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Disability Weights for Pediatric Surgical Procedures: A Systematic Review and Analysis

Emily R Smith1,2, Tessa Concepcion3, Stephanie Lim4

  • 1Robbins College of Health and Human Services, Baylor University, Waco, TX, USA. emily.smith1@duke.edu.

World Journal of Surgery
|February 15, 2018
PubMed

Insights

Disability weights (DWs) for pediatric surgical conditions are poorly defined, especially in low- and middle-income countries (LMICs). Existing DWs are inadequate for accurately measuring the burden of these conditions, necessitating the development of new metrics.

Area of Science:

  • Global Health
  • Pediatric Surgery
  • Health Economics

Background:

  • Disability weights (DWs) are crucial for measuring the burden of disease, but are poorly defined for pediatric surgical conditions.
  • Accurate metrics are needed to assess the cost-effectiveness and impact of pediatric surgical interventions in low- and middle-income countries (LMICs).

Purpose of the Study:

  • To systematically review existing disability weights (DWs) for pediatric surgical conditions in LMICs.
  • To evaluate the adequacy of current DWs for quantifying the burden of pediatric surgical disease.

Main Methods:

  • Systematic literature search of MEDLINE for pediatric surgery cost-effectiveness studies in LMICs (1996-2017).
  • Inclusion of DWs from Global Burden of Disease studies, bibliographies, and expert opinion.
  • Analysis of 194 discrete DWs for 66 pediatric surgical conditions.

Main Results:

  • The Global Burden of Disease studies were the primary source of DWs (72%).
  • Only a small fraction of reported DWs reflected pre- (12) or post-surgical (12) severity.
  • Significant variation in methodological quality was observed among included studies and DWs.

Conclusions:

  • Existing disability weights are insufficient for accurately quantifying the burden of pediatric surgical conditions.
  • Development of a comprehensive set of DWs is needed, considering pediatric-specific factors and disease severity.
  • Improved metrics are essential for informed policy decisions regarding pediatric surgical care in LMICs.
Abstract

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