{"id":246,"date":"2015-05-09T21:48:03","date_gmt":"2015-05-09T21:48:03","guid":{"rendered":"http:\/\/www.ef.panicola.com\/?p=246"},"modified":"2015-05-09T21:48:03","modified_gmt":"2015-05-09T21:48:03","slug":"wired-ihme","status":"publish","type":"post","link":"https:\/\/www.ef.panicola.com\/?p=246","title":{"rendered":"WIRED: IHME"},"content":{"rendered":"<p>Decent story about IHME, the development of DALY&#8217;s, WHO&#8217;s reluctance to return to politically sensitive measures and how Australia apparently used the measures to improve its health system.<\/p>\n<p>http:\/\/www.wired.com\/2015\/04\/epic-measures<\/p>\n<header id=\"post-header\" class=\"standard small-art mob-marg-t-med marg-t-50 clearfix\" tabindex=\"0\" data-js=\"postHeader\">\n<ul class=\"center metadata marg-b-25\" tabindex=\"0\">\n<li class=\"byline marg-r-sm inline-block mob-marg-b-sm\" tabindex=\"0\"><span class=\"link-underline-sm marg-r-sm\"><a tabindex=\"-1\" href=\"http:\/\/www.wired.com\/author\/daniellev\/\" rel=\"author\">DANIELLE VENTON<\/a><\/span><\/li>\n<li class=\"meta-pubdate marg-r-sm inline-block\" tabindex=\"0\"><span class=\"visually-hidden\">DATE OF PUBLICATION: 04.28.15.<\/span><time>04.28.15<\/time><\/li>\n<li class=\"marg-r-sm inline-block\" tabindex=\"0\"><span class=\"visually-hidden\">TIME OF PUBLICATION: 2:45 PM.<\/span><time>2:45 PM<\/time><\/li>\n<\/ul>\n<h1 id=\"post-title\">ONE DOCTOR\u2019S QUEST TO SAVE THE WORLD WITH DATA<\/h1>\n<\/header>\n<section class=\"post-container clearfix relative\" data-js=\"post\">\n<div id=\"sharing\" class=\"absolute top bottom hide-mob hide-sm hide-med\" data-js=\"social\"><a class=\"visually-hidden skip-to-text-link focusable bg-white\" href=\"http:\/\/www.wired.com\/2015\/04\/epic-measures#latest-news-list\">Skip Social. Skip to: Latest News.<\/a><\/p>\n<div id=\"sharing-wrap\" class=\"headroom hr-pinned hr-top\" data-js=\"socialSticky\" data-headroom=\"\" data-sticky=\"\">\n<div id=\"consol-share\" class=\"marg-b-med ui-consol opacity-3 flex-box align-m justify-c\"><span class=\"meta text-c black\">2K<\/span><\/div>\n<p><a id=\"fb-share\" class=\"fb clearfix marg-b-med\" href=\"http:\/\/www.facebook.com\/sharer\/sharer.php?u=http%3A%2F%2Fwww.wired.com%2F2015%2F04%2Fepic-measures%2F&amp;t=One+Doctor%E2%80%99s+Quest+to+Save+the+World+With+Data\" target=\"_blank\"><span class=\"visually-hidden\">Share this story on Facebook<\/span><i class=\"block ui ui-social ui-fb opacity-3 relative\"><\/i><\/a><a id=\"twitter-share\" class=\"twitter clearfix marg-b-med\" href=\"https:\/\/twitter.com\/intent\/tweet?via=WIRED&amp;text=One+Doctor%E2%80%99s+Quest+to+Save+the+World+With+Data&amp;related=DanielleVenton&amp;url=http%3A%2F%2Fwww.wired.com%2F2015%2F04%2Fepic-measures%2F\" target=\"_blank\"><span class=\"visually-hidden\">Share this story on Twitter<\/span><i class=\"block ui ui-social ui-twit opacity-3 relative\"><\/i><\/a><a id=\"pint-share\" class=\"pint clearfix marg-b-med\" href=\"http:\/\/pinterest.com\/pin\/create\/button\/?url=http%3A%2F%2Fwww.wired.com%2F2015%2F04%2Fepic-measures%2F&amp;media=http%3A%2F%2Fwww.wired.com%2Fwp-content%2Fuploads%2F2015%2F04%2F103265210-929x697-e1430181453815.jpg&amp;description=One+Doctor%E2%80%99s+Quest+to+Save+the+World+With+Data\" target=\"_blank\"><span class=\"visually-hidden\">Share this story on Pinterest<\/span><i class=\"block ui ui-social ui-pint opacity-3 relative\"><\/i><\/a><a id=\"mail-share\" class=\"mail clearfix marg-b-med\" href=\"mailto:?subject=WIRED:%20One%20Doctor%E2%80%99s%20Quest%20to%20Save%20the%20World%20With%20Data&amp;body=Check%20out%20this%20great%20article%20I%20read%20on%20WIRED:%0D%0A%0D%0AOne%20Doctor%E2%80%99s%20Quest%20to%20Save%20the%20World%20With%20Data%0D%0A%0D%0Ahttp:\/\/www.wired.com\/2015\/04\/epic-measures\/\"><span class=\"visually-hidden\">Share this story via Email<\/span><i class=\"block ui ui-social ui-mail opacity-3 relative\"><\/i><\/a><a id=\"comments-open-bubble\" class=\"comments clearfix\" data-ui=\"commentsOpen\" data-js=\"wordBubble\"><\/a><span class=\"visually-hidden\">Comment on this story<\/span><i class=\"no-marg ui ui-social ui-comments opacity-3 relative\"><\/i><\/div>\n<\/div>\n<article id=\"start-of-content\" class=\"content link-underline relative\" tabindex=\"0\" data-js=\"content\">\n<div id=\"small-art\" class=\"inset-container\" data-share=\"\">\n<figure id=\"attachment_1773458\" class=\"wp-caption landscape alignnone\" data-js=\"\"><a><img loading=\"lazy\" decoding=\"async\" class=\"size-default-top-art wp-image-1773458 cursor-zoom\" src=\"http:\/\/www.wired.com\/wp-content\/uploads\/2015\/04\/103265210-582x437.jpg\" alt=\"103265210\" width=\"582\" height=\"437\" data-pin-description=\"One Doctor\u2019s Quest to Save the World With Data\" data-ui=\"overlayOpen\" data-order=\"0\" \/><span class=\"visually-hidden\">Click to Open Overlay Gallery<\/span><\/a><figcaption class=\"wp-caption-text link-underline\"><span class=\"credit\">PHIL ASHLEY\/GETTY IMAGES<\/span><\/figcaption><\/figure>\n<\/div>\n<p><span class=\"lede\" tabindex=\"-1\">IN RWANDA, PEOPLE <\/span>have to deal with all kinds of threats to their health: malaria, HIV\/AIDS, severe diarrhea. But in late 2012, Agnes Binagwaho, Rwanda\u2019s Minister of Health, realized her country\u2019s key health enemy was\u00a0 <a href=\"http:\/\/www.healthdata.org\/acting-data\/agnes-binagwaho-rwanda%E2%80%99s-doctor\" target=\"_blank\">something far more innocuous<\/a>.\u00a0The thing causing the most harm to her people, the leading risk factor for premature death and disability, was\u00a0inside their own homes: Dirty indoor air, from\u00a0cooking food over burning dung and vegetation in poorly ventilated huts. Within weeks,\u00a0Binagwaho\u00a0announced a program to distribute one million clean cookstoves to the poorest households in the young, mostly rural country.<\/p>\n<p>Binagwaho was able to improve millions of lives thanks to a new kind of medical record-keeping, only possible in this\u00a0era of big data.\u00a0Just as Billy Beane, general manager of the Oakland Athletics, used sabermetrics\u00a0to maximize wins, epidemiologists can crunch data to determine the so-called\u00a0<a href=\"http:\/\/www.healthdata.org\/research-article\/global-regional-and-national-age-sex-specific-all-cause-and-cause-specific\" target=\"_blank\">global burden of disease<\/a>\u2014information that\u00a0can be used to optimize the health of a neighborhood, nation, or the entire globe. Call it\u00a0<em>Moneyball\u00a0<\/em>for public health.<\/p>\n<p>You might think that policymakers and health czars would jump at the chance to save the maximum number of lives with a minimum of investment. But it hasn\u2019t always been easy going for Christopher Murray, the godfather of the approach, who today directs the Institute for Health Metrics and Evaluation at the University of Washington. In\u00a0<em><a href=\"http:\/\/jeremynsmith.com\/Jeremy_N._Smith\/Epic_Measures.html\" target=\"_blank\">Epic Measures<\/a>,<\/em>\u00a0published earlier this month, health journalist Jeremy Smith recounts Murray\u2019s struggle to index the global burden of disease\u2014and the political obstacles\u00a0he encountered in publishing and distributing his findings.<\/p>\n<h3>A Precocious Pharmacist<\/h3>\n<p>The roots of the global burden of disease stretch back to Murray\u2019s childhood. At\u00a010 years old, his family traveled to Niger to help run a rural hospital. After traveling more than a month through the Saharan desert to get there, they found no power, no water, no medical supplies and no other staff. At 10 years old, Murray was promoted to role of hospital pharmacist. In his role, he saw children sick with malaria and suffering from malnourishment, along with a fair share of donkey bite victims.<\/p>\n<p>Those experiences shaped the rest of his life: \u201cIt gave me my primary question, which I continue to try to get the answer to,\u201d Murray says. \u201cWhat are people\u2019s main problems and what can you do to fix them in a way that transcends individual clinical practice?\u201d<\/p>\n<p>More than 20 years later, as a leader at the World Health Organization (the United Nation\u2019s health arm), Murray noticed that official reports and analyses of those main problems\u00a0didn\u2019t quite reflect medical reality. In fact, the numbers\u2014many of which came from advocacy groups, seeking money and attention for specific causes\u2014didn\u2019t make sense. \u201cIf you added things up,\u201d he says, \u201cpeople were dying three times over.\u201d<\/p>\n<p>So Murray took\u00a0a different approach. He and his collaborators\u2014not advocacy groups\u2014calculated disease impacts, double checking to ensure they\u00a0matched the total number of people who had\u00a0died. And he revised a strategy he and medical demographer Alan Lopez had pioneered in the early 1990s at the Harvard School of Public Health, where they\u00a0<a href=\"https:\/\/en.wikipedia.org\/wiki\/Disability-adjusted_life_year\" target=\"_blank\">created a new metric<\/a> for quality of life and health loss (disability-adjusted life years, or DALYs). Using DALYs as a quality of life measure makes it possible to compare one disease to another, giving a complete view of the global burden of disease.<\/p>\n<p>\u201cIt\u2019s a study of everything wrong with everyone everywhere, in all countries for all time,\u201d says Smith. \u201cI mean everything that makes people sick, everything that kills people, everything that causes pain and suffering and the risk factors for those things.\u201d That\u00a0can include anything\u00a0from whether you live with an abusive partner to how much lunch meat you consume.<\/p>\n<h3>Explosive Results<\/h3>\n<p>In 2000 Murray\u2019s team released a\u00a0new version of the global burden of disease data, analyzing world health between 1990 and 2000 and adding new insights.\u00a0Rankings\u00a0of\u00a0national health systems performance were\u00a0among those additions\u2014including\u00a0the famous statistic that the United States has the 37<sup>th<\/sup> best health system, despite spending the most per capita.<\/p>\n<p>Controversy erupted. \u201cThat generated much greater reaction than anything else,\u201d Murray says. \u201cWhen you start talking about performance of health systems, you get very close to the job description of the minister of health in a country.\u201d<\/p>\n<p>Some politicians and ministers felt the ranking was a direct threat, an evaluation of how well they did their jobs. (Murray says the clever ones used the results to push for more money.) Jos\u00e9 Serra was the health minister of Brazil at the time, running a presidential election campaign. \u201cHe really went after us at the WHO at the time,\u201d says Murray, \u201csaying that this was not appropriate for the UN to do this. I think the WHO still shows the scars.\u201d Since the conflict, Murray says, the WHO\u00a0has been enormously reluctant to venture near health care system performance.<\/p>\n<h3>A Third\u00a0Life for GBD<\/h3>\n<p>But Murray\u2019s quest\u00a0still lives. The <a href=\"http:\/\/www.healthdata.org\/gbd\" target=\"_blank\">study\u2019s current iteration<\/a>, housed at the <a href=\"http:\/\/www.healthdata.org\/\" target=\"_blank\">Institute for Health Metrics and Evaluation<\/a> in Seattle,\u00a0analyzes\u00a0global health data up to 2013. A\u00a0super-computing cluster is busily whirring away at the University of Washington\u2014supported by more than $100 million in funding from the Gates Foundation\u2014crunching information\u00a0from sources like hospital and police records to output more than a billion data points.<\/p>\n<p>That data and the approach it drives will go on to accomplish grand things, Murray hopes. Already it\u2019s racking up success stories. Australia used the data\u00a0to re-map their health systems: In 1970 the life expectancy of the average Australian man was about the same as a man in the United States (about 71). Now, Australia is neck and neck with Japan (80 years).<\/p>\n<p>The same approach worked in Colombia, where Rodrigo Guerrero, mayor of Cali, analyzed data\u00a0<a href=\"http:\/\/opinionator.blogs.nytimes.com\/2014\/11\/20\/colombias-data-driven-fight-against-crime\/?_r=0&amp;assetType=opinion\" target=\"_blank\">to understand patterns of violence<\/a>. Deaths were concentrated on weekends, he found, particularly near paydays. Drugs and gangs weren\u2019t the sole cause of gun violence and murders\u2014the devil, in this case, was the dangerous combination of young men, alcohol, and an already violent culture. Guerrero changed where and when booze could be sold and instituted gun bans,\u00a0cutting shootings and murders nearly by\u00a0half.<\/p>\n<p>The information Murray and his more than 500 collaborators have gathered is designed to\u00a0help you lead a better life, too. One of best health\u00a0interventions for Americans, turns out, is simply to\u00a0<a href=\"http:\/\/ihmeuw.org\/39j1\" target=\"_blank\">eat more fruit<\/a>, helping to\u00a0prevent heart disease and stroke.\u00a0That\u2019s the beauty of the DALY: It works to identify the root cause of the greatest health threats, whether it\u2019s a dung-filled fire, alcohol-fueled violence, or in the case of American <a href=\"http:\/\/ihmeuw.org\/39j0\" target=\"_blank\">men in their late 30s<\/a>, processed meat. Sorry, guys: The data doesn\u2019t lie.<\/p>\n<p><a class=\"visually-hidden skip-to-text-link focusable bg-white\" href=\"http:\/\/www.wired.com\/2015\/04\/epic-measures#start-of-content\">Go Back to Top. Skip To: Start of Article.<\/a><\/p>\n<ul id=\"article-tags\" class=\"list-none center metadata marg-t-50 marg-b-50 pad-b-med border-t border-b\">\n<li class=\"pad-t-med marg-r-sm mob-marg-b-med\"><a href=\"http:\/\/www.wired.com\/tag\/big-data\/\" rel=\"tag\">BIG DATA<\/a><\/li>\n<li class=\"list-none pad-t-med marg-r-sm mob-marg-b-med\"><a href=\"http:\/\/www.wired.com\/tag\/health\/\" rel=\"tag\">HEALTH<\/a><\/li>\n<li class=\"list-none pad-t-med marg-r-sm mob-marg-b-med\"><a href=\"http:\/\/www.wired.com\/tag\/medicine\/\" rel=\"tag\">MEDICINE<\/a><\/li>\n<li class=\"list-none pad-t-med marg-r-sm mob-marg-b-med\"><a href=\"http:\/\/www.wired.com\/tag\/science\/\" rel=\"tag\">SCIENCE<\/a><\/li>\n<\/ul>\n<\/article>\n<\/section>\n","protected":false},"excerpt":{"rendered":"<p>Decent story about IHME, the development of DALY&#8217;s, WHO&#8217;s reluctance to return to politically sensitive measures and how Australia apparently used the measures to improve its health system. http:\/\/www.wired.com\/2015\/04\/epic-measures DANIELLE VENTON DATE OF PUBLICATION: 04.28.15.04.28.15 TIME OF PUBLICATION: 2:45 PM.2:45 PM ONE DOCTOR\u2019S QUEST TO SAVE THE WORLD WITH DATA Skip Social. 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