AUTHOR=Lobo Eunice , Nanda Lipika , Akhouri Shuchi Sree , Shrivastava Chandni , Ronghang Roshan , Menon Geetha R. , Dutta Ambarish 

TITLE=Describing the Development of a Health State Valuation Protocol to Obtain Community-Derived Disability Weights

JOURNAL=Frontiers in Public Health

VOLUME=Volume 7 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2019.00276

DOI=10.3389/fpubh.2019.00276

ISSN=2296-2565

ABSTRACT=For prioritization allocation of national resources, estimating burden of disease studies play a critical role. Hence the first Global Burden of Disease study conducted in 1990s was done for this particular estimation. By means of introducing disability-adjusted life year (DALY) metric, burden of various diseases was calculated using disability weights (DWs) – a component of DALY. DWs are actually values that capture individual’s perception regarding the severity of diseases that involves valuation tools and health state descriptions. 
 Various studies have been conducted over the past few decades to valuate health states and derive disease-specific disability weights using Person-Trade off, Time-trade off etc. However, use of these complex and cognitively demanding methods has been carried out in developed countries, where the bulk of the populace is more educated. Few attempts have been made in low and middle income countries as India, where not only the majority is less educated but also the social construct of diseases and health conditions are diverse.  Therefore, due to absence of methodological protocols of health state valuations for application at the community-level in the developing world, we attempted to systematically describe the procedure that can be used universally and cross-culturally for various health states. We began with the tentative selection of health states and health states valuation methods by conducting a meticulous literature review, followed by community exploration and medical consultations. This lead to developing vignettes (clinical description) and 6D5L pictorial narrations (functional status description). Two field tests for checking the usability and refinement of the tools was done. Final consultation by an expert panel comprising of medical and non-medical professionals was held/conducted to finalize the health state labels and functional status profiles of each health state. The methodical approach provides a robust and thorough procedure for guiding researchers to implement health state valuation studies at community level.