Ignored and undervalued in public health: a systematic review of health state utility values associated with syphilis infection

Miao, Patrick; Terris-Prestholt, Fern; Fairley, Christopher K.; Tucker, Joseph D.; Wiseman, Virginia; Mayaud, Philippe; Zhang, Ying; Rowley, Jane; Gottlieb, Sami; Korenromp, Eline L.; Watts, Caroline G.; Ong, Jason J.

doi:10.1186/s12955-024-02234-1

Table 5 Disability weights for syphilis-related conditions in Global Burden of Disease Studies^a and Related Studies

From: Ignored and undervalued in public health: a systematic review of health state utility values associated with syphilis infection

Study	Methods	Sequela	Mapped health state	Disability weight	Ranges or 95% confidence intervals	Stated source for disability weight	Disease duration	Source for duration
Global Burden of Disease
Global Burden of Disease 1990 [44]; Global Burden of Disease 1990 (2004 update) [45]	Time trade-off: small groups of health professionals performed weighting exercises to make a composite judgment on the severity distribution of the condition and the social preference for time spent in each severity level	Congenital syphilis	··	0·315	··	··	··	··
		Low birth weight	··	0·106	··	··	··	··
		Primary syphilis	··	0·014 (1-44 years) 0·015 (45+ years)	··	··	··	··
		Secondary syphilis	··	0·048 (1-59 years) 0·044 (60+ years)	··	··	··	··
		Tertiary syphilis	··	0·283	··	··	··	··
Global Burden of Disease 2019 [4]	Disability weights have been generated using data collected from more than 31 000 respondents through population-based surveys in multiple countries and an open internet survey	Mild early syphilis infection	Infectious disease, acute episode, mild	0·006	0·002-0·012	··	··	··
		Asymptomatic early syphilis infection	Asymptomatic	0	-	··	··	··
		Cardiovascular complications due to adult tertiary syphilis	Infectious disease, acute episode, moderate	0·051	0·032-0·074	··	··	··
		Severe disfigurement due to adult tertiary syphilis	Disfigurement, level 3	0·405	0·275-0·546	··	··	··
		Neurological problems due to adult tertiary syphilis	Motor plus cognitive impairments, moderate	0·203	0·134-0·29	··	··	··
		Asymptomatic adult tertiary syphilis	Asymptomatic	0	-	··	··	··
		Neurological problems and cardiovascular complications due to adult tertiary syphilis	Moderate motor plus cognitive impairments and moderate infectious disease, acute episode	0·243	0·168-0·333	··	··	··
		Severe disfigurement and cardiovascular complications due to adult tertiary syphilis	Level 3 disfigurement and moderate infectious disease, acute episode	0·435	0·306-0·571	··	··	··
		Severe disfigurement and neurological problems due to adult tertiary syphilis	Level 3 disfigurement and moderate motor plus cognitive impairments	0·523	0·378-0·669	··	··	··
		Severe disfigurement, neurological problems, and cardiovascular complications due to adult tertiary syphilis	Level 3 disfigurement, moderate motor plus cognitive impairments, and moderate infectious disease, acute episode	0·547	0·402-0·691	··	··	··
Related Studies
The Burden of Disease and Injury in Australia 1999 [50]	Taken from GBD 1990	Primary syphilis	··	0·148	··	GBD 1990	··	··
		Secondary syphilis	··	0·048	··		··	··
		Tertiary syphilis (cardiovascular)	··	0·196	··		··	··
		Tertiary syphilis (gummas)	··	0·102	··		··	··
		Tertiary syphilis (neurologic)	··	0·283	··		··	··
		Congenital syphilis	··	0·315	··		··	··
Victorian Burden of Disease Study 2001 [51]	Taken from GBD 1990	Secondary syphilis	··	0·048	··	GBD 1990	··	··
		Tertiary syphilis (cardiovascular)	··	0·196	··		··	··
		Tertiary syphilis (gummas)	··	0·102	··		··	··
		Tertiary syphilis (neurologic)	··	0·283	··		··	··
		Congenital syphilis	··	0·315	··		··	··
		Congenital syphilis	··	0·315	··		··	··
Ontario Burden of Infectious Disease 2010 [52]	Uses a Canadian-developed combination of scores for 11 attributes (using a standard gamble) with predominantly lay panels to develop a severity weight by subtracting the preference weight from 1·0^a	Primary syphilis	··	0·017	··	Primary source	14 days	The Burden of Disease and Injury in Australia 1999 [50]
		Secondary syphilis	··	0·039	··		28 days
		Neurosyphilis	··	0·074	··		10 years
		Congenital syphilis	··	0·139	··		3 years
State of Infectious Diseases in the Netherlands 2013 [53]	Taken from GBD 1990	Primary syphilis	··	0·014 (1-44 years) 0·015 (45+ years)	··	GBD 1990	··	··
		Secondary syphilis	··	0·048 (1-59 years) 0·044 (60+ years)	··		··	··
		Neurosyphilis	··	0·281	··		··	··
		Congenital syphilis	··	0·315	··		··	··
Kuznik 2015 [54]	Estimate the public health burden resulting from adverse pregnancy outcomes due to syphilis infection among pregnant women not screened for syphilis in 43 countries in sub-Saharan Africa	Congenital syphilis	··	0·315	··	GBD 1990	Lifetime	··
		Low birth weight	··	0·106	··		Lifetime	··
		Stillbirth	··	1	··		··	··
		Neonatal death	··	1	··		··	··
Liu 2018 [55]	Estimate the disease burden resulting from syphilis-related adverse pregnancy outcomes in Hunan Province and assess the progress of a free syphilis screening and treatment program	Congenital syphilis	··	0·315	··	GBD 1990 (2004 update)	Lifetime	··
		Low birth weight	··	0·106	··		Lifetime	··
		Miscarriage	··	1	··		··	··
		Stillbirth	··	1	··		··	··
		Neonatal death	··	1	··		··	··

Global Burden of Disease studies for 2010, 2013, 2015, and 2017 have been omitted [46,47,48,49], because they are added to each iteration, culminating in the 2019 values (see Supplementary File S3)
Data found from Global Health Data Exchange at http://ghdx.healthdata.org/ run by the Institute for Health Metrics and Evaluation (IHME) [86]
GBD Global Burden of Disease, CLAMES Classification and Measurement System of Functional Health
^aUses a “severity weight”, which is conceptually similar to a disability weight – that is, the higher the weight, the “worse” the health state

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