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Levels of anchorage
to local data and NBD Results:
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Inputs from the Global
Burden of Disease study (World Bank,
1993; Murray and Lopez, 1996) were used
to generate the minimally anchored NBD
estimates for Andhra Pradesh. The final
results of the first global burden of
disease study were published in 1996 -
GBD96. By the time of this final
revision, causes of death in urban areas
of Maharashtra had been gathered by the
Andhra Pradesh Burden of Disease Study,
to approximate the mortality experience
in urban areas of India. The urban cause
of death data from Maharashtra was
incorporated by the GBD96 study for the
Indian estimates (Murray and Lopez, 1996
p139). In the present study, urban causes
of death data remain the same while rural
causes of death data have been a recent
addition. The GBD96 study also had access
to some preliminary insights from the
pilot study on rural cause of death in
Andhra Pradesh (Murray and Lopez, 1996
p140). Since the GBD96 study already
incorporates a lot of local information
on causes of death, it will be
interesting to look at the first GBD
estimates published in the World
Development Report, 1993 (World Bank,
1993). Call this the WDR93. The WDR93
results used here for comparative
purposes are the results taken for India
directly from the World Development
Report (1993, Appendix B). The GBD96
based estimates have been computed for
Andhra Pradesh using the cause-specific
mortality proportions, incidence, and
duration data for India as used by the
GBD96 study. The GBD96 disability weights
are also used as such. These general
demographic estimates are common inputs
to the GBD96 based estimate and the
intermediately anchored estimates for
Andhra Pradesh. |
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Three intermediately
anchored estimates are presented. The
first one starts with the inputs used for
the GBD96 based estimate, but with the
cause-specific mortality proportions
replaced by local estimates. The local
cause-specific mortality proportions come
from two studies. The rural cause of
death study provided the cause-specific
mortality proportions for the rural
population of Andhra Pradesh. We call
this the cause of death anchored (COD
anchored) estimate. All other inputs are
the same as in case of the GBD96
estimate. The second one starts with
inputs for the COD anchored estimate and
replaces the GBD96 disability weights
with the APHSV-VAS weights. Call this the
HSV-VAS anchored estimate. The third
estimate uses APHSV99-Torrance-TTO
disability weights instead of the
APHSV99-VAS weights. Call this the
HSV-Torrance-TTO estimate. The
epidemiological parameters like
incidence, duration and age at onset,
remain same as in GBD96. The locally
anchored estimates were computed
separately for rural and urban areas of
the state whereas the GBD96 estimate has
been computed for the whole state
population. The WDR93 and GBD96 are the
two minimally anchored estimates. The
three intermediately anchored estimates
comprise of the COD anchored, and the two
HSV anchored estimates. |
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Overview of
Burden of Disease Estimates for
Andhra Pradesh with different
levels of anchorage to local
data.
|
| Estimate |
Anchor
to Local Data |
GBD
Resource |
| WDR93 |
None |
GBD
Regional estimate for India |
| GBD96 |
General
demographic estimates for AP Maharashtra
urban cause of death data
|
Cause-specific
mortality in India
Incidence, age at onset and
duration
Disability weights |
| COD
anchored |
As above,
plus Rural cause of death
data from AP
|
Incidence,
age at onset and duration.
Disability weights |
| HSV-VAS
anchored |
As above,
plus Community-based
health state valuation
|
Incidence,
age at onset and duration |
| HSV-Torrance-TTO
anchored |
As above,
but HSV-VAS disability weights
are transformed using power
function estimated by Torrance
(1976), relating VAS to TTO
valuations. |
As above |
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