Disability Weights for Pediatric Surgical Procedures: A Systematic Review and Analysis
Corresponding Author
Emily R. Smith
- [email protected]
- +1 919-684-6508
Robbins College of Health and Human Services, Baylor University, Waco, TX, USA
Duke Global Health Institute, Duke University, 310 Trent Drive, 27710 Durham, NC, USA
Tel.: +1 919-684-6508, [email protected]Search for more papers by this authorTessa Concepcion
Duke Global Health Institute, Duke University, 310 Trent Drive, 27710 Durham, NC, USA
Search for more papers by this authorStephanie Lim
Duke University School of Medicine, Durham, NC, USA
Search for more papers by this authorDan Poenaru
Division of Pediatric General and Thoracic Surgery, The Montreal Children’s Hospital, McGill University Health Centre, Montreal, QC, Canada
Search for more papers by this authorAnthony T. Saxton
Duke Global Health Institute, Duke University, 310 Trent Drive, 27710 Durham, NC, USA
Department of Surgery, Duke University Medical Center, Durham, NC, USA
Search for more papers by this authorMark Shrime
Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
Search for more papers by this authorEmmanuel Ameh
Division of Paediatric Surgery, Department of Surgery, National Hospital, Abuja, Nigeria
Search for more papers by this authorHenry E. Rice
Duke Global Health Institute, Duke University, 310 Trent Drive, 27710 Durham, NC, USA
Department of Surgery, Duke University Medical Center, Durham, NC, USA
Search for more papers by this authorGlobal Initiative for Children’s Surgery
Search for more papers by this authorCorresponding Author
Emily R. Smith
- [email protected]
- +1 919-684-6508
Robbins College of Health and Human Services, Baylor University, Waco, TX, USA
Duke Global Health Institute, Duke University, 310 Trent Drive, 27710 Durham, NC, USA
Tel.: +1 919-684-6508, [email protected]Search for more papers by this authorTessa Concepcion
Duke Global Health Institute, Duke University, 310 Trent Drive, 27710 Durham, NC, USA
Search for more papers by this authorStephanie Lim
Duke University School of Medicine, Durham, NC, USA
Search for more papers by this authorDan Poenaru
Division of Pediatric General and Thoracic Surgery, The Montreal Children’s Hospital, McGill University Health Centre, Montreal, QC, Canada
Search for more papers by this authorAnthony T. Saxton
Duke Global Health Institute, Duke University, 310 Trent Drive, 27710 Durham, NC, USA
Department of Surgery, Duke University Medical Center, Durham, NC, USA
Search for more papers by this authorMark Shrime
Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
Search for more papers by this authorEmmanuel Ameh
Division of Paediatric Surgery, Department of Surgery, National Hospital, Abuja, Nigeria
Search for more papers by this authorHenry E. Rice
Duke Global Health Institute, Duke University, 310 Trent Drive, 27710 Durham, NC, USA
Department of Surgery, Duke University Medical Center, Durham, NC, USA
Search for more papers by this authorGlobal Initiative for Children’s Surgery
Search for more papers by this authorElectronic supplementary material: The online version of this article (https://doi.org/10.1007/s00268-018-4537-6) contains supplementary material, which is available to authorized users.
Abstract
Background
Metrics to measure the burden of surgical conditions, such as disability weights (DWs), are poorly defined, particularly for pediatric conditions. To summarize the literature on DWs of children’s surgical conditions, we performed a systematic review of disability weights of pediatric surgical conditions in low- and middle-income countries (LMICs).
Method
For this systematic review, we searched MEDLINE for pediatric surgery cost-effectiveness studies in LMICs, published between January 1, 1996, and April 1, 2017. We also included DWs found in the Global Burden of Disease studies, bibliographies of studies identified in PubMed, or through expert opinion of authors (ES and HR).
Results
Out of 1427 publications, 199 were selected for full-text analysis, and 30 met all eligibility criteria. We identified 194 discrete DWs published for 66 different pediatric surgical conditions. The DWs were primarily derived from the Global Burden of Disease studies (72%). Of the 194 conditions with reported DWs, only 12 reflected pre-surgical severity, and 12 included postsurgical severity. The methodological quality of included studies and DWs for specific conditions varied greatly.
Interpretation
It is essential to accurately measure the burden, cost-effectiveness, and impact of pediatric surgical disease in order to make informed policy decisions. Our results indicate that the existing DWs are inadequate to accurately quantify the burden of pediatric surgical conditions. A wider set of DWs for pediatric surgical conditions needs to be developed, taking into account factors specific to the range and severity of surgical conditions.
Supporting Information
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