. "4. Comparison of Disease Burdens." New Vaccine Development: Establishing Priorities: Volume II, Diseases of Importance in Developing Countries. Washington, DC: The National Academies Press, 1986.
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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries
TABLE 4.4 Example of an Individual Scheme of Trade-off Values
Trade-Off Values
Morbidity Category
Description
Unit
Under 5 Years
5–14 Years
15–59 Years
60 Years and Over
A
Moderate localized pain and/or mild systemic reaction, or impairment requiring minor change in normal activities, and associated with some restriction of work activity
Days
20,000
15,000
10,000
5,000
B
Moderate pain and/or moderate impairment requiring moderate change in normal activities, e.g., housebound or in bed, and associated with temporary loss of ability to work
Days
10,000
10,000
5,000
500
C
Severe pain, severe short-term impairment, or hospitalization
Days
1,000
500
200
100
D
Mild chronic disability (not requiring hospitalization, institutionalization, or other major limitation of normal activity, and resulting in minor limitation of ability to work)
Cases
100
100
200
200
E
Moderate to severe chronic disability (requiring hospitalization, special care, or other major limitation of normal activity, and seriously restricting ability to work)
Cases
5
5
10
2
F
Total impairment
Cases
1
1
1
2
G
Reproductive impairment resulting in infertility
Cases
5
5
2
100
H
Death
Cases
1
1
1
1
Deaths adjusted for age group
1
0.5
0.3
3
The total score or total disease burden value (TDBV) is then a summation of the subtotals. A sample calculation sheet is shown in Table 4.6.
The views of various individuals on the relative importance of diseases can be compared by ranking diseases based on their TDBVs or by normalizing values so that the highest value represents some arbitrary common number, such as 100.
Prior to presenting the results of the disease burden comparison performed by this committee, some discussion of the method is desirable.
