Using the years-of-healthy-life measure to calculate QALYs.
BACKGROUND
The quality-adjusted life year (QALY) is an attractive outcome measure because it captures both health-related quality of life (HRQL) and life expectancy in a single metric. We present a method for calculating QALYs that is simple, utilizes data that are free of charge, and may improve consistency in burden-of-disease investigations.


METHODS
For purposes of illustration, we calculated the burden of disease due to stroke using two abridged life tables, each adjusted for HRQL. The first life table was generated using all-cause mortality and morbidity data (a reference cohort) and the second was generated using all diseases except stroke (a stroke-free cohort). The difference in total QALYs and in quality-adjusted life expectancy (QALE) was determined by subtraction.


RESULTS
Approximately 61,328 (95% CI=60,272, 62,383) QALYs were lost to stroke in the life-table cohort. Stroke is responsible for a decrement of 0.03 years of life expectancy and 0.61 years of QALE in the United States.


CONCLUSIONS
The "years of health life"measure affords a rapid, inexpensive, and sensitive means for estimating the burden of disease for local health priorities and may assist research efforts in including QALYs as an outcome measure.
Muennig
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Robert J. Milano Graduate School, New School University, New York, New York 10011, USA. muennigp@newschool.edu
Gold
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D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006304:Health Status; D006801:Humans; D008017:Life Expectancy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis / Q000401:mortality*; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology