IntroductionCompleteness of Global Burden of Disease (GBD) Study data is acknowledged as a limitation. To date, no study has evaluated this issue for low back pain, a leading contributor to disease burden globally.MethodsWe retrieved reports, in any language, based on citation details from the GBD 2017 study website. Pairs of raters independently extracted the following data: number of prevalence reports tallied across countries, age groups, gender and years from 1987 to 2017. We also considered if studies enrolled a representative sample and/or used an acceptable measure of low back pain.ResultsWe retrieved 488 country-level reports that provide prevalence data for 103 of 204 countries (50.5%), with most prevalence reports (61%) being for high-income countries. Only 16 countries (7.8%) have prevalence reports for each of the three decades of the GBD. Most of the reports (79%) did not use an acceptable measure of low back pain when estimating prevalence.ConclusionWe found incomplete coverage across countries and time, and limitations in the primary prevalence studies included in the GBD 2017 study. This means there is considerable uncertainty about GBD estimates of low back pain prevalence and the disease burden metrics derived from prevalence.
Objective
To describe the proportion of national health surveys that contained questions on the prevalence and consequences of musculoskeletal conditions.
Methods
We used a comprehensive search strategy to obtain national health surveys from the 218 countries listed by the World Bank. Two authors independently extracted information from each national health survey. Outcomes were the proportion of surveys that: (i) contained questions on the prevalence of musculoskeletal conditions using the Global Burden of Disease categorisation of rheumatoid arthritis, osteoarthritis, low back pain, neck pain, gout and other; (ii) contained condition-specific questions about activity limitation, severity of pain, and work absence. We also measured how frequently prevalence of low back pain was measured using a consensus-based standard definition for low back pain prevalence studies.
Results
We identified national health surveys from 170 countries. Sixty-two (36.4%), the majority from high-income countries (N = 43), measured prevalence of at least one musculoskeletal condition. Osteoarthritis (53, 85.4%), low back pain (39, 62.9%) and neck pain (37, 59.7%) were the most commonly measured, while rheumatoid arthritis and gout prevalence were only measured in 10 (5.9%) and 3 (1.8%) surveys, respectively. A minority of surveys assessed condition-specific activity limitation (6, 3.6%), pain severity (5, 2.9%) and work absence (1, 0.6%). Only one survey used the consensus-based standard definition for low back pain.
Conclusion
Musculoskeletal conditions are being neglected in the majority of national health surveys. Monitoring musculoskeletal conditions through ongoing surveys is crucial for the development and evaluation of health policies to reduce their burden.
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