Disability weights

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Disability weights describe the weights that are given to different diseases in the calculation of disability-adjusted life years (DALY).

Question

What are disability weights for different disases, and how should they be used in calculating burden of disease?

Answer

This code can be used on this page to calculate YLD (years of life under disease). The code can also be copied to another page in Opasnet. It runs on R, so it is also possible to copy and use it outside the Opasnet workspace.

How many cases of disease are there? (#):

What is the duration of disease? (years):

+ Show code

NOTE! Old official WHO disability weights were used in a previous version of this page. The current version uses disability weights from Salomon (Salomon et al., Lancet 2012-2013

[1]).

D↷

Rationale

Data

Disability weights are obtained by posing two different Person Trade-Off (PTO) questions to expert panels

  • Question 1 compares life extensions for disabled and healthy people
  • Question 2 compares cures for illness with extension of life

Ideally, these values should be derived from empirical data among representative populations. Combining the answers to these questions results in an average disability weight. Usually, these weights are presented as a fixed parameter, without a confidence interval or other type of distribution.

Arguments defending this approach include:

  • DALY weights are an intrinsically subjective value for which no "true estimate" exists. They should be treated as a normative value, which does not need further uncertainty intervals.
  • Uncertainty in very small DALY weights (for less severe effects) affects overall outcomes of DALY calculations much more than uncertainty in large disability weights. This is a "flaw" of the method: if health would be defined as 1 and death as 0 (as is being done with QALYs), the more severe outcomes would have more overall uncertainty. The uncertainty is greatest for the smallest disability weights and narrows as more severe weights are attained (figure 5.16

[2] ).This provides a skewed image. In order to avoid this, distributions should not be used. Another solution might be to normalize the weights. D↷

Arguments opposing this approach include:

  • Estimates of DALY weights differ between experts, so this variation should be presented in the overall distribution of these weights.

Including uncertainty intervals of disability weights will probably not affect the ranking of overall disease burden estimates very significantly (WHO GBD study). However, it will affect the confidence interval of individual estimates.



List of data files or sources:

Disability weights

Comment: ICD (ICD-10) codes should be added for indexing/OH 19 May 2009

The previous version of disability weights is archived. The data was from [2] (WHO → GBD → Tools → National tools → NATIONAL BURDEN OF DISEASE SUPPLEMENTARY FILES → Disability weights [xls 313kb]).

Disability weights based on IHME (Salomon et al., Lancet 13 Dec, 2012):

Disability weights(fraction)
ObsDiagnosisWeight
1Infectious disease: acute episode, mild0.005 (0.002-0.011)
2Infectious disease: acute episode, moderate0.053 (0.033-0.081)
3Infectious disease: acute episode, severe0.210 (0.139-0.298)
4Infectious disease: post-acute consequences (fatigue, emotional lability, insomnia)0.254 (0.170-0.355)
5Diarrhoea: mild0.061 (0.036-0.093)
6Diarrhoea: moderate0.202 (0.133-0.299)
7Diarrhoea: severe0.281 (0.184-0.399)
8Epididymo-orchitis0.097 (0.063-0.137)
9Herpes zoster0.061 (0.039-0.094)
10HIV: symptomatic, pre-AIDS0.221 (0.146-0.310)
11HIV/AIDS: receiving antiretroviral treatment0.053 (0.034-0.079)
12AIDS: not receiving antiretroviral treatment0.547 (0.382-0.715)
13Intestinal nematode infections: symptomatic0.030 (0.016-0.048)
14Lymphatic filariasis: symptomatic0.110 (0.073-0.157)
15Ear pain0.018 (0.009-0.031)
16Tuberculosis: without HIV infection0.331 (0.222- 0.450)
17Tuberculosis: with HIV infection0.399 (0.267-0.547)
18Cancer: diagnosis and primary therapy0.294 (0.199-0.411)
19Cancer: metastatic0.484 (0.330-0.643)
20Mastectomy0.038 (0.022-0.059)
21Stoma0.086 (0.055-0.131)
22Terminal phase: with medication (for cancers, end-stage kidney or liver disease)0.508 (0.348-0.670)
23Terminal phase: without medication (for cancers, end-stage kidney or liver disease)0.519 (0.356-0.683)
24Acute myocardial infarction: days 1-20.422 (0.284-0.566)
25Acute myocardial infarction: days 3-280.056 (0.035-0.082)
26Angina pectoris: mild0.037 (0.022-0.058)
27Angina pectoris: moderate0.066 (0.043-0.095)
28Angina pectoris: severe0.167 (0.109-0.234)
29Cardiac conduction disorders and cardiac dysrhythmias0.145 (0.097-0.205)
30Claudication0.016 (0.008-0.028)
31Heart failure: mild0.037 (0.021-0.058)
32Heart failure: moderate0.070 (0.044-0.102)
33Heart failure: severe0.186 (0.128-0.261)
34Stroke: long-term consequences, mild0.021 (0.011-0.037)
35Stroke: long-term consequences, moderate0.076 (0.050-0.110)
36Stroke: long-term consequences, moderate plus cognition problems0.312 (0.211-0.433)
37Stroke: long-term consequences, severe0.539 (0.363-0.705)
38Stroke: long-term consequences, severe plus cognition problems0.567 (0.394-0.738)
39Diabetic foot0.023 (0.012-0.039)
40Diabetic neuropathy0.099 (0.066-0.145)
41Chronic kidney disease (stage IV)0.105 (0.069-0.154)
42End-stage renal disease: with kidney transplant0.027 (0.015-0.043)
43End-stage renal disease: on dialysis0.573 (0.397-0.749)
44Decompensated cirrhosis of the liver0.194 (0.127-0.273)
45Gastric bleeding0.323 (0.214-0.461)
46Crohn's disease or ulcerative colitis0.225 (0.152-0.314)
47Benign prostatic hypertrophy: symptomatic0.070 (0.046-0.102)
48Urinary incontinence0.142 (0.094-0.204)
49Impotence0.019 (0.010-0.034)
50Infertility: primary0.011 (0.005-0.021)
51Infertility: secondary0.006 (0.002-0.013)
52Asthma: controlled0.009 (0.004-0.018)
53Asthma: partially controlled0.027 (0.015-0.045)
54Asthma: uncontrolled0.132 (0.087-0.190)
55COPD and other chronic respiratory diseases: mild0.015 (0.007-0.028)
56COPD and other chronic respiratory diseases: moderate0.192 (0.129-0.271)
57COPD and other chronic respiratory diseases: severe0.383 (0.259-0.528)
58Dementia: mild0.082 (0.055-0.117)
59Dementia: moderate0.346 (0.233-0.475)
60Dementia: severe0.438 (0.299-0.584)
61Headache: migraine0.433 (0.287-0.593)
62Headache: tension-type0.040 (0.025-0.062)
63Multiple sclerosis: mild0.198 (0.137-0.278)
64Multiple sclerosis: moderate0.445 (0.303-0.593)
65Multiple sclerosis: severe0.707 (0.522-0.857)
66Epilepsy: treated, seizure free0.072 (0.047-0.106)
67Epilepsy: treated, with recent seizures0.319 (0.211-0.445)
68Epilepsy: untreated0.420 (0.279-0.572)
69Epilepsy: severe0.657 (0.464-0.827)
70Parkinson's disease: mild0.011 (0.005-0.021)
71Parkinson's disease: moderate0.263 (0.179-0.360)
72Parkinson's disease: severe0.549 (0.383-0.711)
73Alcohol use disorder: mild0.259 (0.176-0.359)
74Alcohol use disorder: moderate0.388 (0.262-0.529)
75Alcohol use disorder: severe0.549 (0.384-0.708)
76Fetal alcohol syndrome: mild0.017 (0.008-0.032)
77Fetal alcohol syndrome: moderate0.057 (0.036-0.087)
78Fetal alcohol syndrome: severe0.177 (0.117-0.255)
79Cannabis dependence0.329 (0.223-0.455)
80Amphetamine dependence0.353 (0.215-0.525)
81Cocaine dependence0.376 (0.235-0.553)
82Heroin and other opioid dependence0.641 (0.459-0.803)
83Anxiety disorders: mild0.030 (0.017-0.048)
84Anxiety disorders: moderate0.149 (0.101-0.210)
85Anxiety disorders: severe0.523 (0.365-0.684)
86Major depressive disorder: mild episode0.159 (0.107-0.223)
87Major depressive disorder: moderate episode0.406 (0.276-0.551)
88Major depressive disorder: severe episode0.655 (0.469-0.816)
89Bipolar disorder: manic episode0.480 (0.323-0.642)
90Bipolar disorder: residual state0.035 (0.021-0.055)
91Schizophrenia: acute state0.756 (0.571-0.894)
92Schizophrenia: residual state0.576 (0.399-0.756)
93Anorexia nervosa0.223 (0.151-0.313)
94Bulimia nervosa0.223 (0.150-0.310)
95Attention-deficit hyperactivity disorder0.049 (0.031-0.074)
96Conduct disorder0.236 (0.154-0.337)
97Asperger's syndrome0.110 (0.073-0.157)
98Autism0.259 (0.177-0.362)
99Intellectual disability: mild0.031 (0.018-0.049)
100Intellectual disability: moderate0.080 (0.053-0.114)
101Intellectual disability: severe0.126 (0.085-0.176)
102Intellectual disability: profound0.157 (0.107-0.221)
103Hearing loss: mild0.005 (0.002-0.012)
104Hearing loss: moderate0.023 (0.013-0.038)
105Hearing loss: severe0.032 (0.018-0.051)
106Hearing loss: profound0.031 (0.018-0.049)
107Hearing loss: complete0.033 (0.020-0.052)
108Hearing loss: mild, with ringing0.038 (0.024-0.058)
109Hearing loss: moderate, with ringing0.058 (0.037-0.085)
110Hearing loss: severe, with ringing0.065 (0.041-0.094)
111Hearing loss: profound, with ringing0.088 (0.058-0.127)
112Hearing loss: complete, with ringing0.092 (0.061-0.134)
113Distance vision: mild impairment0.004 (0.001-0.010)
114Distance vision: moderate impairment0.033 (0.020-0.052)
115Distance vision: severe impairment0.191 (0.129-0.269)
116Distance vision blindness0.195 (0.132-0.272)
117Near vision impairment0.013 (0.006-0.024)
118Low back pain: acute, without leg pain0.269 (0.184-0.373)
119Low back pain: acute, with leg pain0.322 (0.219-0.447)
120Low back pain: chronic, without leg pain0.366 (0.248-0.499)
121Low back pain: chronic, with leg pain0.374 (0.252-0.506)
122Neck pain: acute, mild0.040 (0.023-0.064)
123Neck pain: acute, severe0.221 (0.150-0.305)
124Neck pain: chronic, mild0.101 (0.067-0.149)
125Neck pain: chronic, severe0.286 (0.197-0.398)
126Musculoskeletal problems: legs, mild0.023 (0.013-0.039)
127Musculoskeletal problems: legs, moderate0.079 (0.053-0.115)
128Musculoskeletal problems: legs, severe0.171 (0.117-0.240)
129Musculoskeletal problems: arms, mild0.024 (0.014-0.041)
130Musculoskeletal problems: arms, moderate0.114 (0.077-0.159)
131Musculoskeletal problems: generalised, moderate0.292 (0.197-0.410)
132Musculoskeletal problems: generalised, severe0.606 (0.421-0.771)
133Gout: acute0.293 (0.198-0.404)
134Amputation of finger(s), excluding thumb: long term, with treatment0.030 (0.018-0.048)
135Amputation of thumb: long term0.013 (0.006-0.025)
136Amputation of one arm: long term, with or without treatment0.130 (0.088-0.185)
137Amputation of both arms: long term, with treatment0.044 (0.028-0.067)
138Amputation of both arms: long term, without treatment0.359 (0.242-0.497)
139Amputation of toe0.008 (0.003-0.017)
140Amputation of one leg: long term, withtreatment0.021 (0.011-0.035)
141Amputation of one leg: long term, without treatment0.164 (0.111-0.229)
142Amputation of both legs: long term, with treatment0.051 (0.032-0.076)
143Amputation of both legs: long term, without treatment0.494 (0.341-0.654)
144Burns of <20% total surface area without lower airway burns: short term, with or without treatment0.096 (0.062-0.140)
145Burns of <20% total surface area or <10% total surface area if head or neck, or hands or wrist involved: long term, with or without treatment0.018 (0.010-0.032)
146Burns of ≥20% total surface area: short term, with or without treatment0.333 (0.220-0.472)
147Burns of ≥20% total surface area or ≥10% total surface area if head or neck, or hands or wrist involved: long term, with treatment0.127 (0.086-0.183)
148Burns of ≥20% total surface area or ≥10% total surface area if head or neck, or hands or wrist involved: long term, without treatment0.438 (0.298-0.588)
149Lower airway burns: with or without treatment0.373 (0.248-0.521)
150Crush injury: short or long term, with or without treatment0.145 (0.093-0.211)
151Dislocation of hip: long term, with or without treatment0.017 (0.008-0.030)
152Dislocation of knee: long term, with or without treatment0.129 (0.087-0.178)
153Dislocation of shoulder: long term, with or without treatment0.080 (0.053-0.116)
154Other injuries of muscle and tendon (includes sprains, strains, and dislocations other than shoulder, knee, or hip)0.009 (0.004-0.018)
155Drowning and non-fatal submersion: short or long term, with or without treatment0.288 (0.191-0.403)
156Fracture of clavicle, scapula, or humerus: short or long term, with or without treatment0.053 (0.033-0.080)
157Fracture of face bone: short or long term, with or without treatment0.173 (0.111- 0.257)
158Fracture of foot bones: short term, with or without treatment0.033 (0.019-0.053)
159Fracture of foot bones: long term, without treatment0.033 (0.019-0.052)
160Fracture of hand: short term, with or without treatment0.025 (0.013-0.043)
161Fracture of hand: long term, without treatment0.016 (0.008-0.028)
162Fracture of neck of femur: short term, with or without treatment0.308 (0.205-0.439)
163Fracture of neck of femur: long term, with treatment0.072 (0.047-0.105)
164Fracture of neck of femur: long term, without treatment0.388 (0.261-0.532)
165Fracture other than neck of femur: short term, with or without treatment0.192 (0.121-0.280)
166Fracture other than neck of femur: long term, without treatment0.053 (0.035-0.079)
167Fracture of patella, tibia or fibula, or ankle: short term, with or without treatment0.087 (0.055-0.127)
168Fracture of patella, tibia or fibula, or ankle: long term, with or without treatment0.070 (0.047-0.102)
169Fracture of pelvis: short term0.390 (0.257-0.545)
170Fracture of pelvis: long term0.194 (0.132-0.272)
171Fracture of radius or ulna: short term, with or without treatment0.065 (0.040-0.101)
172Fracture of radius or ulna: long term, without treatment0.050 (0.032-0.075)
173Fracture of skull: short or long term, with or without treatment0.073 (0.046-0.109)
174Fracture of sternum or fracture of one or two ribs: short term, with or without treatment0.150 (0.098-0.215)
175Fracture of vertebral column: short or long term, with or without treatment0.132 (0.085-0.195)
176Fractures: treated, long term0.003 (0.001-0.008)
177Injured nerves: short term0.065 (0.040-0.096)
178Injured nerves: long term0.136 (0.092-0.189)
179Injury to eyes: short term0.079 (0.050-0.118)
180Severe traumatic brain injury: short term, with or without treatment0.235 (0.156-0.331)
181Traumatic brain injury: long-term consequences, minor, with or without treatment0.106 (0.072-0.147)
182Traumatic brain injury: long-term consequences, moderate, with or without treatment0.224 (0.153-0.314)
183Traumatic brain injury: long-term consequences, severe, with or without treatment0.625 (0.444-0.789)
184Open wound: short term, with or without treatment0.005 (0.002-0.013)
185Poisoning: short term, with or without treatment0.171 (0.116-0.239)
186Severe chest injury: long term, with or without treatment0.056 (0.036-0.082)
187Severe chest injury: short term, with or without treatment0.352 (0.229-0.484)
188Spinal cord lesion below neck: treated0.047 (0.029-0.072)
189Spinal cord lesion below neck: untreated0.440 (0.290-0.588)
190Spinal cord lesion at neck: treated0.369 (0.243-0.513)
191Spinal cord lesion at neck: untreated0.673 (0.475-0.837)
192Abdominopelvic problem: mild0.012 (0.005-0.023)
193Abdominopelvic problem: moderate0.123 (0.083-0.176)
194Abdominopelvic problem: severe0.326 (0.219-0.451)
195Anaemia: mild0.005 (0.002-0.011)
196Anaemia: moderate0.058 (0.038-0.086)
197Anaemia: severe0.164 (0.112-0.228)
198Periodontitis0.008 (0.003-0.017)
199Dental caries: symptomatic0.012 (0.005-0.023)
200Severe tooth loss0.072 (0.048-0.103)
201Disfigurement: level 10.013 (0.006-0.025)
202Disfigurement: level 20.072 (0.048-0.103)
203Disfigurement: level 30.398 (0.271-0.543)
204Disfigurement: level 1 with itch or pain0.029 (0.016-0.048)
205Disfigurement: level 2, with itch or pain0.187 (0.125-0.264)
206Disfigurement: level 3, with itch or pain0.562 (0.394-0.725)
207Generic uncomplicated disease: worry and daily medication0.031 (0.017-0.050)
208Generic uncomplicated disease: anxiety about diagnosis0.054 (0.033-0.082)
209Iodine-deficiency goitre0.200 (0.134-0.283)
210Kwashiorkor0.055 (0.033-0.085)
211Severe wasting0.127 (0.081-0.183)
212Speech problems0.054 (0.034-0.081)
213Motor impairment: mild0.012 (0.005-0.022)
214Motor impairment: moderate0.076 (0.050-0.109)
215Motor impairment: severe0.377 (0.251-0.518)
216Motor plus cognitive impairments: mild0.054 (0.033-0.084)
217Motor plus cognitive impairments: moderate0.221 (0.141-0.314)
218Motor plus cognitive impairments: severe0.425 (0.286-0.587)
219Rectovaginal fistula0.492 (0.330-0.660)
220Vesicovaginal fistula0.338 (0.228-0.467)

See also

  • Global Burden of Disease Study
  • Disability-adjusted life years
  • Disability-adjusted life year in Wikipedia
  • WHO report describing DALYs and presents disability weights: Murray CJL, Lopez AD, eds. 1996. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge, Harvard School of Public Health on behalf of the World Health Organization and the World Bank.
  • An update of the disability weights [3]
  • Data by regions (European), for example YLD (years of life lived with the disease) [4]
  • Dutch disability weights [5] (Available only in Dutch)
  • Severity weights for noise outcomes

References

  1. Salomon JA, Vos T, Hogan DR, Gagnon M, Naghavi M et al. Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010. Lancet. 2013 Dec 15;380(9859):2129-43. doi:10.1016/S0140-6736(12)61680-8 .
  2. Colin D. Mathers, Joshua A. Salomon, Majid Ezzati, Stephen Begg, Stephen Vander Hoorn, and Alan D. Lopez, "Sensitivity and Uncertainty Analyses for Burden of Disease and Risk Factor Estimates." 2006. Global Burden of Disease and Risk Factors,ed. , 399-426. New York: Oxford University Press. DOI: 10.1596/978-0-8213-6262-4/Chpt-5.