The Unjournal · Pivotal Questions Initiative

DALY/QALY↔WELLBY Conversion

Approaches to interconvertibility between health and wellbeing measures

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SEGMENT 3 25 minutes (12:15–12:40 PM ET)

Discussion Lead: Julian Jamison (University of Exeter)

Presenter: Samuel Dupret (Happier Lives Institute)

Julian will frame the DALY-WELLBY conversion question and facilitate discussion. Samuel will present HLI's approach to DALY-WELLBY conversion and moral weights.

Focal Question (DALY_01)

If the impact of one program is measured in WELLBYs and another program impact is measured in DALYs, and we have a reported effect size and standard deviation for each, what is the best numerical conversion or mapping between them?

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Note: This may be treated as a secondary topic depending on time constraints.

Overview

This segment addresses the practical challenge of comparing interventions measured in different units. When funders want to compare StrongMinds[1]StrongMinds: group-based interpersonal therapy for depression in sub-Saharan Africa. Cost-effectiveness estimates range from highly cost-effective to uncertain depending on WELLBY valuation method. (measured in WELLBYs) to malaria bednets[2]Malaria bednets are GiveWell's top-recommended intervention, with well-established DALY impact estimates. They serve as a common benchmark for comparing other interventions. (measured in DALYs), what conversion factor should they use?

Current Approaches

Approach Description Limitations
SD-equivalence[3]Standard deviation equivalence: treating 1 SD in WELLBY as equivalent to 1 SD in DALY. Simple but assumes distributions have comparable meaning, which may not hold. 1 SD WELLBY ≈ 1 SD DALY Assumes comparable distributions
Direct estimates Literature-based conversion factors[4]Estimates vary widely. Frijters et al. (2024, Nature Human Behaviour) suggest ~6 WELLBYs per DALY averted as a baseline; other sources use different values. Context, methodology, and assumptions drive substantial differences. Wide range (2-15 WELLBYs per DALY)
Stated preference[5]Directly asking people: "Would you trade X improvement in life satisfaction for Y years of life?" Vulnerable to framing effects—how questions are posed affects answers. Survey-based trade-off elicitation Framing effects, hypothetical bias

Discussion Topics

Relevant Pivotal Questions

This discussion directly addresses several of our Pivotal Questions:

Key Literature

Note: The "2-15 WELLBYs per DALY" range cited in the table requires verification; sources vary.

📄 Background: DALY↔WELLBY Conversion

This document maps the key conversion approaches: UK Green Book (~7:1), empirical estimates (5-10 WELLBYs per QALY), and the conceptual issues underlying different methods.

View Analysis →

AI-assisted draft (Mar 2026) — annotate errors directly.

Collaborative Notes

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Questions & Comments

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📚 Empirical Evidence: Unjournal Evaluations

These evaluations assess research directly relevant to DALY-WELLBY conversion—mapping depression outcomes to life satisfaction, estimating effect durations, and comparing mental health interventions to cash transfers:

See also: Focal case box comparing StrongMinds vs AMF

Notes

  1. StrongMinds: group-based interpersonal therapy for depression in sub-Saharan Africa. Cost-effectiveness estimates range from highly cost-effective to uncertain depending on WELLBY valuation method.
  2. Malaria bednets are GiveWell's top-recommended intervention, with well-established DALY impact estimates. They serve as a common benchmark for comparing other interventions.
  3. Standard deviation equivalence: treating 1 SD in WELLBY as equivalent to 1 SD in DALY. Simple but assumes distributions have comparable meaning, which may not hold.
  4. Estimates vary widely. Frijters et al. (2024, Nature Human Behaviour) suggest ~6 WELLBYs per DALY averted as a baseline; other sources use different values. Context, methodology, and assumptions drive substantial differences.
  5. Directly asking people: "Would you trade X improvement in life satisfaction for Y years of life?" Vulnerable to framing effects—how questions are posed affects answers.
  6. Cooper's review in Fiscal Studies surveys methods for measuring welfare beyond GDP, including subjective wellbeing and capability approaches. Essential background for understanding WELLBY's theoretical foundations.
  7. This Nature article by Frijters et al. presents the WELLBY framework and its application to policy evaluation. Key reference for understanding how WELLBYs are intended to be used.