Abstract
The burden of disease framework facilitates the assessment of the health impact of diseases through the use of summary measures of population health such as Disability-Adjusted Life Years (DALYs). However, calculating, interpreting and communicating the results of studies using this methodology poses a challenge. The aim of the Burden of Communicable Disease in Europe (BCoDE) project is to summarize the impact of communicable disease in the European Union and European Economic Area Member States (EU/EEA MS). To meet this goal, a user-friendly software tool (BCoDE toolkit), was developed. This stand-alone application, written in C++, is open-access and freely available for download from the website of the European Centre for Disease Prevention and Control (ECDC). With the BCoDE toolkit, one can calculate DALYs by simply entering the age group- and sex-specific number of cases for one or more of selected sets of 32 communicable diseases (CDs) and 6 healthcare associated infections (HAIs). Disease progression models (i.e., outcome trees) for these communicable diseases were created following a thorough literature review of their disease progression pathway. The BCoDE toolkit runs Monte Carlo simulations of the input parameters and provides disease-specific results, including 95% uncertainty intervals, and permits comparisons between the different disease models entered. Results can be displayed as mean and median overall DALYs, DALYs per 100,000 population, and DALYs related to mortality vs. disability. Visualization options summarize complex epidemiological data, with the goal of improving communication and knowledge transfer for decision-making.
Highlights
Summary measures of population health (SMPH) are composite indicators that facilitate comprehensive and comparable quantitative assessments of health-related phenomena
DisabilityAdjusted Life Years (DALYs) is a composite metric quantifying the health losses measured in years by adding the number of years of life lost due to disability (YLD) and the number of years of life lost due to premature death (YLL)
A principal goal of the Burden of Communicable Disease in Europe (BCoDE) project is to provide the European Union and European Economic Area Member States (EU/EEA MS) with a tool to estimate the impact of communicable diseases on population health expressed in DALYs
Summary
Summary measures of population health (SMPH) are composite indicators that facilitate comprehensive and comparable quantitative assessments of health-related phenomena. A principal goal of the Burden of Communicable Disease in Europe (BCoDE) project is to provide the European Union and European Economic Area Member States (EU/EEA MS) with a tool to estimate the impact of communicable diseases on population health expressed in DALYs. The main objectives are to promote evidence-based methods in epidemiology, to facilitate planning and prioritization related to public health decision making, to identify gaps in surveillance data availability and quality, and to provide a comprehensive framework for communicating complex information to decision-makers. The use and interpretation of DALY estimates is often challenging due to the complexity of a composite health indicator and due to the underlying assumptions made. In this paper we describe the technical and computational characteristics of the BCoDE toolkit and how this represents an important step forward by providing a consistent computational framework across diseases and populations
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