A Reevaluation of Health Status Indicators

Goldsmith, Seth B.

doi:10.2307/4594956

Cited by 16 publications

(5 citation statements)

References 5 publications

(1 reference statement)

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“…The allocation of research resources within medicine, evaluation of the effects upon the population of various types of industrial and other exposure, the planning of health and medical care, and estimation of the benefit that may accrue from actions in health policy, presuppose indicators which will enable diseases to be arranged in their order of priority (Cohen, 1965;Havard, 1973;Phillips, 1974;. The search for such indicators has resulted in a number of indices, based upon morbidity, mortality, and different kinds of disability, and their combinations (Goldsmith, 1973). The aim of these indices has been to find a basis for priority which takes into account all possible aspects.…”

Section: Discussionmentioning

confidence: 99%

The increase in working years due to elimination of cancer as a cause of death

Hakulinen

Teppo

1976

Intl Journal of Cancer

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The relative significance of various forms of cancer in terms of causing death is analysed by estimation of the increase in person-years of working age (20-64 years) following elimination of the disease. Methods based upon the theory of competing risks are applied to the statistics on causes of death in Finland during the years 1966-70. It is estimated that if there were no lung cancer (the commonest type of cancer in both morbidity and mortality statistics in males in Finland) the annual deaths saved would yield 5,900 working years (both sexes combined). Leukaemia and cancer of the stomach would be next in rank order, with figures of respectively 4,000 and 3,900 working years more. Female cancer with the highest incidence, that of the breast, would be characterized by 2,900 additional working years. The significance of types of cancer that affect young people is stressed in these calculations: leukaemia, brain tumours and lymphomas (both sexes combined) are 6th, 12th and 11th respectively in the statistics of cancer causes of death, but 2nd, 4th and 6th respectively in the list of additional working years to be gained by elimination of the disease. On the other hand, cancer of the prostate, 3rd in males according to the annual numbers of cancer deaths, would take the 15th position for the increase in working years in males. If no risk of cancer existed, the annual deaths saved would produce 36,000 working years, a figure exceeded only by those for cardiovascular diseases (55,000 working years) and accidents (51,000 working years). The results indicate that no practical differences exist between the results derived under the assumptions of various models for competing risks, but that the exclusion of competing risks may result in considerable degrees of bias in estimation if the population has a high general mortality.

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Section: Discussionmentioning

confidence: 99%

The increase in working years due to elimination of cancer as a cause of death

Hakulinen

Teppo

1976

Intl Journal of Cancer

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“…Therefore, great relevance has been placed on the importance of quality of life in measuring health status and evaluating medical care results, especially in chronic illnesses [1]. Measurement of the health-related quality of life (HRQoL) makes it possible to obtain information about illness and its impact on the patients' life, in a standardized, comparative and more objective way [2,3]. Interest in HRQoL instruments started to increase during the decade of the eighties in four broad contexts: Measuring the health of populations, assessing the benefit of alternative uses of resources, comparing two or more interventions in a clinical trial and making a decision on treatment for an individual patient [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…. , x k ; (3) The values of the outcome variable Y should have a normal distribution for each set of values of the predictor variables x 1 , x 2 , . .…”

Section: Introductionmentioning

confidence: 99%

Analysis of the short form‐36 (SF‐36): the beta‐binomial distribution approach

Aróstegui

Núñez‐Antón

Quintana

2006

Statistics in Medicine

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Health-related quality of life (HRQoL) is an important indicator of health status and the Short Form-36 (SF-36) is a generic instrument to measure it. Multiple linear regression (MLR) is often used to study the relationship of HRQoL with patients' characteristics, though HRQoL outcomes tend to be not normally distributed, skewed and bounded (e.g. between 0 and 100). A sample of 193 patients with eating disorders has been analysed to assess the performance of the MLR under non-normality conditions. Normal distribution was rejected for seven out of the eight domains. A beta-binomial distribution is suggested to fit the SF-36 scores. The beta-binomial distribution is not rejected for five out of the eight domains. Thus, a beta-binomial regression (BBR) is suggested to analyse the SF-36 scores. Results using MLR and BBR have been compared for real and simulated data. Performance of the BBR is shown to be better than MLR in the HRQoL domains with few ordered categories and very similar to MLR in the more continuous domains. Moreover, the interpretation of the estimates obtained with BBR is clinically more meaningful. A common technique of statistical analysis is preferable for all the HRQoL dimensions. Therefore, the BBR approach is recommended not only to detect significant predictors of HRQoL when SF-36 is used, but also to analyse and interpret the effect of several explanatory variables on HRQoL. Further work is required to test the better performance of BBR against standard methods for other HRQoL outcomes, populations or interventions.

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“…1 Validated instruments for measuring health-related quality of life (HRQoL) make it possible to obtain information about illness and its impact on patients' lives in a standardized, comparative, and relatively objective way. 2,3 The impact of eating disorders (EDs) on an individual and their cost to the community are usually described in terms of morbidity and mortality. HRQoL, however, must not be overlooked.…”

Section: Introductionmentioning

confidence: 99%