Disability Weights Measurement for 17 Diseases in Japan: A Survey Based on Medical Professionals

When judging a population’s health to determine disability-adjusted life years, disability weight is a tool for measuring the severity of disability caused by a disease. However, previous studies have pointed out that surveys targeting ordinary citizens produce unclear disability weight values. Therefore, in an attempt to obtain clearer estimations, we conduct a paper-based questionnaire survey of medical professionals—nurses with over ten years of experience—believed to have extensive knowledge of diseases and experience in patient care. We find that disability weight estimations based on the survey of medical professionals presents higher values than those based on a survey of ordinary citizens using the same estimation approach, especially for non-terminal-stage diseases. This suggests that medical-professionals-based surveys may correct the underestimated disability weights of non-terminal diseases (e.g., early stage of cancers and mellitus) found through ordinary-citizens-based surveys. Moreover, we illustrate that depressive disorder and early-stage cancers have almost the same health loss since their disability weights are similar. While regulating policy, it is recommended that more attention be paid to non-terminal diseases and depression

Influences of the absence of random assignment of bids on estimating willingness to pay using a discrete-choice question

This study examined the influences of the interaction between a bid and the respondent's characteristics due to insufficient random assignment of bids on the estimation of willingness to pay (WTP) using data from a discrete-choice question. A contingent valuation survey of 152 examinees undergoing X-ray testing for gastric cancer screening was conducted, and the median and mean WTP for the serum pepsinogen test were estimated using a logistic regression model to which the interaction terms between the bid and the respondent's characteristics, which included gender, age, annual income, frequency of prior use of a gastric cancer screening program, and perceived health, were added. There were remarkable differences in the estimated WTP according to whether the interaction term of annual income, to which the bids had failed to be assigned randomly and which had been positively correlated with the bid, was added in the model. It is suggested that it may be necessary to check if the bids were randomly assigned to the respondent's characteristics and, when correlations with the bid are found, to adjust their interaction effects. Copyright © 2004 John Wiley & Sons, Ltd.

Sex differences in predictive factors for onset of type 2 diabetes in Japanese individuals: A 15‐year follow‐up study

Abstract Aims/Introduction The increase in the number of patients with type 2 diabetes mellitus is an important concern worldwide. The goal of this study was to investigate factors involved in the onset of type 2 diabetes mellitus, and sex differences in long‐term follow up of people with normal glucose tolerance. Materials and Methods Of 1,309 individuals who underwent screening at our facility in 2004, 748 individuals without diabetes were enrolled. Correlations of metabolic markers including serum adiponectin (APN) with onset of type 2 diabetes mellitus were examined over 15 years in these individuals. Results The Kaplan–Meier curve for onset of type 2 diabetes mellitus for 15 years in the decreased APN group was examined. Hazard ratios for the APN concentration for onset of diabetes were 1.78 (95% confidence interval [CI] 1.20–2.63, P = 0.004) in all participants, 1.48 (95% CI 0.96–2.29, P = 0.078) for men and 3.01 (95% CI 1.37–6.59, P = 0.006) for women. During the follow‐up period of 15 years, body mass index, estimated glomerular filtration rate, fatty liver, C‐reactive protein and alanine aminotransferase in men were significant in univariate analysis, but only estimated glomerular filtration rate and fatty liver were significantly related to onset of type 2 diabetes mellitus in multivariate analysis. In women, body mass index, systolic blood pressure, triglyceride, fatty liver and APN were significant in univariate analysis, and APN was the only significant risk factor in multivariate analysis (P < 0.05). Conclusions There are differences between men and women with regard to targets for intervention to prevent the onset of type 2 diabetes mellitus. Individuals requiring intensive intervention should be selected with this finding to maximize the use of limited social and economic resources