Research

Cross-national agreement on disability weights: the European Disability Weights Project

Michaël Schwarzinger¹ , Marlies EA Stouthard² , Kristina Burström³ and Erik Nord⁴ for the European Disability Weights Group

¹  Department of Public Health, Hôpital Henri Mondor, AP-HP, Créteil, France

²  Division of Clinical Methods and Public Health, Academic Medical Center, Amsterdam, The Netherlands

³  Department of Public Health Sciences, Division of Social Medicine, Karolinska Institute, Stockholm, Sweden

⁴  National Institute of Public Health, Oslo, Norway

author email corresponding author email

Population Health Metrics 2003, 1:9doi:10.1186/1478-7954-1-9

Published:	21 November 2003

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 lower level of agreement with the PTO method, which focuses more on societal values in resource allocation.