The impact of worldwide, national and sub-national severity distributions in Burden of Disease studies: a case study of individual cancer types in Scotland

AbstractAimThe main aim of this study was to consider the extent to which the use of worldwide severity distributions in Burden of Disease studies are influencing cross-country comparisons, by comparing Global Burden of Disease distributions with nationally derived severity distributions in Scotland for cancer types.MethodsWe obtained individual records from the Scottish Cancer Registry for 21 cancer types and linked these to registered deaths. We estimated prevalent cancer cases for 2016 and assigned each case to sequelae using Global Burden of Disease (GBD) 2016 study definitions. We compared the impact of using severity distributions based on GBD 2016, a Scotland-wide distribution, and a distribution specific to deprivation strata in Scotland, on the weighted-average disability weights for each cancer type in Scotland.ResultsThe relative difference in point estimates of weighted-average disability weights based on GBD 2016 worldwide severity distributions compared with Scottish national severity distributions resulted in overestimates in the majority of cancers (17 out of 21 cancer types). The largest overestimates were for gallbladder and biliary tract cancer (70.8%), oesophageal cancer (31.6%) and pancreatic cancer (31.2%). Furthermore, the use of weighted-average disability weights based on Scottish national severity distributions rather than sub-national Scottish severity distributions stratified by deprivation quintile overestimated weighted-average disability weights in the least deprived areas (16 out of 18 cancer types), and underestimated in the most deprived areas (16 out of 18 cancer types).ConclusionOur findings illustrate a bias in point estimates of weighted-average disability weights created using worldwide severity distributions. This bias would have led to the misrepresentation of non-fatal estimates of the burden of individual cancers, and underestimated the scale of socioeconomic inequality in this non-fatal burden. This highlights the importance of not interpreting non-fatal estimates of burden of disease too precisely, especially for sub-national estimates and those comparing populations when relying on data inputs from other countries. It is essential to ensure that any estimates are based upon the best available country-specific data at the lowest granularity.

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Developing and evaluating national severity distributions for use in Burden of Disease studies: a case study of cancers in Scotland

International Journal for Population Data Science ◽

10.23889/ijpds.v4i3.1256 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Grant Wyper ◽

Ian Grant ◽

Eilidh Fletcher ◽

Gerry McCartney ◽

Diane Stockton

Keyword(s):

Burden Of Disease ◽

Weighted Average ◽

Systematic Bias ◽

Specific Data ◽

Tract Cancer ◽

Disability Weights ◽

Cancer Types ◽

Relative Differences ◽

The Impact

BackgroundIncreasingly Burden of Disease (BOD) measures are being used to influence policy decisions because they summarise health loss in an equitable manner. An important part of producing non-fatal BOD estimates are severity distributions (SDs). The Global Burden of Disease (GBD) study use the same SDs across countries due to a lack of available data. Aim To develop and assess the impact of national SDs compared with GBD worldwide severity distributions for 21 cancer types. MethodsPatient-level records from the Scottish Cancer Registry for 21 cancers were obtained and linked to death registrations. We estimated prevalent cancer cases for 2016 and assigned each case to one of four phases (diagnosis and treatment; controlled; metastatic; and terminal) using GBD 2016 study definitions. SDs were calculated by considering relative proportions. The impact of choice of SDs was evaluated by comparing relative differences between weighted-average disability weights (DW) derived using GBD 2016 worldwide SDs with those derived from Scottish SDs. ResultsFor the majority of cancers the most prevalent phase was the controlled phase, which contributed a higher proportion than the combined proportion from the other three phases across all cancers except mesothelioma. Differences in the composition of severity meant that most point-estimates of Scottish severity proportions were out-with the 95% uncertainty intervals. These differences resulted in overestimates of weighted-average DWs based on GBD 2016 worldwide SDs (17 out of 21 cancer types). The largest relative overestimates were for gallbladder and biliary tract cancer, oesophageal cancer and pancreatic cancer (71%, 32% and 31% higher respectively). ConclusionThese findings illustrate a systematic bias introduced by using worldwide SDs. Current non-fatal BOD estimates should not be interpreted too precisely when comparing populations when they rely on data inputs from other countries. It is essential to ensure that any estimates are based upon country-specific data as far as possible.

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The impact of redistributing deaths by ill-defined and unspecified causes on cancer mortality in Brazil

10.21203/rs.3.rs-15493/v1 ◽

2020 ◽

Author(s):

Alessandro Bigoni ◽

Amanda Ramos da Cunha ◽

José Leopoldo Ferreira Antunes

Keyword(s):

Burden Of Disease ◽

Cancer Mortality ◽

World Health ◽

Global Burden Of Disease ◽

Mortality Data ◽

Global Burden ◽

World Population ◽

Cancer Type ◽

Ministry Of Health ◽

The Impact

Abstract Background The reliability of mortality data is a critical aspect of epidemiological studies on cancer. The under-registration of deaths, a high proportion of deaths classified as due to unspecified causes,4 and inadequate report of immediate or mediate conditions as the underlying cause of death are the main problems affecting the reliability of mortality data. Several statistical techniques to correct this problem were reported, resulting in a variety of methods for the same purpose. This study aims to discuss the impact on the magnitude and temporal trends of mortality of four different strategies of redistribution that have been used to assess cancer mortality in Brazil. Methods This study used anonymized georeferenced provided by the Brazilian Ministry of Health. Four different approaches were used to perform the redistribution of ill-defined deaths and garbage codes. Age-standardized mortality rates used the world population as reference. Prais-Winsten autoregression allowed calculating trends for each region, sex and cancer type. Results Death rates increased considerably in all regions after performing the redistribution. Overall, the Elisabeth B. França and World Health Organization methods had a milder impact on trends and magnitudes of rates when compared to the method used in the Global Burden of Disease 2010 study. This study also observed that when the Brazilian Ministry of Health dealt with the problem of redistributing ill-defined deaths, the results were similar to those obtained by the Global Burden of Disease method. The redistribution methods also influenced the assessment of trends; however, differences in the annual percent change were less pronounced. Conclusions Given the impossibility of developing a gold standard method for comparison, the matching of global techniques with those that consider the local reality may be an alternative for methodology selection. In the present study, the compatibility of the findings suggests the validity of the Global Burden of Disease method as concerning the Brazilian context. However, caution is needed in this interpretation. Future studies should assess the impact of these methods as applied to the redistribution of deaths to type-specific neoplasms.

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The Global Trends in Incidence of Different Oral Disorders: Results from the Global Burden of Disease Study 2017 and the Impact on the Prevention

SSRN Electronic Journal ◽

10.2139/ssrn.3362452 ◽

2019 ◽

Author(s):

Chuan-Yu Hu ◽

Wei-Ming Wang ◽

Jun Zhang ◽

Hai-Rong He ◽

Yuan-Jie Li ◽

...

Keyword(s):

Burden Of Disease ◽

Global Burden Of Disease ◽

Global Burden ◽

Global Trends ◽

Disease Study ◽

The Impact

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Burden of non-communicable diseases in Cyprus, 1990–2017: findings from the Global Burden of Disease 2017 study

Archives of Public Health ◽

10.1186/s13690-021-00655-8 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Periklis Charalampous ◽

Elena Pallari ◽

Stefanos Tyrovolas ◽

Nicos Middleton ◽

Mary Economou ◽

...

Keyword(s):

Burden Of Disease ◽

Acne Vulgaris ◽

Communicable Diseases ◽

Global Burden Of Disease ◽

Cancer Drug ◽

Global Burden ◽

Years Of Life Lost ◽

Non Communicable Diseases ◽

Life Years ◽

The Impact

Abstract Background Non-communicable diseases (NCDs) accounted for over 90% of all deaths in the Cypriot population, in 2018. However, a detailed and comprehensive overview of the impact of NCDs on population health of Cyprus over the period of 1990 to 2017, expressed in disability-adjusted life years (DALYs), is currently not available. Knowledge about the drivers of changes in NCD DALYs over time is paramount to identify priorities for the prevention of NCDs in Cyprus and guide evidence-based decision making. The objectives of this paper were to: 1) assess the burden of NCDs in terms of years of life lost (YLLs), years lived with disability (YLDs), and DALYs in Cyprus in 2017, and 2) identify changes in the burden of NCDs in Cyprus over the 28-year period and assess the main drivers of these changes. Methods We performed a secondary database descriptive study using the Global Burden of Disease (GBD) 2017 results on NCDs for Cyprus from 1990 to 2017. We calculated the percentage change of age-standardized DALY rates between 1990 and 2017 and decomposed these time trends to assess the causes of death and disability that were the main drivers of change. Results In Cyprus in 2017, 83% (15,129 DALYs per 100,000; 12,809 to 17,707 95%UI) of total DALYs were due to NCDs. The major contributors to NCD DALYs were cardiovascular diseases (16.5%), neoplasms (16.3%), and musculoskeletal disorders (15.6%). Between 1990 and 2017, age-standardized NCD DALY rates decreased by 23%. For both males and females, the largest decreases in DALY rates were observed in ischemic heart disease and stroke. For Cypriot males, the largest increases in DALY rates were observed for pancreatic cancer, drug use disorders, and acne vulgaris, whereas for Cypriot females these were for acne vulgaris, psoriasis and eating disorders. Conclusion Despite a decrease in the burden of NCDs over the period from 1990 to 2017, NCDs are still a major public health challenge. Implementation of interventions and early detection screening programmes of modifiable NCD risk factors are needed to reduce occurrence and exacerbation of leading causes of NCDs in the Cypriot population.

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Sustainable Development Goals and Global burden of disease stakeholders

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.650 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

P Van Den Hazel

Keyword(s):

Sustainable Development ◽

Burden Of Disease ◽

Sustainable Development Goals ◽

Global Burden Of Disease ◽

Chronic Obstructive ◽

Global Burden ◽

Starting Point ◽

Health Related ◽

Development Goals ◽

The Impact

Abstract The Global Burden of Disease is the most comprehensive effort to date to measure epidemiological levels and trends worldwide. It is the product of a global research collaborative and quantifies the impact of hundreds of diseases, injuries, and risk factors in countries around the world. The publication published in The Lancet on September 12, 2017, namely the study, “Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016,” is the starting point to discuss the health-related SDG indicators as develop by the Institute for Health Metrics and Evaluation (IHME) and Global Burden of Disease collaborators. The projected increases in mortality are steep for chronic obstructive pulmonary disease and other chronic diseases. Non-communicable diseases are increasingly recognized as major causes of death and disability worldwide. The question is whether the targets in the SDGs are sufficiently addressing these increases. Or are demographic changes underlying the projected increases? Health related SDGs have been addressed in a tool made by the Institute for Health Metrics and Evaluation (IHME). Results on air pollution, smoking, unsafe water, sanitation and hygiene are presented by current and projected data in an interactive tool.

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