年中国慢性阻塞性肺疾病标化发病率在下降,但是仍处于较高水平,因此进行早筛查、早预防和早治疗,及广泛开展慢阻肺相关知识普及,对于做好COPD疾病管理具有重要意义。
