Disability-adjusted Life Years In Applied Research, Adverse Drug Reactions Harm In The Degree Of Quantitative Evaluation

Objectives:This study aims to employ DALYs to analyze hazard of ADR, taking Shuanghuanglian injection as an example. At the same time, severity index of ADR(SIADR) is used as an comparison to explore the science and feasibility of employing DALYs to evaluate hazard of ADR.Methods:literature retrieval is used to collect ADR cases of Shuanghuanglian injection, then DALYs and SIADR are employed to analyze the hazard degree of these ADR cases. And then, the analysis results of the two research methods are compared by relevant statistical methods, such as Kappa consistency check.Results:Through literature retrieval,520 ADR cases of Shuanghuanglian injection are collected. And then DALYs is employed to analyze the hazard degree of these ADR cases quantitively. As a result, years of life lost and lived with disability amount to 313.51(a), including 143.75(a) of male cases and 169.76(a) of female cases. And the average loss of healthy life years reach to 0.6 (a) per case, among which the average loss of male and female adds respectively up to 0.49(a) and 0.75(a). According to statistical analysis, there is some difference between the male and female average loss of healthy life years. Since the median of female DALYs is higher than the one of male DALYs, we can conclude that Shuanghuanglian injection ADR causes more harm to womman than to man. Meanwhile, there is also some difference between average loss of healthy life years of various age groups. Through the difference analysis, we can also conclude that the ADR harm degree of 45～59 age group is the hightest and the one of 30-44 age group is second. On the other hand, when SIADR is used to evaluate the harm degree of the ADR cases, the overall severity index is 2.64, while SIADR of male and female group are respectively 2.68 and 2.60. However, through the difference analysis, there is no apparent difference between the harm degree caused by Shuanghuanglian injection ADR to man and woman. But, various age groups differ in the harm degree, showing that 60～69 age group is the hightest and 45～59 age group is second.Conclusion:Through Kappa consistency check, the two methods lead to different results. The reasons may be related to the limitations of the SIADR method, such as:(1) The ADR classification of WHO has its limitations; (2) The method is still semi-quantitative, which involves more or less subjectivity so that the ADR harm degree is hard to be Objectively assessed; (3) The index actually only refer to severity of ADR, without taking in account of incidence, which necessarily result in some one-sidedness. Also, the reasons may be related to the limitations of the DALYs method. However, according to this research results,we can find that the DALYs method is evidently better than the SIADR method, showing in:(1) This method overcomes the limitations of ADR classification and semi-quantitative assess; (2) Health outcome is directly uesed to evaluate the effect of ADR, meaning that severity and incidence have been both considered; (3) The method is not only pretty straightforward and operable but also closer to thinking of doctor and patient because it uses the loss of healthy life years as a measurement.