scholarly journals The Devils in the DALY: Prevailing Evaluative Assumptions

2020 ◽  
Vol 13 (3) ◽  
pp. 259-274
Author(s):  
Carl Tollef Solberg ◽  
Preben Sørheim ◽  
Karl Erik Müller ◽  
Espen Gamlund ◽  
Ole Frithjof Norheim ◽  
...  
Keyword(s):  
Burden Of Disease ◽  
Disease Burden ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Time Discounting ◽  
Disability Adjusted Life ◽  
Disability Adjusted Life Year

Abstract In recent years, it has become commonplace among the Global Burden of Disease (GBD) study authors to regard the disability-adjusted life year (DALY) primarily as a descriptive health metric. During the first phase of the GBD (1990–1996), it was widely acknowledged that the DALY had built-in evaluative assumptions. However, from the publication of the 2010 GBD and onwards, two central evaluative practices—time discounting and age-weighting—have been omitted from the DALY model. After this substantial revision, the emerging view now appears to be that the DALY is primarily a descriptive measure. Our aim in this article is to argue that the DALY, despite changes, remains largely evaluative. Our analysis focuses on the understanding of the DALY by comparing the DALY as a measure of disease burden in the two most significant phases of GBD publications, from their beginning (1990–1996) to the most recent releases (2010–2017). We identify numerous assumptions underlying the DALY and group them as descriptive or evaluative. We conclude that while the DALY model arguably has become more descriptive, it remains, by necessity, largely evaluative.

scholarly journals Completeness and quality of low back pain prevalence data in the Global Burden of Disease Study 2017

2021 ◽  
Vol 6 (5) ◽  
pp. e005847
Author(s):  
Mamata Tamrakar ◽  
Priti Kharel ◽  
Adrian Traeger ◽  
Chris Maher ◽  
Mary O'Keeffe ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Burden Of Disease ◽  
Disease Burden ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Low Back ◽  
Prevalence Data ◽  
Pain Prevalence ◽  
Acceptable Measure

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.

Socio-demographic development and burden of mental, substance use disorders, and self-harm: An ecological analysis using the Global Burden of Disease study 2019

2021 ◽  
pp. 000486742110667
Author(s):  
Guillaume Barbalat ◽  
Sze Liu
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Burden Of Disease ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Demographic Development ◽  
Disability Adjusted Life ◽  
Geographical Regions ◽  
Self Harm ◽  
Disease Study

Objectives: Whether a country’s level of development is associated with an increased or decreased burden of mental and behavioural problems is an important yet unresolved question. Here, we examined the association between the burden of mental and substance use disorders and self-harm with socio-demographic development along temporal and geographical dimensions. Methods: We collected data from the Global Burden of Disease study 2019, which uses robust statistical modelling techniques to calculate disease burden estimates where data are sparse or unavailable. We extracted age-standardized Disability Adjusted Life Year rates as a measure of disease burden for 204 countries and territories, as well as the Socio-Demographic Index, a measure of development reflecting income per capita, fertility rate and level of education. We tested the association between Socio-Demographic Index and Disability Adjusted Life Years for mental and substance use disorders and self-harm, between 1990 and 2019, and across six geographical regions as defined by the World Health Organization. Results: The association between Socio-Demographic Index and Disability Adjusted Life Years was heterogeneous across world regions for all mental and behavioural conditions. For substance use disorders and self-harm, these regional variations were further moderated by time period. Our findings were robust to down-weighing outlier observations, as well as controlling for other socio-demographic variables, and the number of data sources available in each country. Conclusion: Based on data from the Global Burden of Disease study 2019, we demonstrated that the association between mental and substance use disorders and self-harm with socio-demographic development is dependent on geographical regions and temporal periods. This heterogeneity is likely related to geographical and temporal variations in socio-cultural norms, attitudes towards mental problems, as well as health care and social policies. Better knowledge of this spatial and temporal heterogeneity is crucial to ensure that countries do not develop at the expense of a higher burden of mental and behavioural conditions.

scholarly journals India’s Performance in Controlling Visceral Leishmaniasis as Compared to Brazil Over Past Three Decades: Findings From Global Burden of Disease Study

2021 ◽  
Author(s):  
DEEPAK DHAMNETIYA ◽  
Ravi Prakash Jha ◽  
Shalini . ◽  
Krittika Bhattacharyya
Keyword(s):  
Visceral Leishmaniasis ◽  
Burden Of Disease ◽  
Rate Of Change ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Mortality And Morbidity ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Disease Study ◽  
Incidence Prevalence

Abstract Visceral leishmaniasis (VL) is a neglected tropical disease which contributes to the mortality and morbidity significantly in India and Brazil. This study was planned to compare the trends of incidence, prevalence, death and disability-adjusted life years (DALY) of VL burden in India and Brazil from 1990 to 2019 using Global burden of disease study (GBD) data. The metrics are presented as age-standardized rates per 100,000 inhabitants with their respective uncertainty intervals (95%UI) and relative percentages of change. The decline in the Incidence rate is more in case of India (16.82 cases per 100,000 in 1990 to 0.60cases in 2019) as compared to Brazil (3.12 cases per 100,000 in 1990 to 2.65 cases in 2019). The annualized rate of change in number of prevalent cases for India is -0.95 (95% UI, -0.98 to -0.91) whereas for Brazil it is -0.06 (95% UI, -0.41 to 0.52). The annualized rate of change in number of DALY for India is -0.94 (95% UI, -0.96 to -0.92) whereas for Brazil it is -0.09 (95% UI, -0.25 to 0.28). The annualized rate of change in number of deaths for India is -0.93 (95% UI, -0.95 to -0.92) whereas for Brazil it is increasing i.e. 0.04 (95% UI, -0.12 to 0.51). India achieves significant reduction in the age standardized incidence, prevalence, mortality and DALY of VL as compare to Brazil during the period of 1990 to 2019. A multi-centric study is required to assess bottleneck in the existing strategies of VLSCP in Brazil.

The global unmet need of congenital cardiac care: a quantitative analysis of the global burden of disease

2020 ◽  
Vol 30 (11) ◽  
pp. 1688-1693 ◽  
Author(s):  
Dominique Vervoort ◽  
Marcelo Cardarelli
Keyword(s):  
Burden Of Disease ◽  
Unmet Need ◽  
Morbidity And Mortality ◽  
Global Burden Of Disease ◽  
Cardiac Care ◽  
Global Burden ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The World

AbstractBackground:CHDs are one of the most frequent congenital malformations, affecting one in hundred live births. In total, 70% will require treatment in the first year of life, but over 90% of cases in low- and middle-income countries receive no treatment or suboptimal treatment. As a result, CHDs are responsible for 66% of preventable deaths due to congenital malformations in low- and middle-income countries. This study examines the unmet need of congenital cardiac care around the world based on the global burden of disease.Materials and methods:CHD morbidity and mortality data for 2006, 2011, and 2016 were collected from the Institute for Health Metrics and Evaluation Global Burden of Disease Results Tool and analysed longitudinally to assess trends in excess morbidity and mortality.Results:Between 2006 and 2016, a 20.7% reduction in excess disability-adjusted life years and 20.6% reduction in excess deaths due to CHDs were observed for children under 15. In 2016, excess global morbidity and mortality due to CHDs remained high with 14,788,418.7 disability-adjusted life years and 171,761.8 paediatric deaths, respectively. In total, 90.2% of disability-adjusted life years and 91.2% of deaths were considered excess.Conclusion:This study illustrates the unmet need of congenital cardiac care around the world. Progress has been made to reduce morbidity and mortality due to CHDs but remains high and largely treatable around the world. Limited academic attention for global paediatric cardiac care magnifies the lack of progress in this area.

scholarly journals Trends in the prevalence and disability-adjusted life years of eating disorders from 1990 to 2017: results from the Global Burden of Disease Study 2017

2020 ◽  
Vol 29 ◽  
Author(s):  
Jiayuan Wu ◽  
Jie Liu ◽  
Shasha Li ◽  
Huan Ma ◽  
Yufeng Wang
Keyword(s):  
Eating Disorders ◽  
Burden Of Disease ◽  
High Income ◽  
Global Burden Of Disease ◽  
Health Concern ◽  
Global Burden ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Increasing Trend

Abstract Aim Eating disorders have increasingly become a public health concern globally. This study aimed to reveal the burden of eating disorders at the global, regional and national levels using the Global Burden of Disease (GBD) Study 2017 data. Methods We extracted the age-standardised rates (ASRs) of prevalence and disability-adjusted life years (DALYs) and their 95% uncertainty intervals (UIs) of eating disorders, including anorexia nervosa and bulimia nervosa, between 1990 and 2017 from the GBD 2017 data. The estimated annual percentage changes (EAPCs) were calculated to quantify the secular trends of the burden of eating disorders. Results The ASRs of prevalence and the DALYs of eating disorders continuously increased worldwide from 1990 to 2017 by an average of 0.65 (95% UI: 0.59–0.71) and 0.66 (95% UI: 0.60–0.72), respectively. The burden of eating disorders was higher in females than in males, but the increment in ASRs was greater in males than in females over time. In 2017, the highest burden of eating disorders was observed in the high sociodemographic index (SDI) regions, especially Australasia (ASR of prevalence = 807.13, 95% UI: 664.20–982.30; ASR of DALYs = 170.74, 95% UI: 113.43–244.14, per 100 000 population), Western Europe and high-income North America. However, the most significant increment of the burden of eating disorders was observed in East Asia (EAPC for prevalence = 2.23, 95% UI: 2.14–2.32; EAPC for DALYs = 2.22, 95% UI: 2.13–2.31), followed by South Asia. An increasing trend in the burden of eating disorders at the national level was observed among most countries or territories. The countries with the top three highest increasing trends were Equatorial Guinea, Bosnia and Herzegovina and China. Positive associations were found between the burden estimates and the SDI levels in almost all geographic regions during the observed 28-year period. We also found that the human development indexes in 2017 were positively correlated with the EAPCs of the ASRs of prevalence (ρ = 0.222, P = 0.002) and DALYs (ρ = 0.208, P = 0.003). Conclusion The highest burden of eating disorders remains in the high-income western countries, but an increasing trend was observed globally and in all SDI-quintiles, especially in Asian regions that were highly populous. These results could help governments worldwide formulate suitable medical and health policies for the prevention and early intervention of eating disorders.

scholarly journals Global, regional, and national burdens of bladder cancer in 2017: estimates from the 2017 global burden of disease study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hairong He ◽  
Hongjun Xie ◽  
Yule Chen ◽  
Chengzhuo Li ◽  
Didi Han ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Latin America ◽  
Burden Of Disease ◽  
Western Europe ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Using Data ◽  
Disease Study

Abstract Background The aim of this study is to describe the prevalence and mortality of bladder cancer (BCa) using data obtained in the Global Burden of Disease study performed in 2017 (GBD 2017). Methods Data on BCa for 2017, including prevalence, mortality, and disability-adjusted life years (DALYs), were obtained from GBD 2017 at the global, regional, and national levels. We also analyzed the association of BCa burden with the country development level. Results There were 2.63 million BCa cases estimated from the GBD 2017 data, with 200,000 persons dying of BCa, resulting in 3.60 million DALYs in 2017. The age-standardized prevalence (ASP) of BCa was 32.91/100,000 persons, and age-standardized death rate (ASDR) was 2.57/100,000 persons. The ASP and ASDR of BCa were higher in males than in females, and higher in people older than 60 years. The ASP and ASDR of BCa were higher in Western Europe and Central Europe than in South Asia, Andean Latin America, and Central Latin America, and higher in countries with a higher sociodemographic index (SDI). Correlation analysis identified that the ASP and ASDR of BCa were positively correlated with the country SDI (P < 0.0001 and ρ = 0.68 for ASP, and P = 0.0048 and ρ = 0.20 for ASDR). In addition, 33.72% deaths and 36.80% DALYs caused by BCa could be attributed to smoking globally. Conclusion The prevalence and mortality of BCa were very high in 2017, especially in high-SDI countries. Smoking-cessation strategies should be strengthened to control the burden associated with BCa.

Sign in / Sign up

Export Citation Format

Share Document