Harvard Center for Risk Analysis
Program on the Economic Evaluation of Medical Technology
GAINS IN LIFE EXPECTANCY FROM MEDICAL INTERVENTIONS – STANDARDIZING
OUTCOMES DATA
By Janice C. Wright, Ph.D., and Milton C. Weinstein, Ph.D.
New England Journal of Medicine: 339()xx-xx
August 6, 1998
Go directly to the Tables of Life Expectancy Gains from Medical Interventions
ABSTRACT
Background
The gain in life expectancy is an important measure of the effectiveness of medical interventions, but its interpretation requires that it be placed in context. The interpretation of gains in life expectancy is particularly problematic for preventive interventions, for which the gains are often just weeks or even days when averaged across the entire target population.
Methods
We tabulated the gains in life expectancy from a variety of medical interventions from 83 published sources and categorized them according to target population and disease. We considered prevention in populations at average risk for particular diseases, prevention in populations at elevated risk, and treatments of populations with established disease.
Results
The gains in life expectancy from preventive interventions in populations at average risk ranged from less than one month to slightly more than one year per person receiving the intervention, but the gains were as high as five years or more if the prevention was targeted at persons at especially high risk. The gains in life expectancy from treatments of established disease ranged from several months (for coronary thrombolysis and revascularization to treat heart disease) to as long as nine years (for chemotherapy to treat advanced testicular cancer).
Conclusions
A gain in life expectancy from a medical intervention can be categorized as large or small by comparing it with gains from other interventions aimed at the same target population. A gain in life expectancy of a month from a preventive intervention targeted at populations at average risk and a gain of a year from a preventive intervention targeted at populations at elevated risk can both be considered large. The framework we developed for standardizing gains in life expectancy can be used in the interpretation of outcome data from intervention studies.
Tables of Life Expectancy Gains from Medical Interventions
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Table 1: Prevention in the General Population
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Table 2: Prevention in Group with Elevated Risks
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Table 3: Treatment of Cardiovascular Disease
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Table 4: Treatment of Cancer
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Table 5: Treatment of Other Diseases
Download references for Tables 1-5
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