Population Health Impact of Disease in Canada (PHI)

Preliminary results for diabetes

• How the estimates were derived
• Health state descriptions and classifications
• Preference scores

How the estimates were derived

A series of health states related to diabetes was identified and the effects of each were described using peer-reviewed literature and expert review. This information was used to create standardized classifications of functional limitations, a series of numbers that represent the level of severity for each of 11 attributes that span physical, mental, and social health. The Classification and Measurement System of Functional Health comprises 11 attributes with four or five levels each for this purpose.

The classification for each health state was then transformed into a global score using a statistical function. The function is based on observed values obtained from lay Canadians.

These preference scores were then integrated with epidemiologic information about the number of cases and duration of each health state related to a particular type of cancer. This provides an estimate of the morbidity, which was then combined with an estimate of mortality to calculate the total impact for each type of cancer.

This information will be synthesized in structured workbooks that calculated health-adjusted life years lost for each type of diabetes and the proportion of them that can be attributed to various risk factors.

Health state descriptions and classifications

The following classifications will be used in the calculation of HALYs and PAFs.

Detailed information and related products

Table 1 Classification of health states related to diabetes

How to read the classification

Core attribute and level Health state PD PF ES FA MT SR Health states for diabetes Type 1 diabetes, chronic, uncomplicated 2 1 2 2 1 2 Type 2 diabetes, chronic, uncomplicated 2 1 1 2 1 1 Gestational diabetes 2 1 1 2 1 1 Sequelae Diabetic retinopathy, chronic, proliferative and non-proliferative 2 3 3 2 1 2 Diabetic neuropathy, chronic 3 3 2 2 1 2 Diabetic foot, chronic 3 3 1 2 1 2

Supplementary attribute and level Health state AN SP HE VI HF Health states for diabetes Type 1 diabetes, chronic, uncomplicated 2 1 1 1 1 Type 2 diabetes, chronic, uncomplicated 2 1 1 1 1 Gestational diabetes 3 1 1 1 1 Sequelae Diabetic retinopathy, chronic, proliferative and non-proliferative 3 1 1 3 1 Diabetic neuropathy, chronic 2 1 1 1 2 Diabetic foot, chronic 3 1 1 1 1

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Preference scores

The following preference scores were developed from these classifications. A scoring function was used to transform the classification into a single number. They will be used in the calculation of the HALYs and PAFs.

Table 2 Preference scores for diabetes

Health states for diabetes Type 1 diabetes, chronic, uncomplicated 0.961 Type 2 diabetes, chronic, uncomplicated 0.961 Gestational diabetes 0.958     Sequelae Diabetic retinopathy, chronic, proliferative and non-proliferative 0.752 Diabetic neuropathy, chronic 0.868 Diabetic foot, chronic 0.874

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