Burden of non-communicable disease studies in Europe: a systematic review of data sources and methodological choices.

Elena Pallari,Federica Gazzelloni,Fimka Tozija,Anette Kocbach Bølling,Miguel Reina Ortiz,Cornelia Melinda Adi Santoso,Terje Andreas Eikemo,Brigita Hengl,Periklis Charalampous,Jane Idavain,Boris Bikbov,Susanne Breitner,Mika Gissler,Elena Von Der Lippe,Paul Hynds,Silvia Riva,Evangelia Nena,Alibek Mereke,Panagiotis Petrou,Gaetano Isola,Rodrigo Sarmiento,Florian Fischer,Stefania Mondello,Che Henry Ngwa,Juan Manuel García-González,Ala’A Alkerwi,Marjeta Majer,Orsolya Varga,Carina Ladeira,Tugce Schmitt,Dimitrios Skempes,Isabel Noguer,Joana Nazaré Morgado,Alberto Freitas,Balázs Ádám,Gerhard Sulo Natasa Terzic,Alicia Padrón‐Monedero ,Sara Monteiro Pires ,Edmond S W Ng ,Mark O’donovan ,Christina C Dahm ,Enkeleint A Mechili ,Ana Catarina Silva ,Jovana Todorović ,Alberto Órtiz ,Francesco Saverio Violante ,João Vasco Santos ,Aleksandar Stevanović ,Z Terzic-Supic ,Lea Sletting Jakobsen ,Rónán Ó’caoimh ,Juanita A Haagsma ,Milena Šantrić Milićević ,Dietrich Plaß ,Grant M A Wyper ,Katarzyna Kissimova-Skarbek,María José Santi-Cano,Vildan Mevsim,Zubair Kabir,Ann Kristin Knudsen,Sarah Cuschieri,Vanessa Gorasso,Naime Meriç Konar,Brigid Unim,Lorenzo Monasta,Louise Mitchell,Vikram Niranjan,Hanène Samouda,Brecht Devleesschauwer,Lisa Van Wilder,Aaron Liew

doi:10.1093/eurpub/ckab218

Abstract

BackgroundAssessment of disability-adjusted life years (DALYs) resulting from non-communicable diseases (NCDs) requires specific calculation methods and input data. The aims of this study were to (i) identify existing NCD burden of disease (BoD) activities in Europe; (ii) collate information on data sources for mortality and morbidity; and (iii) provide an overview of NCD-specific methods for calculating NCD DALYs.MethodsNCD BoD studies were systematically searched in international electronic literature databases and in grey literature. We included all BoD studies that used the DALY metric to quantify the health impact of one or more NCDs in countries belonging to the European Region.ResultsA total of 163 BoD studies were retained: 96 (59%) were single-country or sub-national studies and 67 (41%) considered more than one country. Of the single-country studies, 29 (30%) consisted of secondary analyses using existing Global Burden of Disease (GBD) results. Mortality data were mainly derived (49%) from vital statistics. Morbidity data were frequently (40%) drawn from routine administrative and survey datasets, including disease registries and hospital discharge databases. The majority (60%) of national BoD studies reported mortality corrections. Multimorbidity adjustments were performed in 18% of national BoD studies.ConclusionThe number of national NCD BoD assessments across Europe increased over time, driven by an increase in BoD studies that consisted of secondary data analysis of GBD study findings. Ambiguity in reporting the use of NCD-specific BoD methods underlines the need for reporting guidelines of BoD studies to enhance the transparency of NCD BoD estimates across Europe.

Highlights

In the early 1990s, the World Bank published the first Global Burden of Disease and Injury (GBD) study, introducing the Disability-Adjusted Life Years (DALYs) as a key metric for assessing the burden of disease (BoD) in populations.[1,2,3] One important feature of the disability-adjusted life years (DALYs) metric is that it aggregates populations’ health losses into a single figure summarizing mortality, measured by Years of Life Lost (YLLs), and morbidity, measured by Years Lived with Disability (YLDs).[3,4] The DALY is the key element of the BoD approach: a framework for integrating all available information on fatal and non-fatal health outcomes to provide an overview of the causes of health loss
We collate the information on data sources for mortality and morbidity; and in a third step, we provide an overview of the non-communicable diseases (NCDs)-specific methodological choices for calculating BoD
This systematic review provides a comprehensive overview of the number and types of NCD BoD activities performed in Europe until early-2020

Summary

Introduction

In the early 1990s, the World Bank published the first Global Burden of Disease and Injury (GBD) study, introducing the Disability-Adjusted Life Years (DALYs) as a key metric for assessing the burden of disease (BoD) in populations.[1,2,3] One important feature of the DALY metric is that it aggregates populations’ health losses into a single figure summarizing mortality, measured by Years of Life Lost (YLLs), and morbidity, measured by Years Lived with Disability (YLDs).[3,4] The DALY is the key element of the BoD approach: a framework for integrating all available information on fatal and non-fatal health outcomes to provide an overview of the causes of health loss. Assessment of disability-adjusted life years (DALYs) resulting from non-communicable diseases (NCDs) requires specific calculation methods and input data. The aims of this study were to (i) identify existing NCD burden of disease (BoD) activities in Europe; (ii) collate information on data sources for mortality and morbidity; and (iii) provide an overview of NCD-specific methods for calculating NCD DALYs. Methods: NCD BoD studies were systematically searched in international electronic literature databases and in grey literature. Of the single-country studies, 29 (30%) consisted of secondary analyses using existing Global Burden of Disease (GBD) results. Conclusion: The number of national NCD BoD assessments across Europe increased over time, driven by an increase in BoD studies that consisted of secondary data analysis of GBD study findings.

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Conclusion