Showing papers by "Juanita A. Haagsma published in 2014"

The global burden of listeriosis: A systematic review and meta-analysis

Abstract: Summary Background Listeriosis, caused by Listeria monocytogenes , is an important foodborne disease that can be difficult to control and commonly results in severe clinical outcomes. We aimed to provide the first estimates of global numbers of illnesses, deaths, and disability-adjusted life-years (DALYs) due to listeriosis, by synthesising information and knowledge through a systematic review. Methods We retrieved data on listeriosis through a systematic review of peer-reviewed and grey literature (published in 1990–2012). We excluded incidence data from before 1990 from the analysis. We reviewed national surveillance data where available. We did a multilevel meta-analysis to impute missing country-specific listeriosis incidence rates. We used a meta-regression to calculate the proportions of health states, and a Monte Carlo simulation to generate DALYs by WHO subregion. Findings We screened 11 722 references and identified 87 eligible studies containing listeriosis data for inclusion in the meta-analyses. We estimated that, in 2010, listeriosis resulted in 23 150 illnesses (95% credible interval 6061–91 247), 5463 deaths (1401–21 497), and 172 823 DALYs (44 079–676 465). The proportion of perinatal cases was 20·7% (SD 1·7). Interpretation Our quantification of the global burden of listeriosis will enable international prioritisation exercises. The number of DALYs due to listeriosis was lower than those due to congenital toxoplasmosis but accords with those due to echinococcosis. Urgent efforts are needed to fill the missing data in developing countries. We were unable to identify incidence data for the AFRO, EMRO, and SEARO WHO regions. Funding WHO Foodborne Diseases Epidemiology Reference Group and the Universite catholique de Louvain.

Calculating disability-adjusted life years to quantify burden of disease

Abstract: The disability-adjusted life year or DALY is a summary measure of public health widely used to quantify burden of disease. In the DALY philosophy, every person is born with a certain number of life years potentially lived in optimal health. People may lose these healthy life years through living with illness and/or through dying before a reference life expectancy. These losses in healthy life years are exactly what is measured by the DALY metric. Ten DALYs, for instance, correspond to ten lost years of healthy life, attributable to morbidity, mortality, or both. On a population level, diseases with a higher public health impact will thus account for more DALYs than those with a lesser impact. DALYs have been the key measure in the four Global Burden of Disease (GBD) studies, each presenting a comprehensive assessment of the worldwide health impact of disease, injury and risk factors (Murray and Lopez 1996; Lopez et al. 2006; World Health Organization 2008; Murray et al. 2013a; Lopez 2013). Table 1 shows the most important diseases according to the different GBD studies. Furthermore, various national and regional DALY calculations have been performed to assess and monitor local health and to set priorities within the local health sector (e.g., Melse et al. 2000; Mathers et al. 2001; Devleesschauwer et al. 2013; Shield et al. 2013). In this Hints and Kinks paper, we summarize the DALY’s basic features and present a description of its calculation. An ‘‘Appendix’’ includes R code to calculate DALYs. The

DALY calculation in practice: A stepwise approach

Abstract: disability weight ð1Þ YLL 1⁄4 Number of deaths life expectancy at the age of death ð2Þ DALY 1⁄4 YLD þ YLL ð3Þ The philosophical and methodological aspects of the DALY calculation have been described (and debated) in great detail (Murray 1994; Murray and Acharya 1997; for critiques, see, amongst others, Anand and Hanson 1997), and are summarized in the accompanying Hints and Kinks paper (Devleesschauwer et al. 2014). The steps preceding the actual calculation, however, remain less well documented. This Hints and Kinks paper tries to address this gap by presenting a stepwise approach towards a DALY calculation.

Traumatic brain injury in the netherlands: Incidence, costs and disability-adjusted life years

Abstract: Objective: Traumatic brain injury (TBI) is a major cause of death and disability, leading to great personal suffering and huge costs to society. Integrated knowledge on epidemiology, economic consequences and disease burden of TBI is scarce but essential for optimizing healthcare policy and preventing TBI. This study aimed to estimate incidence, cost-of-illness and disability-adjusted life years (DALYs) of TBI in the Netherlands.Methods: This study included data on all TBI patients who were treated at an Emergency Department (ED - National Injury Surveillance System), hospitalized (National Medical Registration), or died due to their injuries in the Netherlands between 2010-2012. Direct healthcare costs and indirect costs were determined using the incidence-based Dutch Burden of Injury Model. Disease burden was assessed by calculating years of life lost (YLL) owing to premature death, years lived with disability (YLD) and DALYs. Incidence, costs and disease burden were stratified by age and gender.Results: TBI incidence was 213.6 per 100,000 person years. Total costs were J314.6 (USD 433.8) million per year and disease burden resulted in 171,200 DALYs (on average 7.1 DALYs per case). Men had highest mean costs per case (J19,540 versus J14,940), driven by indirect costs. 0-24-year-olds had high incidence and disease burden but low economic costs, whereas 25-64-year-olds had relatively low incidence but high economic costs. Patients aged 65 + had highest incidence, leading to considerable direct healthcare costs. 0-24-year-olds, men aged 25-64 years, traffic injury victims (especially bicyclists) and home and leisure injury victims (especially 0-5-year-old and elderly fallers) are identified as risk groups in TBI.Conclusions: The economic and health consequences of TBI are substantial. The integrated approach of assessing incidence, costs and disease burden enables detection of important risk groups in TBI, development of prevention programs that target these risk groups and assessment of the benefits of these programs. These authors have no support or funding to report.

Review of disability weight studies: comparison of methodological choices and values

Abstract: The disability-adjusted life year (DALY) is widely used to assess the burden of different health problems and risk factors. The disability weight, a value anchored between 0 (perfect health) and 1 (equivalent to death), is necessary to estimate the disability component (years lived with disability, YLDs) of the DALY. After publication of the ground-breaking Global Burden of Disease (GBD) 1996, alternative sets of disability weights have been developed over the past 16 years, each using different approaches with regards to the panel, health state description, and valuation methods. The objective of this study was to review all studies that developed disability weights and to critically assess the methodological design choices (health state and time description, panel composition, and valuation method). Furthermore, disability weights of eight specific conditions were compared. Disability weights studies (1990-2012) in international peer-reviewed journals and grey literature were identified with main inclusion criteria being that the study assessed DALY disability weights for several conditions or a specific group of illnesses. Studies were collated by design and methods and evaluation of results. Twenty-two studies met the inclusion criteria of our review. There is considerable variation in methods used to derive disability weights, although most studies used a disease-specific description of the health state, a panel that consisted of medical experts, and nonpreference-based valuation method to assess the values for the majority of the disability weights. Comparisons of disability weights across 15 specific disease and injury groups showed that the subdivision of a disease into separate health states (stages) differed markedly across studies. Additionally, weights for similar health states differed, particularly in the case of mild diseases, for which the disability weight differed by a factor of two or more. In terms of comparability of the resulting YLDs, the global use of the same set of disability weights has advantages, though practical constraints and intercultural differences should be taken into account into such a set.

Health-related quality of life after upper extremity injuries and predictors for suboptimal outcome

Abstract: Purpose The purpose of this study was to examine the impact of upper extremity injuries (UEIs) on health-related quality of life (HRQoL) in adult patients compared with victims of other types of injuries and with the general population, in order to establish recovery patterns of different types of UEIs and determine predictors for suboptimal outcome in the long term. Methods Data were obtained from the Dutch Injury Surveillance System, from the National Hospital Discharge Registry, and from a patient follow-up survey. A total of 608 patients (aged ≥18 years) with an UEI were included. The main outcome measure was HRQoL measured at 2.5, 5, 9 and 24 months after UEI according to the EuroQol-5D (EQ-5D). The predictors for the suboptimal outcome were examined by multivariate linear regression analyses. Results For non-hospitalized UEI patients, a substantial loss in HRQoL was observed after 2.5 months which improved to the level of the general population norms by 24 months. For hospitalized UEI patients, HRQoL improved from 2.5 to 24 months but remained far below population norms. The more proximal UEI had a lower HRQoL and a slower recovery of HRQoL than distal injuries. At all time points, the proportion of UEI patients with limitations on the health domains self-care, usual activities and complaints of pain and/or discomfort was higher than in the group of all injuries. Female gender, higher age, low educational level, co-morbidity, shoulder or upper arm injury, multiple injuries and hospitalization are independent predictors for long-term loss in HRQoL. Conclusions The impact of UEI exceeds the health consequences of the group with all injuries, for both non-hospitalized and hospitalized patients. The presence of UEI substantially reduces HRQoL in the short and long term, mainly due to limitations on the health domains self-care, usual activities and complaints of pain and/or discomfort. Clinical relevance The impact of UEIs on HRQoL exceeds the health consequences of the group with all injuries. Proximal UEIs had a lower HRQoL and slower recovery than distal injuries. The predictors for the outcome on specific UEIs need to be further investigated in clinical studies, to understand how these differences affect patient-reported outcome measures. These data provide additional insight into treatment outcome and are needed to improve quality of care.

Health-related quality of life in patients with melanoma expressed as utilities and disability weights

Abstract: BACKGROUND: Few studies about health-related quality of life (HRQoL) in patients with melanoma have expressed their results in terms of utilities or disability weights (DWs). Utilities are required for calculating quality-adjusted life years and therefore for cost-effectiveness analyses. DWs are useful to assess the burden of diseases through disability-adjusted life years. OBJECTIVES: To provide utilities and DWs regarding patients with melanoma. METHODS: The patients were classified into eight groups using four stages based on the 2009 American Joint Committee on Cancer stages, with each stage subdivided into treatment and remission phases. The EuroQoL Five Dimensions Five Levels (EQ-5D-5L) questionnaire was completed by the patients with melanoma to provide a mean utility for each group. In addition to this, the EuroQoL visual analogue scale (VAS) and a validated quality-of-life questionnaire dedicated to patients with melanoma [Functional Assessment of Cancer Therapy Melanoma (FACT-M)] were completed by the same patients in order to compare their results with the obtained utilities. DWs were obtained by calculating, for each patient, the difference between his/her utility and the corresponding sex- and age-specific population norm. RESULTS: A total of 395 questionnaire sets were completed. Utilities and DWs showed significant differences between follow-up groups. Treatment groups had similar utilities and DWs but these results were obtained during different treatment durations and therefore have different weights. The VAS and the FACT-M were found to be less sensitive. Nevertheless, the FACT-M identified some problems not found by the EQ-5D-5L questionnaire. CONCLUSIONS: The EQ-5D-5L questionnaire seems adequate to provide utilities and DWs in patients with melanoma. Lower HRQoL in female patients with melanoma is probably linked to lower HRQoL in the general population.

Psychoactive substance (drugs and alcohol) use by Emergency Department patients before injury.

Abstract: OBJECTIVE: The aim of this study was to determine the prevalence and risk factors of alcohol, medication and illicit drug use before accidents in Emergency Department (ED)-treated trauma victims with internationally recommended methods to minimize registration bias. PATIENTS AND METHODS: The study design was cross-sectional and was carried out at Erasmus Medical Centre in Rotterdam. Alcohol, psychoactive medication and illicit drug use were assessed in an interview by an independent researcher on the basis of the standardized WHO questionnaire. During 84 shifts, covering 4 weeks 24/7, data on a comprehensive population of ED-treated injury patients were collected prospectively. RESULTS: A total of 475 patients were included (response rate 87%). The prevalence of alcohol intoxication (defined as ≥3 U alcohol) before trauma was 19%. Alcohol-intoxicated trauma patients were significantly more often men [odds ratio (OR) 2.88, 95% confidence interval (CI) 1.54-5.40], of Dutch descent (native) (OR 2.26, 95% CI 1.24-4.13), unemployed or students (OR 1.77, 95% CI 1.03-3.04), and alcohol intoxication decreased with age (OR 0.98, 95% CI 0.96-0.99). Psychoactive medication was used by 7% of ED trauma patients; increasing age (OR 1.05, 95% CI 1.03-1.07) and living alone (OR 2.4, 95% CI 1.04-5.52) were risk factors. Illicit drugs were used by 4% of trauma patients. Overall, 27% of patients were under the influence of at least one psychoactive substance. CONCLUSION: Over a quarter of trauma patients visiting the ED had used alcohol, psychoactive medication and/or illicit drugs before their accident. By far, the majority of intoxications before trauma were because of alcohol (19%). We found higher prevalence rates of alcohol intoxication and lower prevalence rates for illicit drug use than others. Because of our comprehensive approach and high response rates, registration bias was minimized.