Improving the usability and communication of burden of disease methods and outputs: the experience of the Burden of Communicable Diseases in Europe software toolkit

Abstract

BackgroundThe Burden of Communicable Diseases in Europe (BCoDE) is a project led and funded by the European Centre for Disease Prevention and Control (ECDC) and by a European consortium with the purpose of estimating the impact of communicable diseases (CDs) expressed in disability-adjusted life-years (DALYs) in the European Union and the European Economic Area member states (MS). MethodsIn order to facilitate use and understanding of the burden of disease methodology, software with a user-friendly interface has been developed, the BCoDE toolkit. The application is written in C++ using Qt C++ toolkit, version 4.8.4. All computations are implemented in C++ and the interface is html with JavaScript. Each selected disease generates a model visible as a graphical outcome tree. By default, users input country-specific notified data (optional The European Surveillance System [TESSy] data source) and age-specific and sex-specific multiplication factors adjusting for underestimation. At will, the user is also allowed to edit population data as well as parameters of the outcome tree. FindingsBCoDE toolkit outputs are disease specific and include impact of acute illness versus sequelae, sex-specific and age-specific DALYs with uncertainty intervals, years of life lost due to premature mortality, and years lived with disability. Aggregated results are displayed as bubble charts (DALYs per 100 000 population) plotted against mortality, incidence, and DALYs per case. Interactive tables and bar charts ranking diseases and uncertainty can be produced and exported. InterpretationThe BCoDE toolkit is being distributed to national experts to allow the estimation of national burden of CDs. The aim of the software is to assist MS in applying the proposed BCoDE evidence-based approach for estimation of the burden of CDs, and to facilitate communication between data generators and users through multiple visualisation options, ultimately fostering its value in health policy formulation. Moreover, integration with TESSy allows national experts to assess availability and quality of data, identify gaps, and generate additional information on national surveillance systems. FundingThe BCoDE consortium is funded by the European Centre for Disease Prevention and Control (Specific agreement No 1 to Framework Partnership Agreement GRANT/2008/003) for the conduct of burden of infectious disease studies in Europe. NextPage Software has developed the software with funding of the BCoDE consortium.