Iran's burden of disease and burden of data collection

Abstract

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 Iran Collaborators presented burden of disease estimates (eg, disability-adjusted life-years [DALYs]) for back and neck pain in Iran's 31 provinces between 1999 and 2019.1GBD 2019 Iran CollaboratorsHealth system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2022; 399: 1625-1645Summary Full Text Full Text PDF PubMed Scopus (30) Google Scholar This level of detail surprised us as we are familiar with prevalence studies for both conditions.To understand the amount of data underpinning the DALY estimates, we used the GBD 2019 Data Input Sources Tool. For neck pain, there was one study reporting data from Tehran, Iran, from 2004 to 2005. For back pain, there were four studies: one national survey from 2013 to 2015 and three subnational surveys (Tehran, 2004–05; east Azarbaijan, 2014–15; and Mazandaran, 2005).Such scarce primary data, particularly for neck pain, make the provincial estimates very uncertain. Even at the national scale, judging change from 1999 to 2019 is challenging when there are only data for 2 years for neck pain and 5 years for back pain. The problem of sparse data is not confined to back and neck pain. Conditions such as Alzheimer's disease and hearing loss have similar problems. The authors suggest that the results of the study are a call to action. To the important points that they offer, we would add that there is an urgent need for more primary research measuring burden of disease. There is also a need to improve data visualisation so readers are alerted to the completeness of primary data that underpin the GBD estimates in a figure.2Tamrakar M Kharel P Traeger A Maher C O'Keeffe M Ferreira G Completeness and quality of low back pain prevalence data in the Global Burden of Disease Study 2017.BMJ Glob Health. 2021; 6e005847Crossref PubMed Scopus (6) Google Scholar At the moment, estimates made on the basis of no primary data, some primary data, or a lot of primary data look identical.We declare no competing interests. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 Iran Collaborators presented burden of disease estimates (eg, disability-adjusted life-years [DALYs]) for back and neck pain in Iran's 31 provinces between 1999 and 2019.1GBD 2019 Iran CollaboratorsHealth system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019.Lancet. 2022; 399: 1625-1645Summary Full Text Full Text PDF PubMed Scopus (30) Google Scholar This level of detail surprised us as we are familiar with prevalence studies for both conditions. To understand the amount of data underpinning the DALY estimates, we used the GBD 2019 Data Input Sources Tool. For neck pain, there was one study reporting data from Tehran, Iran, from 2004 to 2005. For back pain, there were four studies: one national survey from 2013 to 2015 and three subnational surveys (Tehran, 2004–05; east Azarbaijan, 2014–15; and Mazandaran, 2005). Such scarce primary data, particularly for neck pain, make the provincial estimates very uncertain. Even at the national scale, judging change from 1999 to 2019 is challenging when there are only data for 2 years for neck pain and 5 years for back pain. The problem of sparse data is not confined to back and neck pain. Conditions such as Alzheimer's disease and hearing loss have similar problems. The authors suggest that the results of the study are a call to action. To the important points that they offer, we would add that there is an urgent need for more primary research measuring burden of disease. There is also a need to improve data visualisation so readers are alerted to the completeness of primary data that underpin the GBD estimates in a figure.2Tamrakar M Kharel P Traeger A Maher C O'Keeffe M Ferreira G Completeness and quality of low back pain prevalence data in the Global Burden of Disease Study 2017.BMJ Glob Health. 2021; 6e005847Crossref PubMed Scopus (6) Google Scholar At the moment, estimates made on the basis of no primary data, some primary data, or a lot of primary data look identical. We declare no competing interests. Health system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019The Iranian health-care system is encountering NCDs as its new challenge, which necessitates a coordinated multisectoral approach. Although the Iranian health-care system has been successful to some extent in controlling mortality, it has overlooked the burden of morbidity and need for rehabilitation. We did not capture alleviation of the burden of diseases in Iran following the 2004 and 2014 health sector reforms; however, the sanctions were associated with deaths of Iranians caused by NCDs. Full-Text PDF Open Access