Prioritising the development of severity distributions in burden of disease studies for countries in the European region

Wyper, Grant M. A.; Grant, Ian; Fletcher, Eilidh; Chalmers, Neil; McCartney, Gerry; Stockton, Diane

doi:10.1186/s13690-019-0385-6

Cited by 22 publications

(29 citation statements)

References 5 publications

(5 reference statements)

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“…In our study of COVID-19 related vulnerable conditions, we did not include some of the leading causes of YLD, such as major depressive disorders and substance use disorders, which are thought to be the most likely to be affected by this assumption. Thus, our COVID-19 vulnerable conditions analysis may be less affected by this assumption [19]. Additionally, our study has assumed that the extent of vulnerability to COVID-19 can be determined by disability weights.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Population vulnerability to COVID-19 in Europe: a burden of disease analysis

et al. 2020

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Background: Evidence has emerged showing that elderly people and those with pre-existing chronic health conditions may be at higher risk of developing severe health consequences from COVID-19. In Europe, this is of particular relevance with ageing populations living with non-communicable diseases, multi-morbidity and frailty. Published estimates of Years Lived with Disability (YLD) from the Global Burden of Disease (GBD) study help to characterise the extent of these effects. Our aim was to identify the countries across Europe that have populations at highest risk from COVID-19 by using estimates of population age structure and YLD for health conditions linked to severe illness from COVID-19. Methods: Population and YLD estimates from GBD 2017 were extracted for 45 countries in Europe. YLD was restricted to a list of specific health conditions associated with being at risk of developing severe consequences from COVID-19 based on guidance from the United Kingdom Government. This guidance also identified individuals aged 70 years and above as being at higher risk of developing severe health consequences. Study outcomes were defined as: (i) proportion of population aged 70 years and above; and (ii) rate of YLD for COVID-19 vulnerable health conditions across all ages. Bivariate groupings were established for each outcome and combined to establish overall population-level vulnerability. Results: Countries with the highest proportions of elderly residents were Italy, Greece, Germany, Portugal and Finland. When assessments of population-level YLD rates for COVID-19 vulnerable health conditions were made, the highest rates were observed for Bulgaria, Czechia, Croatia, Hungary and Bosnia and Herzegovina. A bivariate analysis indicated that the countries at high-risk across both measures of vulnerability were:

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Section: Strengths and Limitationsmentioning

confidence: 99%

Population vulnerability to COVID-19 in Europe: a burden of disease analysis

et al. 2020

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“…These issues raise uncertainties over interpreting YLD estimates, particularly if they are being used to develop and influence policies and to determine priorities across diseases and populations. It is clear that GBD researchers and those carrying out national studies need to work towards ensuring that estimates are based upon country-specific data, and, if possible, that the impact of assumptions are fully tested and understood [ 74 ]. Assessing the leading causes of YLDs and differences between the highest and lowest health state disability weights can be used to identify priority diseases for which it would be most beneficial to further develop severity distributions and help understand the wider uncertainties over applicability that are currently unanswered.…”

Section: Estimation Of Yldsmentioning

confidence: 99%

Reflections on key methodological decisions in national burden of disease assessments

et al. 2020

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Background Summary measures of population health are increasingly used in different public health reporting systems for setting priorities for health care and social service delivery and planning. Disability-adjusted life years (DALYs) are one of the most commonly used health gap summary measures in the field of public health and have become the key metric for quantifying burden of disease (BoD). BoD methodology is, however, complex and highly data demanding, requiring a substantial capacity to apply, which has led to major disparities across researchers and nations in their resources to perform themselves BoD studies and interpret the soundness of available estimates produced by the Global Burden of Disease Study. Methods BoD researchers from the COST Action European Burden of Disease network reflect on the most important methodological choices to be made when estimating DALYs. The paper provides an overview of eleven methodological decisions and challenges drawing on the experiences of countries working with BoD methodology in their own national studies. Each of these steps are briefly described and, where appropriate, some examples are provided from different BoD studies across the world. Results In this review article we have identified some of the key methodological choices and challenges that are important to understand when calculating BoD metrics. We have provided examples from different BoD studies that have developed their own strategies in data usage and implementation of statistical methods in the production of BoD estimates. Conclusions With the increase in national BoD studies developing their own strategies in data usage and implementation of statistical methods in the production of BoD estimates, there is a pressing need for equitable capacity building on the one hand, and harmonization of methods on the other hand. In response to these issues, several BoD networks have emerged in the European region that bring together expertise across different domains and professional backgrounds. An intensive exchange in the experience of the researchers in the different countries will enable the understanding of the methods and the interpretation of the results from the local authorities who can effectively integrate the BoD estimates in public health policies, intervention and prevention programs.

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“…Another area where improvements could be made relates to the severity distributions (which represent the proportion of people for a particular disease by levels of severity), given the significant impact these can have on the final estimates [65,66]. The ABDS was able to use Australian data for some severity distributions (including cancers and a number of injuries, musculoskeletal conditions, vision-related disorders, respiratory diseases and neurological diseases [26]), but relied on the GBD distributions for others.…”

Section: Current Focus and Remaining Challengesmentioning

confidence: 99%

History and development of national burden of disease assessment in Australia

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Australia’s 1996 national burden of disease (BoD) study was one of the first in the world and updates have continued over the following two decades with the fifth study now underway. The studies adapt the global framework most recently implemented by the Global Burden of Disease Study and the World Health Organization to suit Australia’s specific needs, producing estimates of fatal and non-fatal burden via the Disability Adjusted Life Year (DALY) metric, as well as attribution of the burden to many risk factors. Detailed Australian data are used with minimal reliance on modelling to fill data gaps. Comprehensive estimates are produced, including for the Indigenous population, for each of the eight states and territories, the five remoteness areas and five socioeconomic quintiles. A number of method developments have been made as part of these studies, including redistribution of deaths data and a detailed quality framework for describing the robustness of the underlying data and methods. Data and methods continue to be refined as part of the studies, and developments in global studies and other national studies are incorporated where appropriate.

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Prioritising the development of severity distributions in burden of disease studies for countries in the European region

Cited by 22 publications

References 5 publications

Population vulnerability to COVID-19 in Europe: a burden of disease analysis

Population vulnerability to COVID-19 in Europe: a burden of disease analysis

Reflections on key methodological decisions in national burden of disease assessments

History and development of national burden of disease assessment in Australia

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