Quality Adjusted Life Expectancy Estimates for the US General Population

描述（由申请人提供）：人口健康的准确测量是必要的，以告知政策，制定研究议程，并分配公共资源。该提案旨在利用几个公开可用的数据集来推进质量调整预期寿命（QALE）估计的科学。QALE是美国推荐用于跟踪人口健康的指标。QALE将预期寿命（死亡率）与生活质量（发病率）结合起来。我们组建了一个在生活质量测量（Janel Hanmer，MD，PhD，Rachel Hess，MD，MS，Mark Roberts，MD，MPP），QALE使用（Rachel Hess，MD，MS，Mark Roberts，MD，MPP）以及调查和纵向方法（Janel Hanmer，MD，PhD，Lan Yu，PhD）方面具有经验的研究团队。 用于量化QALE的生活质量的措施被称为健康效用措施。卫生效用措施已被纳入各种调查中，以便对卫生效用进行横截面估计。以前的QALE估计是通过将健康效用的横截面估计与预期寿命相结合来进行的。虽然这种估计数可以从相对较少的数据中计算出来，但这种模式有几个局限性，包括假设年龄和性别分层的健康效用将随着时间的推移而保持不变。 本计画发展一种替代技术，使用来自同一样本的健康效用与预期寿命的联合估计来估计QALE。这种技术有几个理论上的优势，包括：在估计发病率和死亡率从同一个样本的一致性，明确的方法，包括年龄和性别分层的健康效用的变化，包括年龄和队列效应的模型，改进的灵活性修改模型的兴趣亚群（如慢性疾病）。 我们将通过以下具体目标实现这一目标：1：估计美国一般人群HRQoL变化的独立年龄、时期和队列效应。2：为美国一般人群制作年龄和性别分层的10年QALE。3：为美国一般人群的常见健康状况提供10年QALE估计。该项目将使用具有全国代表性的公开数据集，包括国家健康访谈调查，医疗支出小组调查和国家死亡指数。 该项目的结果将提供国家规范性QALE估计值，可与较小的社区和临床样本进行比较。我们将在一个公开的网站上发布我们的最终模型，用户可以输入年龄，性别和健康信息，并获得10年的QALE。将有一个先进版本的计算器，用户可以修改疾病对预期寿命或健康效用的影响。准确的QALE估计将提高研究人员、公共卫生专业人员和政策制定者了解美国人口健康状况以及常见健康状况的相对影响的能力。

DESCRIPTION (provided by applicant): Accurate measurement of population health is necessary to inform policy, set research agendas, and allocate public resources. This proposal is designed to leverage several publicly available datasets to advance the science of Quality Adjusted Life Expectancy (QALE) estimation. QALE is the metric recommended to track population health in the United States. QALE integrates life expectancy (mortality) with quality-of-life (morbidity). We have assembled a research team with experience in quality of life measurement (Janel Hanmer, MD, PhD, Rachel Hess, MD, MS, Mark Roberts, MD, MPP), QALE use (Rachel Hess, MD, MS, Mark Roberts, MD, MPP), and both survey and longitudinal methods (Janel Hanmer, MD, PhD, Lan Yu, PhD). The measures used to quantify quality-of-life for QALE are called health utility measures. Health utility measures have been included in a variety of surveys allowing for cross-sectional estimates of health utility. Previous QALE estimates have been made by combining cross-sectional estimates of health utility with life expectancy. While such estimates can be calculated from relatively few data, such models have several limitations including the assumption that age- and sex-stratified health utility will be static over time. This project develops an alternative technique which uses joint estimation of health utility and life expectancy from the same sample to estimate QALE. This technique has several theoretical advantages including: consistency in estimating morbidity and mortality from the same sample, an explicit method to include changes in age- and sex-stratified health utility by including age and cohort effects in the model, improved flexibility for modifying the model for subpopulations of interest (such as those with chronic disease). We will achieve this goal through the following specific aims: 1: Estimate independent age, period, and cohort effects in HRQoL changes in the US general population. 2: Produce age- and sex-stratified 10-year QALE for the US general population. 3: Produce 10-year QALE estimates for common health conditions in the US general population. This project will use nationally representative publicly available datasets including the National Health Interview Survey, the Medical Expenditures Panel Survey, and the National Death Index. The results of this project will provide national normative QALE estimates to which smaller community and clinical samples can be compared. We will disseminate our final models on a publicly available website where users can input age, sex, and health information and receive 10-year QALE. There will be an advanced version of the calculator where the user can modify the effect of disease on life expectancy or health utility This project will vastly improve the estimates of QALE in the United States. Accurate QALE estimates will improve the ability of researchers, public health professionals, and policy makers to understand the health of the US population as well as the relative impacts of common health conditions.