Estimation of Disability Weights in the General Population of South Korea Using a Paired Comparison

Abstract

We estimated the disability weights in the South Korean population by using a paired comparison-only model wherein ‘full health’ and ‘being dead’ were included as anchor points, without resorting to a cardinal method, such as person trade-off. The study was conducted via 2 types of survey: a household survey involving computer-assisted face-to-face interviews and a web-based survey (similar to that of the GBD 2010 disability weight study). With regard to the valuation methods, paired comparison, visual analogue scale (VAS), and standard gamble (SG) were used in the household survey, whereas paired comparison and population health equivalence (PHE) were used in the web-based survey. Accordingly, we described a total of 258 health states, with ‘full health’ and ‘being dead’ designated as anchor points. In the analysis, 4 models were considered: a paired comparison-only model; hybrid model between paired comparison and PHE; VAS model; and SG model. A total of 2,728 and 3,188 individuals participated in the household and web-based survey, respectively. The Pearson correlation coefficients of the disability weights of health states between the GBD 2010 study and the current models were 0.802 for Model 2, 0.796 for Model 1, 0.681 for Model 3, and 0.574 for Model 4 (all P-values<0.001). The discrimination of values according to health state severity was most suitable in Model 1. Based on these results, the paired comparison-only model was selected as the best model for estimating disability weights in South Korea, and for maintaining simplicity in the analysis. Thus, disability weights can be more easily estimated by using paired comparison alone, with ‘full health’ and ‘being dead’ as one of the health states. As noted in our study, we believe that additional evidence regarding the universality of disability weight can be observed by using a simplified methodology of estimating disability weights.

A Comparison of Disability Weights for Alcohol Use Disorders

“…The disability weights calculated using the VAS method among the non-AUD respondents (0.44, 0.56 and 0.62 for mild, moderate, and severe AUD, respectively) were comparable with those from a Korean study, which used a pairwise method among the general population (0.47, 0.49 and 0.56). 20 Furthermore, the TTO method in our study elicited disability weights for mild (0.22) and moderate (0.38) AUD, which were similar to those obtained from the pairwise method in the GBD study 4 (0.24 and 0.37); however, the severe AUD disability weight was lower in our study (0.39 vs. 0.57). As different valuation methods were used, it is difficult to explain if the differences were solely because of methodological discrepancy and/or due to the effects of other social and environmental factors.…”

Updating Disability Weights for Measurement of Healthy Life Expectancy and Disability-adjusted Life Year in Korea

“…Although not used in this study, it is also possible to compare EQ-5D's DWs with utility weights. 19 25 Considering these points together, we conclude that ‘Model 2 in Group 1’ has several advantages over others. However, due to the emergence of new diseases, changes in characteristics of the disease, development of new drugs and treatment techniques, and changes in social perspectives on disability, the DWs calculated in the past may not be valid presently, so that it is necessary to evaluate and revise DWs continuously.…”

“…In this context, there is an ongoing effort since 2000 to estimate DW that reflects the unique social and cultural context of Korea. 3 17 18 19 Most DW studies conducted in Korea have targeted people who received medical education to allow more objective and broader assessment of disease characteristics. 3 17 18 Although reflecting preferences of the general population is required for priority setting and rational allocation of limited resources, the general population may have biases about disease status and may not be able to determine the severity of the diseases that are not very well-known.…”

Estimating the disease burden of ME/CFS in the United States and its relation to research funding

“…We derived the disability weight from the adjusted EQ-5D utility score, QoL, based on the assumption that DW = 1 -QoL [28,29]. This results in an estimated disability weight (DW) of 0.44 for ME/CFS.…”

“…The Australian study did not state how the disability weights were computed from the EQ-5D data, and we inferred a conversion formula for the Danish study [28][29]. Either approach could impact the validity of results and the comparability with disease burden estimates in the Saloman 2013 Global Burden of Disease study and ultimately impact the NIH funding analysis.…”