Development of Novel DALY-Based Indices for Assessing Productivity Loss and Resource Allocation for Liver Cancer in the MENA Region

Development of Novel DALY-Based Indices for Assessing Productivity Loss and Resource Allocation for Liver Cancer in the MENA Region | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Development of Novel DALY-Based Indices for Assessing Productivity Loss and Resource Allocation for Liver Cancer in the MENA Region Shekoofeh Sadat Momahhed, Arian Banaee, Atefeh Haghighathoseini, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5652166/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 17 Oct, 2025 Read the published version in Population Health Metrics → Version 1 posted 13 You are reading this latest preprint version Abstract Objective This study presents new indices to evaluate productivity inefficiency and resource expenditure for liver cancer in the MENA region, aiming to bridge the gap between health outcomes and economic factors for better policy insights. Setting Population data from eight MENA countries between 2000 and 2021 was analyzed, focusing on liver cancer rates among different age and gender groups. The study assessed GDP per capita, health expenditure, employment levels, and the Socio-Demographic Index (SDI) to evaluate health and economic resilience. Design Data from the Global Burden of Disease (GBD) database and the World Bank were analyzed. A Random Forest Regressor assessed the importance of features related to Productivity Loss and Resource Allocation indices, while a sensitivity analysis confirmed their robustness. Results Liver cancer predominantly affects adults aged 20 to 49 and those 50 and older, with alcohol use as the main risk factor. Men are mostly diagnosed with hepatitis B and C, while women tend to have Non-Alcoholic Steatohepatitis (NASH). Egypt has the highest health-related productivity loss index (IHAPI), indicating significant losses, while Saudi Arabia has the lowest, suggesting better economic resilience. A Random Forest analysis showed that the Economic Vulnerability and Health Index (EVHI) explained over 71% of the variation in IHAPI, followed by the Risk Level of Cancer Loss (RLCL) at 22%. Sensitivity analysis indicated that indices like HAPLI, EVHI, RLCL, and IHAPI showed narrow variability, while the Total Productivity Loss Transition Index (TPLTI) and Socio-Demographic Health Equity Index (SD-HEI) were more volatile concerning Disability-Adjusted Life Years (DALY). Resource allocation indices (RAEI, HSRI, CBRPI) were close to 1, indicating effective resource use and a strong health system. Conclusions This study highlights liver cancer's impact on health and economies in MENA countries, aiding in case identification, resource optimization, and policy goal setting to reduce productivity losses. Liver cancer MENA region Disability-Adjusted Life Years (DALY) productivity loss resource allocation Random Forest analysis Full Text Additional Declarations No competing interests reported. Supplementary Files Appendixlivercancer.docx Cite Share Download PDF Status: Published Journal Publication published 17 Oct, 2025 Read the published version in Population Health Metrics → Version 1 posted Editorial decision: Revision requested 20 Jul, 2025 Reviews received at journal 13 Jul, 2025 Reviewers agreed at journal 13 Jul, 2025 Reviews received at journal 12 Jul, 2025 Reviewers agreed at journal 12 Jul, 2025 Reviews received at journal 10 Jul, 2025 Reviewers agreed at journal 02 Jun, 2025 Reviews received at journal 01 Jun, 2025 Reviewers agreed at journal 31 May, 2025 Reviewers invited by journal 23 May, 2025 Editor assigned by journal 17 Dec, 2024 Submission checks completed at journal 17 Dec, 2024 First submitted to journal 16 Dec, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5652166","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":391376105,"identity":"fbbe31a8-5365-44eb-8b1d-13cf6b961487","order_by":0,"name":"Shekoofeh Sadat 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The study assessed GDP per capita, health expenditure, employment levels, and the Socio-Demographic Index (SDI) to evaluate health and economic resilience.\u003c/p\u003e \u003cp\u003e \u003cb\u003eDesign\u003c/b\u003e Data from the Global Burden of Disease (GBD) database and the World Bank were analyzed. A Random Forest Regressor assessed the importance of features related to Productivity Loss and Resource Allocation indices, while a sensitivity analysis confirmed their robustness.\u003c/p\u003e \u003cp\u003e \u003cb\u003eResults\u003c/b\u003e Liver cancer predominantly affects adults aged 20 to 49 and those 50 and older, with alcohol use as the main risk factor. Men are mostly diagnosed with hepatitis B and C, while women tend to have Non-Alcoholic Steatohepatitis (NASH).\u003c/p\u003e \u003cp\u003eEgypt has the highest health-related productivity loss index (IHAPI), indicating significant losses, while Saudi Arabia has the lowest, suggesting better economic resilience. A Random Forest analysis showed that the Economic Vulnerability and Health Index (EVHI) explained over 71% of the variation in IHAPI, followed by the Risk Level of Cancer Loss (RLCL) at 22%. Sensitivity analysis indicated that indices like HAPLI, EVHI, RLCL, and IHAPI showed narrow variability, while the Total Productivity Loss Transition Index (TPLTI) and Socio-Demographic Health Equity Index (SD-HEI) were more volatile concerning Disability-Adjusted Life Years (DALY). Resource allocation indices (RAEI, HSRI, CBRPI) were close to 1, indicating effective resource use and a strong health system.\u003c/p\u003e \u003cp\u003e \u003cb\u003eConclusions\u003c/b\u003e This study highlights liver cancer's impact on health and economies in MENA countries, aiding in case identification, resource optimization, and policy goal setting to reduce productivity losses.\u003c/p\u003e","manuscriptTitle":"Development of Novel DALY-Based Indices for Assessing Productivity Loss and Resource Allocation for Liver Cancer in the MENA Region","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-19 10:32:29","doi":"10.21203/rs.3.rs-5652166/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-07-21T02:02:31+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-13T06:43:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"21174788572418811261008628867227682736","date":"2025-07-13T05:43:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-12T23:57:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"185843123918013274769419285025106329912","date":"2025-07-12T04:25:46+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-10T16:30:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"122148441530534474868602877988428641421","date":"2025-06-02T10:49:51+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-01T04:43:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"69077522242987076082810188103825019953","date":"2025-05-31T18:10:17+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-24T01:22:22+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-12-17T11:41:40+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-12-17T11:40:17+00:00","index":"","fulltext":""},{"type":"submitted","content":"Population Health Metrics","date":"2024-12-16T08:59:07+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"population-health-metrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pohm","sideBox":"Learn more about [Population Health Metrics](http://pophealthmetrics.biomedcentral.com/)","snPcode":"12963","submissionUrl":"https://submission.nature.com/new-submission/12963/3","title":"Population Health Metrics","twitterHandle":"@PHMjournal","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"929c6162-aeee-45da-a30d-610f9a1510a5","owner":[],"postedDate":"December 19th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-10-20T16:01:48+00:00","versionOfRecord":{"articleIdentity":"rs-5652166","link":"https://doi.org/10.1186/s12963-025-00423-8","journal":{"identity":"population-health-metrics","isVorOnly":false,"title":"Population Health Metrics"},"publishedOn":"2025-10-17 15:57:37","publishedOnDateReadable":"October 17th, 2025"},"versionCreatedAt":"2024-12-19 10:32:29","video":"","vorDoi":"10.1186/s12963-025-00423-8","vorDoiUrl":"https://doi.org/10.1186/s12963-025-00423-8","workflowStages":[]},"version":"v1","identity":"rs-5652166","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5652166","identity":"rs-5652166","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}