On QALYs and DALYs

When it comes to quantifying things in Medicine, there are perhaps no concepts more crude than QALYs (Quality-adjusted life year) and DALYs (Disability-adjusted life year).  I wont go into details about them, but QALYs and DALYs are  frequently used by health economists to quantify the individual burden of a disease and assess cost-effectiveness of various interventions.  There are several nice brief explanatory videos of QALYs and DALYs. Here is a particularly good one:


 While most tools used to quantify medical phenomena provide at least a vague outline of the phenomena they are measuring, QALY’s and DALY’s are so crude and primitive, that I often wonder whether the discussion or article I’m reading is a parody. I mean, to suggest that we can objectively quantify a medical condition as a percentage of what it is like to live a year in perfect health, (living with hip arthritis is 0.80 of a QALY, living with Erectile Dysfunction is 0.85 of a QALY)  is so preposterous, so vulgar, so primitive, that I am truly at a loss for words. It reminds me of the scene in The Dead  Poet’s Society when they read the section on understanding poetry by J Evan’s Pritchard and his quantitative technique for measuring the greatness of a poem. I’m at a loss for words.