Cross-national agreement on disability weights: the European Disability Weights Project
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Cross-national agreement on disability weights: the European Disability Weights Project Michaël Schwarzinger*1, Marlies EA Stouthard2, Kristina Burström3, Erik Nord4 and the European Disability Weights Group Address: 1Department of Public Health, Hôpital Henri Mondor, AP-HP, Créteil, France, 2Division of Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands, 3Department of Public Health Sciences, Division of Social Medicine, Karolinska Institute, Stockholm, Sweden and 4National Institute of Public Health, Oslo, Norway Email: Michaël Schwarzinger* - [email protected]; Marlies EA Stouthard - [email protected]; Kristina Burström - [email protected]; Erik Nord - [email protected]; the European Disability Weights Group - [email protected] * Corresponding author
Published: 21 November 2003 Population Health Metrics 2003, 1:9
Received: 13 May 2003 Accepted: 21 November 2003
This article is available from: http://www.pophealthmetrics.com/content/1/1/9 © 2003 Schwarzinger et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
cross-national comparisonoutcome measuresvaluation methodsDisability-Adjusted Life YearsQuality-Adjusted Life Years
Abstract Background: Disability weights represent the relative severity of disease stages to be incorporated in summary measures of population health. The level of agreement on disability weights in Western European countries was investigated with different valuation methods. Methods: Disability weights for fifteen disease stages were elicited empirically in panels of health care professionals or non-health care professionals with an academic background following a strictly standardised procedure. Three valuation methods were used: a visual analogue scale (VAS); the time trade-off technique (TTO); and the person trade-off technique (PTO). Agreement among England, France, the Netherlands, Spain, and Sweden on the three disability weight sets was analysed by means of an intraclass correlation coefficient (ICC) in the framework of generalisability theory. Agreement among the two types of panels was similarly assessed. Results: A total of 232 participants were included. Similar rankings of disease stages across countries were found with all valuation methods. The ICC of country agreement on disability weights ranged from 0.56 [95% CI, 0.52–0.62] with PTO to 0.72 [0.70–0.74] with VAS and 0.72 [0.69–0.75] with TTO. The ICC of agreement between health care professionals and non-health care professionals ranged from 0.64 [0.58–0.68] with PTO to 0.73 [0.71–0.75] with VAS and 0.74 [0.72–0.77] with TTO. Conclusions: Overall, the study supports a reasonably high level of agreement on disability weights in Western European countries with VAS and TTO methods, which focus on individual preferences, but a lowe
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