scholarly journals Variability in the burden of disease estimates with or without age weighting and discounting: a methodological study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027825 ◽  
Author(s):  
Oluwaseun Egunsola ◽  
Jacques Raubenheimer ◽  
Nicholas Buckley
Keyword(s):  
Young Adults ◽  
Burden Of Disease ◽  
The Elderly ◽  
Mortality Data ◽  
Years Of Life Lost ◽  
Relative Contribution ◽  
National Burden ◽  
Acceptable Method ◽  
Total Burden ◽  
The Impact

ObjectivesThis study examines the impact of the type of method used on the estimation of the burden of diseases.DesignComparison of methods of estimating disease burden.SettingFour metrics of burden of disease estimation, namely, years of potential life lost (YPLL), non-age weighted years of life lost (YLL) without discounting and YLL with uniform or non-uniform age weighting and discounting were used to calculate the burden of selected diseases in three countries: Australia, USA and South Africa.ParticipantsMortality data for all individuals from birth were obtained from the WHO database.OutcomesThe burden of 10 common diseases with four metrices, and the relative contribution of each disease to the overall national burden when each metric is used.ResultsThere were variations in the burden of disease estimates with the four methods. The standardised YPLL estimates were higher than other methods of calculation for diseases common among young adults and lower for diseases common among the elderly. In the three countries, discounting decreased the contributions of diseases common among younger adults to the total burden of disease, while the contributions of diseases of the elderly increased. After discounting with age weighting, there were no distinct patterns for diseases of the elderly and young adults in the three countries.ConclusionsGiven the variability in the estimates of the burden of disease with different approaches, there should be transparency regarding the type of metric used and a generally acceptable method that incorporates all the relevant social values should be developed.

scholarly journals The non-fatal burden of cancer in Belgium, 2004–2018

2021 ◽  
Author(s):  
Vanessa Gorasso ◽  
Geert Silversmit ◽  
Marc Arbyn ◽  
Astrid Cornez ◽  
Robby De Pauw ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Burden Of Disease ◽  
Quality Data ◽  
Years Of Life Lost ◽  
Non Melanoma Skin Cancer ◽  
Life Years ◽  
National Burden ◽  
Disease Study ◽  
The Impact ◽  
Melanoma Skin

Abstract Background The importance of assessing and monitoring the health status of a population has grown in the last decades. Consistent and high quality data on the morbidity and mortality impact of a disease represent the key element for this assessment. Being increasingly used in global and national burden of diseases (BoD) studies, the Disability-Adjusted Life Year (DALY) is an indicator that combines healthy life years lost due to living with disease (Years Lived with Disability; YLD) and due to dying prematurely (Years of Life Lost; YLL). As a step towards a comprehensive national burden of disease study, this study aims to estimate the non-fatal burden of cancer in Belgium using national data. Methods We estimated the Belgian cancer burden from 2004 to 2018 in terms of YLD, using national population-based cancer registry data and international disease models. We developed a microsimulation model to translate incidence- into prevalence-based estimates, and used expert elicitation to integrate the long-term impact of increased disability due to surgical treatment. Results The age-standardized non-fatal burden of cancer increased from 2004 to 2018 by 6% and 2% respectively for incidence- and prevalence-based YLDs. In 2018, in Belgium, breast cancer had the highest morbidity impact among women, followed by colorectal and non-melanoma skin cancer. Among men, prostate cancer had the highest morbidity impact, followed by colorectal and non-melanoma skin cancer. Between 2004 and 2018, non-melanoma skin cancer significantly increased for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 48 to 107 for men and from 15 to 37 for women. Important decreases were seen for colorectal cancer for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 104 to 85 for men and from 52 to 46 for women. Conclusions Breast and prostate cancers represent the greatest proportion of cancer morbidity, while for both sexes the morbidity burden of skin cancer has shown an important increase from 2004 onwards. Integrating the current study in the Belgian national burden of disease study will allow monitoring of the burden of cancer over time, highlighting new trends and assessing the impact of public health policies.

scholarly journals The non-fatal burden of cancer in Belgium, 2004–2019: a nationwide registry-based study

BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Vanessa Gorasso ◽  
Geert Silversmit ◽  
Marc Arbyn ◽  
Astrid Cornez ◽  
Robby De Pauw ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Burden Of Disease ◽  
Quality Data ◽  
Years Of Life Lost ◽  
Non Melanoma Skin Cancer ◽  
Life Years ◽  
National Burden ◽  
Disease Study ◽  
The Impact ◽  
Melanoma Skin

Abstract Background The importance of assessing and monitoring the health status of a population has grown in the last decades. Consistent and high quality data on the morbidity and mortality impact of a disease represent the key element for this assessment. Being increasingly used in global and national burden of diseases (BoD) studies, the Disability-Adjusted Life Year (DALY) is an indicator that combines healthy life years lost due to living with disease (Years Lived with Disability; YLD) and due to dying prematurely (Years of Life Lost; YLL). As a step towards a comprehensive national burden of disease study, this study aims to estimate the non-fatal burden of cancer in Belgium using national data. Methods We estimated the Belgian cancer burden from 2004 to 2019 in terms of YLD, using national population-based cancer registry data and international disease models. We developed a microsimulation model to translate incidence- into prevalence-based estimates, and used expert elicitation to integrate the long-term impact of increased disability due to surgical treatment. Results The age-standardized non-fatal burden of cancer increased from 2004 to 2019 by 6 and 3% respectively for incidence- and prevalence-based YLDs. In 2019, in Belgium, breast cancer had the highest morbidity impact among women, followed by colorectal and non-melanoma skin cancer. Among men, prostate cancer had the highest morbidity impact, followed by colorectal and non-melanoma skin cancer. Between 2004 and 2019, non-melanoma skin cancer significantly increased for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 49 to 111 for men and from 15 to 44 for women. Important decreases were seen for colorectal cancer for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 105 to 84 for men and from 66 to 58 for women. Conclusions Breast and prostate cancers represent the greatest proportion of cancer morbidity, while for both sexes the morbidity burden of skin cancer has shown an important increase from 2004 onwards. Integrating the current study in the Belgian national burden of disease study will allow monitoring of the burden of cancer over time, highlighting new trends and assessing the impact of public health policies.

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

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.

scholarly journals The burden of cancer in Belgium, 2004-2017

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Cornez ◽  
G Silversmit ◽  
V Gorasso ◽  
I Grant ◽  
G M A Wyper ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lung Cancer ◽  
Burden Of Disease ◽  
Disease Burden ◽  
Expert Elicitation ◽  
Years Of Life Lost ◽  
Cancer Burden ◽  
Life Years ◽  
Belgian Population ◽  
The Impact

Abstract Background Monitoring the health status of a population requires consistent and comparable data on the morbidity and mortality impacts of a disease. The Disability-Adjusted Life Year (DALY) is an increasingly used disease burden indicator, combining healthy life years lost due to living with disease (Years Lived with Disability; YLDs) and due to dying prematurely (Years of Life Lost; YLLs). In Belgium, as in many other developed countries, cancer is a major contributor to the overall burden of disease. To date, however, local estimates of the burden of cancer are lacking. Methods We estimated the burden of 48 cancers in Belgium from 2004 to 2017 in terms of DALYs, using national population-based cancer registry data and international disease models. We developed a microsimulation model to translate incidence- into prevalence-based estimates, and used expert elicitation to integrate the long-term impact of surgical treatment. Results In 2017, in Belgium, breast cancer was the cancer with the highest disease burden among women, followed by lung cancer and colorectal cancer. Among men, lung cancer had the highest disease burden, followed by colorectal cancer and prostate cancer. Between 2004 and 2017, the burden of lung cancer increased by more than 50% in women, while in both sexes, significant increases were observed in melanoma and skin cancer burden. The majority of the cancer burden remained linked to premature mortality. Conclusions Cancer maintains a major impact on the health of the Belgian population. Current resources allocated for their prevention and treatment will need to be maintained to further reduce the cancer burden. Lung cancer remains a crucial challenge, among both men and women, calling for strengthened tobacco control policies. Integrating the current study in the Belgian national burden of disease study (BeBOD) will allow monitoring the burden of cancer over time, highlighting new trends and assessing the impact of public health policies. Key messages Burden of disease studies allow assessing and monitoring the impact of diseases and risk factors in a comparable way. Cancer maintains a major impact on the health of the Belgian population; lung cancer in particular remains a crucial challenge.

scholarly journals The Impact of Cold and Heat on Years of Life Lost in a Northwestern Chinese City with Temperate Continental Climate

2019 ◽  
Vol 16 (19) ◽  
pp. 3529 ◽  
Author(s):  
Jiangtao Liu ◽  
Yueling Ma ◽  
Yuhong Wang ◽  
Sheng Li ◽  
Shuyu Liu ◽  
...  
Keyword(s):  
Respiratory Diseases ◽  
Heat Waves ◽  
Age Groups ◽  
The Elderly ◽  
Years Of Life Lost ◽  
Weather Variables ◽  
Distributed Lag ◽  
Heat Effects ◽  
The Impact ◽  
Continental Climate

Cold spells and heat waves in a changing climate are well known as great public-health concerns due to their adverse effects on human health. However, very few studies have quantified health impacts of heat and cold in the region of Northwestern China. The purpose of the present study was to evaluate the effects of cold and heat on years of life lost (YLL) in Lanzhou, a city with temperate continental climate. We compiled a daily dataset including deaths, weather variables, and air pollutants in Lanzhou, China, from 2014–2017. We used a distributed lag non-linear model to estimate single-day and cumulative effects of heat and cold on daily YLL. Results indicated that both cold and heat were associated with increased YLL for registered residents in Lanzhou. Estimated heat effects appeared immediately in the first two days, while estimated cold effects lasted over a longer period (up to 30 days). Cold significantly increased the YLL of all residents except for males and those with respiratory diseases (≥65 years). Our results showed that both heat and cold had more pronounced effects on cardiovascular diseases compared to respiratory diseases. Males might be more vulnerable to heat, while females might suffer more YLL from cold. The effects of cold or heat on the elderly might appear earlier and last longer than those for other age groups.

scholarly journals The Impact of Non-optimum Ambient Temperature on Years of Life Lost: A Multi-county Observational Study in Hunan, China

2020 ◽  
Vol 17 (8) ◽  
pp. 2699
Author(s):  
Ling-Shuang Lv ◽  
Dong-Hui Jin ◽  
Wen-Jun Ma ◽  
Tao Liu ◽  
Yi-Qing Xu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Ambient Temperature ◽  
Respiratory Disease ◽  
Age Groups ◽  
The Elderly ◽  
Cold Temperature ◽  
Years Of Life Lost ◽  
Distributed Lag ◽  
Preventative Measures ◽  
The Impact

The ambient temperature–health relationship is of growing interest as the climate changes. Previous studies have examined the association between ambient temperature and mortality or morbidity, however, there is little literature available on the ambient temperature effects on year of life lost (YLL). Thus, we aimed to quantify the YLL attributable to non-optimum ambient temperature. We obtained data from 1 January 2013 to 31 December 2017 of 70 counties in Hunan, China. In order to combine the effects of each county, we used YLL rate as a health outcome indicator. The YLL rate was equal to the total YLL divided by the population of each county, and multiplied by 100,000. We estimated the associations between ambient temperature and YLL with a distributed lag non-linear model (DNLM) in a single county, and then pooled them in a multivariate meta-regression. The daily mean YLL rates were 22.62 y/(p·100,000), 10.14 y/(p·100,000) and 2.33 y/(p·100,000) within the study period for non-accidental, cardiovascular, and respiratory disease death. Ambient temperature was responsible for advancing a substantial fraction of YLL, with attributable fractions of 10.73% (4.36–17.09%) and 16.44% (9.09–23.79%) for non-accidental and cardiovascular disease death, respectively. However, the ambient temperature effect was not significantly for respiratory disease death, corresponding to 5.47% (−2.65–13.60%). Most of the YLL burden was caused by a cold temperature than the optimum temperature, with an overall estimate of 10.27% (4.52–16.03%) and 15.94% (8.82–23.05%) for non-accidental and cardiovascular disease death, respectively. Cold and heat temperature-related YLLs were higher in the elderly and females than the young and males. Extreme cold temperature had an effect on all age groups in different kinds of disease-caused death. This study highlights that general preventative measures could be important for moderate temperatures, whereas quick and effective measures should be provided for extreme temperatures.

scholarly journals Reduced Ebola vaccine responses in CMV+ young adults is associated with expansion of CD57+KLRG1+ T cells

2020 ◽  
Vol 217 (7) ◽  
Author(s):  
Georgina Bowyer ◽  
Hannah Sharpe ◽  
Navin Venkatraman ◽  
Pierre Birahim Ndiaye ◽  
Djibril Wade ◽  
...  
Keyword(s):  
T Cells ◽  
Young Adults ◽  
Killer Cell ◽  
Adenovirus Type ◽  
The Elderly ◽  
Younger Adults ◽  
Vaccine Responses ◽  
Cell Responses ◽  
Type 3 ◽  
The Impact

CMV is associated with immunosenescence and reduced vaccine responses in the elderly (>70 yr). However, the impact of CMV in young adults is less clear. In this study, healthy UK and Senegalese adults aged 18–50 yr (average, 29 yr) were vaccinated with the Ebola vaccine candidate chimpanzee adenovirus type 3–vectored Ebola Zaire vaccine (ChAd3-EBO-Z) and boosted with modified vaccinia Ankara Ebola Zaire–vectored (MVA–EBO-Z) vaccine. CMV carriage was associated with an expansion of phenotypically senescent CD4+ and CD8+ T cells expressing CD57 and killer cell lectin-like receptor G1 (KLRG1), which was negatively associated with vaccine responses in both cohorts. Ebola-specific T cell responses induced by vaccination also contained significantly increased frequencies of terminally differentiated CD57+KLRG1+ cells in CMV seropositive (CMV+) individuals. This study suggests that CMV can also affect vaccine responses in younger adults and may have a particularly marked impact in many developing countries where CMV seroprevalence is almost universal.

scholarly journals The burden of atherosclerosis in Portugal

2020 ◽  
Author(s):  
João Costa ◽  
Joana Alarcão ◽  
Francisco Araujo ◽  
Raquel Ascenção ◽  
Daniel Caldeira ◽  
...  
Keyword(s):  
Burden Of Disease ◽  
Clinical Manifestations ◽  
Premature Death ◽  
Mortality Data ◽  
Years Of Life Lost ◽  
Disability Adjusted Life Years ◽  
Mainland Portugal ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Years Lived With Disability

Abstract Aims This article sought to estimate the burden of disease attributable to atherosclerosis in mainland Portugal in 2016. Methods and results The burden of atherosclerosis was measured in disability-adjusted life years following the latest 2010 Global Burden of Disease (GBD) methodology. Disability-adjusted life years were estimated as the sum of years of life lost (YLL) with years lived with disability (YLD). The following clinical manifestations of atherosclerosis were included: ischaemic heart disease (IHD) (including acute myocardial infarction, stable angina, and ischaemic heart failure), ischaemic cerebrovascular disease (ICVD), and peripheral arterial disease (PAD). Years of life lost were estimated based on all-cause mortality data for the Portuguese population and mortality due to IHD, ICVD, and PAD for the year 2016 sourced from national statistics. Standard life expectancy was sourced from the GBD study. Years lived with disability corresponded to the product of the number of prevalent cases by an average disability weight for all possible combinations of disease. Prevalence data for the different clinical manifestations of atherosclerosis were sourced from epidemiological studies. Disability weights were sourced from the published literature. In 2016, 15 123 deaths were attributable to atherosclerosis, which corresponded to 14.3% of overall mortality in mainland Portugal. Disability-adjusted life years totalled 260 943, 75% due to premature death (196 438 YLL) and 25% due to disability (64 505 YLD). Conclusion Atherosclerosis entails a high disease burden to society. A large part of this burden would be avoidable if evidence-based effective and cost-effective interventions targeting known risk factors, from prevention to treatment, were implemented.

scholarly journals The Impact of Age Difference on the Efficacy and Safety of COVID-19 Vaccines: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiting Wang ◽  
Yue Tong ◽  
Duo Li ◽  
Jun Li ◽  
Yaling Li
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Young People ◽  
Publication Bias ◽  
Meta Analysis ◽  
Geometric Mean ◽  
The Elderly ◽  
Age Difference ◽  
Efficacy And Safety ◽  
The Impact

ObjectiveThis meta-analysis compared the efficacy and safety of five kinds of COVID-19 vaccines in different age groups (young adults and older adults), aiming to analyze the difference of adverse events (AEs) rate and virus geometric mean titer (GMT) values between young and older people, in order to find a specific trend, and explore the causes of this trend through meta-analysis.MethodMeta-analysis was used to analyze the five eligible articles. The modified Jadad scoring scale was used to evaluate the quality of eligible literature with a scoring system of 1 to 7. The primary endpoint of the effectiveness index was GMT. The primary endpoints of the safety index were the incidence of local AEs and systemic AEs. Stata 12.0 software was used for meta-analysis. Revman 5.0 software was used to map the risk of publication bias, and Egger’s test was used to analyze publication bias.ResultsThe GMT values of young adults were higher than older adults (SMD = 1.40, 95% CI (0.79, 2.02), P<0.01). There was a higher incidence of local and systemic AEs in young people than in the elderly (OR = 1.10, 95% CI (1.08, 1.12), P<0.01; OR = 1.18, 95% CI (1.14, 1.22), P<0.01).ConclusionThe immune effect of young people after being vaccinated with COVID-19 vaccines was better than that of the elderly, but the safety was worse than that of old people, the most common AEs were fever, rash, and local muscle pain, which were tolerable for young people. As the AEs of the elderly were lower, they can also be vaccinated safely; the reason for the low level of GMT in the elderly was related to Immunosenescence. The vaccine tolerance of people of different ages needs to be studied continuously.

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