Transparent Health Estimates Reporting Research Articles

Global, regional, and national burden and attributable risk factors of transport injuries: Global Burden of Disease Study 1990-2019.

Global, regional, and national burden and attributable risk factors of transport injuries: Global Burden of Disease Study 1990-2019.

Mapping length of inpatient treatment duration and year-wise relapse rates in eating disordered populations in a well-defined Western-European healthcare region across 1998-2020.

Updated international guideline recommendations for AN inpatient care rely on expert opinions/observational evidence and promote extended inpatient stays, warranting investigation using higher-level ecological evidence. The study was conducted according to Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Data encompassing 13,885 ED inpatients (5336 adolescents and 8549 adults) was retrieved from Swedish public health registries. Variables analyzed included (1) ED inpatient care opportunities, (2) unique number of ED inpatients and (3) mean length of ED-related inpatient stays in age groups 15-19 and 20-88+, across 1998-2020. Mean length of inpatient stays was inversely correlated to relapse to ED-related inpatient care within the same year (p<0.001, R-squaredadj =0.5216 and p<0.00001, R-squaredadj =0.5090, in the 15-19 and 20-88+ age groups, respectively), independent of number of ED inpatients treated within a year in both age groups. Extending mean adolescent inpatient duration from 35 to 45days was associated with a ∼30% reduction in the year-wise relapse rate. Mean length of ED-related inpatient treatment stays was associated with reduced relapses to inpatient care within the same year, which could be interpreted as support for recommendations to include a stabilization phase in inpatient ED treatment.

Compliance of WHO and UNICEF estimates of national immunization coverage (WUENIC) with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) criteria

Background: The objective of the study was to assess compliance of the WHO and UNICEF estimates of national immunization coverage (WUENIC) against the 18 criteria of the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) that define and promote good practice in reporting of global health estimates. Methods: We conducted a desk review of the WUENIC estimation and reporting process vis-à-vis each of the 18 GATHER criteria to complete a self-assessment of compliance with GATHER. Results: Overall, WUENIC estimates are fully compliant with 17 of the GATHER criteria and partially compliant with one criterion—criterion 11, which is related to candidate model evaluation and final model selection. Conclusion: The GATHER criteria provide a useful framework for documenting WUENIC’s compliance with contemporary reporting requirements. Given the role of vaccination coverage estimates in global monitoring and guiding disease control efforts, WHO and UNICEF strive to produce and publish robust estimates of vaccination coverage through a transparent process that emphasizes country involvement.

Compliance of WHO and UNICEF estimates of national immunization coverage (WUENIC) with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) criteria.

Background: The objective of the study was to assess compliance of the WHO and UNICEF estimates of national immunization coverage (WUENIC) against the 18 criteria of the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) that define and promote good practice in reporting of global health estimates. Methods: We conducted a desk review of the WUENIC estimation and reporting process vis-à-vis each of the 18 GATHER criteria to complete a self-assessment of compliance with GATHER. Results: Overall, WUENIC estimates are fully compliant with 17 of the GATHER criteria and partially compliant with one criterion-criterion 11, which is related to candidate model evaluation and final model selection. Conclusion: The GATHER criteria provide a useful framework for documenting WUENIC's compliance with contemporary reporting requirements. Given the role of vaccination coverage estimates in global monitoring and guiding disease control efforts, WHO and UNICEF strive to produce and publish robust estimates of vaccination coverage through a transparent process that emphasizes country involvement.

National case fatality rates of the COVID-19 pandemic

ObjectivesThe case fatality rate (CFR) of coronavirus disease 2019 (COVID-19) varies significantly between countries. We aimed to describe the associations between health indicators and the national CFRs of COVID-19. MethodsWe identified for each country health indicators potentially associated with the national CFRs of COVID-19. We extracted data for 18 variables from international administrative data sources for 34 member countries of the Organization for Economic Cooperation and Development (OECD). We excluded the collinear variables and examined the 16 variables in multivariable analysis. A dynamic web-based model was developed to analyse and display the associations for the CFRs of COVID-19. We followed the Guideline for Accurate and Transparent Health Estimates Reporting (GATHER). ResultsIn multivariable analysis, the variables significantly associated with the increased CFRs were percentage of obesity in ages >18 years (β = 3.26; 95%CI = 1.20, 5.33; p 0.003), tuberculosis incidence (β = 3.15; 95%CI = 1.09, 5.22; p 0.004), duration (days) since first death due to COVID-19 (β = 2.89; 95%CI = 0.83, 4.96; p 0.008), and median age (β = 2.83; 95%CI = 0.76, 4.89; p 0.009). The COVID-19 test rate (β = –3.54; 95%CI = –5.60, –1.47; p 0.002), hospital bed density (β = –2.47; 95%CI = –4.54, –0.41; p 0.021), and rural population ratio (β = –2.19; 95%CI = –4.25, –0.13; p 0.039) decreased the CFR. ConclusionsThe pandemic hits population-dense cities. Available hospital beds should be increased. Test capacity should be increased to enable more effective diagnostic tests. Older patients and patients with obesity and their caregivers should be warned about a potentially increased risk.

Protocol for the Data-Linkage Alcohol Cohort Study (DACS): investigating mortality, morbidity and offending among people with an alcohol-related problem using linked administrative data

IntroductionThe aims of this program of research are to use linked health and law enforcement data to describe individuals presenting to emergency and inpatient healthcare services with an acute alcohol...

New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis

SummaryBackgroundExisting WHO estimates of the prevalence of mental disorders in emergency settings are more than a decade old and do not reflect modern methods to gather existing data and derive estimates. We sought to update WHO estimates for the prevalence of mental disorders in conflict-affected settings and calculate the burden per 1000 population.MethodsIn this systematic review and meta-analysis, we updated a previous systematic review by searching MEDLINE (PubMed), PsycINFO, and Embase for studies published between Jan 1, 2000, and Aug 9, 2017, on the prevalence of depression, anxiety disorder, post-traumatic stress disorder, bipolar disorder, and schizophrenia. We also searched the grey literature, such as government reports, conference proceedings, and dissertations, to source additional data, and we searched datasets from existing literature reviews of the global prevalence of depression and anxiety and reference lists from the studies that were identified. We applied the Guidelines for Accurate and Transparent Health Estimates Reporting and used Bayesian meta-regression techniques that adjust for predictors of mental disorders to calculate new point prevalence estimates with 95% uncertainty intervals (UIs) in settings that had experienced conflict less than 10 years previously.FindingsWe estimated that the prevalence of mental disorders (depression, anxiety, post-traumatic stress disorder, bipolar disorder, and schizophrenia) was 22·1% (95% UI 18·8–25·7) at any point in time in the conflict-affected populations assessed. The mean comorbidity-adjusted, age-standardised point prevalence was 13·0% (95% UI 10·3–16·2) for mild forms of depression, anxiety, and post-traumatic stress disorder and 4·0% (95% UI 2·9–5·5) for moderate forms. The mean comorbidity-adjusted, age-standardised point prevalence for severe disorders (schizophrenia, bipolar disorder, severe depression, severe anxiety, and severe post-traumatic stress disorder) was 5·1% (95% UI 4·0–6·5). As only two studies provided epidemiological data for psychosis in conflict-affected populations, existing Global Burden of Disease Study estimates for schizophrenia and bipolar disorder were applied in these estimates for conflict-affected populations.InterpretationThe burden of mental disorders is high in conflict-affected populations. Given the large numbers of people in need and the humanitarian imperative to reduce suffering, there is an urgent need to implement scalable mental health interventions to address this burden.FundingWHO; Queensland Department of Health, Australia; and Bill & Melinda Gates Foundation.

Global and Regional Incidence, Mortality Trends and Predictions of Urologic Cancer, 1990-2026: A Systematic Analysis of the Global Burden of Disease Study 2016

Background: Urologic cancer, including prostate cancer, kidney cancer, bladder cancer, and testicular cancer, are substantially increasing with the growing and ageing population. This study analyzed trends in the incidence and mortality of these urologic cancers to provide evidence for policy makers to inform national policies for disease prevention and treatment and allocate resources appropriately. Methods: This study used the Global Burden of Disease Study data and methodologies to describe the incidence and mortality trends of urologic cancer from 1990 to 2016. Based on the data, we predicted the 10-year trends in urologic cancer incidence and death. Trends were analyzed over time, as well as by age, sex, and sociodemographic index (SDI). Findings: In 2016, 2282117 new urologic cancer cases occurred worldwide (95% uncertainty interval [UI], 2115350-2486237), nearly 2.2-fold the number in 1990 (1024819; 95% UI, 956085-1072322). Cumulative deaths increased by 1.9-fold from 380801 (95% UI, 353032-404060) in 1990 to 707566 (95% UI, 636888-749766) in 2016. UC incident cases are increased by 55%, while deaths increased by 86% between 1990 and 2016. From 1990 to 2026, kidney cancers in both sexes are projected to increase substantially in high SDI, middle SDI, low-middle SDI, and low SDI countries, while the trends in incidence rates will remain stable globally and in high-middle SDI countries. Globally, the trends in deaths due to kidney cancer will remain stable. Bladder cancer will have the greatest occurrence in high SDI countries, followed by high-middle SDI countries. Moreover, bladder cancer incidence rates may increase substantially in middle SDI countries, while the incidence rates will remain relatively stable in other SDI countries for both sexes. From 1990 to 2026, bladder cancer deaths will continue to increase in low SDI countries, while deaths in other SDI countries will continue to decrease 2026. Of note, from 1990 to 2016, the most common incident urologic cancer globally for men was prostate cancer. Globally, from 1990 to 2026, the trends in prostate cancer incident cases are increasing substantially. By SDI subtypes, prostate cancer will most frequently occur in high SDI countries over the next 10 years, followed by high-middle SDI countries, low SDI countries, middle SDI countries, and low-middle SDI countries. Simultaneously, the trends in prostate cancer deaths are expected to increase worldwide. The highest mortality rates will present in low SDI countries, followed by high SDI countries, high-middle SDI countries, and low-middle SDI countries. However, trends in prostate cancer deaths are expected to slightly decrease in middle SDI countries from 2016 to 2026.Testicular cancer will most frequently occur in high SDI countries and at a highly increased rate. From 1990 to 2026, testicular cancer incident cases are projected to rise in all SDI countries except for the low SDI and low-middle SDI countries, where they will remain stable. However, the trends in testicular cancer deaths decreased in the high-middle SDI countries in 2016, and are projected to increase from 2016 to 2026. Testicular cancer death rates in other SDI countries will decline from 1990 to 2026. Interpretations: The incidence of urologic cancer is highly variable among countries but has increased uniformly since 1990. The findings of increases in total deaths and accelerated population ageing call for specific focus from health policy makers to ensure that health care systems are equipped to meet peoples' needs. However, the incidence and mortality of urologic cancer are steadily increasing globally, resulting in further challenges in the allocation of limited health care resources. The current study provides comprehensive knowledge of the local burden of disease and assists with the appropriate allocation of resources for urologic cancer prevention, screening, and treatment. Funding Statement: The research was funded by the National Natural Science Foundation of China (NSFC, Grant No. 91746205, 71673199, and 71473175). Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: The present study complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).

Group B Streptococcal Disease Worldwide for Pregnant Women, Stillbirths, and Children: Why, What, and How to Undertake Estimates?

Improving maternal, newborn, and child health is central to Sustainable Development Goal targets for 2030, requiring acceleration especially to prevent 5.6 million deaths around the time of birth. Infections contribute to this burden, but etiological data are limited. Group B Streptococcus (GBS) is an important perinatal pathogen, although previously focus has been primarily on liveborn children, especially early-onset disease. In this first of an 11-article supplement, we discuss the following: (1) Why estimate the worldwide burden of GBS disease? (2) What outcomes of GBS in pregnancy should be included? (3) What data and epidemiological parameters are required? (4) What methods and models can be used to transparently estimate this burden of GBS? (5) What are the challenges with available data? and (6) How can estimates address data gaps to better inform GBS interventions including maternal immunization? We review all available GBS data worldwide, including maternal GBS colonization, risk of neonatal disease (with/without intrapartum antibiotic prophylaxis), maternal GBS disease, neonatal/infant GBS disease, and subsequent impairment, plus GBS-associated stillbirth, preterm birth, and neonatal encephalopathy. We summarize our methods for searches, meta-analyses, and modeling including a compartmental model. Our approach is consistent with the World Health Organization (WHO) Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER), published in The Lancet and the Public Library of Science (PLoS). We aim to address priority epidemiological gaps highlighted by WHO to inform potential maternal vaccination.

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

SummaryBackgroundAs mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016.MethodsWe estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between incidence, prevalence, remission, and cause of death rates for each condition. For some causes, we used alternative modelling strategies if incidence or prevalence needed to be derived from other data. YLDs were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae, corrected for comorbidity and aggregated to cause level. We updated the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. GBD 2016 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).FindingsGlobally, low back pain, migraine, age-related and other hearing loss, iron-deficiency anaemia, and major depressive disorder were the five leading causes of YLDs in 2016, contributing 57·6 million (95% uncertainty interval [UI] 40·8–75·9 million [7·2%, 6·0–8·3]), 45·1 million (29·0–62·8 million [5·6%, 4·0–7·2]), 36·3 million (25·3–50·9 million [4·5%, 3·8–5·3]), 34·7 million (23·0–49·6 million [4·3%, 3·5–5·2]), and 34·1 million (23·5–46·0 million [4·2%, 3·2–5·3]) of total YLDs, respectively. Age-standardised rates of YLDs for all causes combined decreased between 1990 and 2016 by 2·7% (95% UI 2·3–3·1). Despite mostly stagnant age-standardised rates, the absolute number of YLDs from non-communicable diseases has been growing rapidly across all SDI quintiles, partly because of population growth, but also the ageing of populations. The largest absolute increases in total numbers of YLDs globally were between the ages of 40 and 69 years. Age-standardised YLD rates for all conditions combined were 10·4% (95% UI 9·0–11·8) higher in women than in men. Iron-deficiency anaemia, migraine, Alzheimer's disease and other dementias, major depressive disorder, anxiety, and all musculoskeletal disorders apart from gout were the main conditions contributing to higher YLD rates in women. Men had higher age-standardised rates of substance use disorders, diabetes, cardiovascular diseases, cancers, and all injuries apart from sexual violence. Globally, we noted much less geographical variation in disability than has been documented for premature mortality. In 2016, there was a less than two times difference in age-standardised YLD rates for all causes between the location with the lowest rate (China, 9201 YLDs per 100 000, 95% UI 6862–11943) and highest rate (Yemen, 14 774 YLDs per 100 000, 11 018–19 228).InterpretationThe decrease in death rates since 1990 for most causes has not been matched by a similar decline in age-standardised YLD rates. For many large causes, YLD rates have either been stagnant or have increased for some causes, such as diabetes. As populations are ageing, and the prevalence of disabling disease generally increases steeply with age, health systems will face increasing demand for services that are generally costlier than the interventions that have led to declines in mortality in childhood or for the major causes of mortality in adults. Up-to-date information about the trends of disease and how this varies between countries is essential to plan for an adequate health-system response.FundingBill & Melinda Gates Foundation, and the National Institute on Aging and the National Institute of Mental Health of the National Institutes of Health.

Guidelines for Accurate and Transparent Health Estimates Reporting: the GATHER Statement

Measurements of health indicators are rarely available for every population and period of interest, and available data may not be comparable. The Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) define best reporting practices for studies that calculate health estimates for multiple populations (in time or space) using multiple information sources. Health estimates that fall within the scope of GATHER include all quantitative population-level estimates (including global, regional, national, or subnational estimates) of health indicators, including indicators of health status, incidence and prevalence of diseases, injuries, and disability and functioning; and indicators of health determinants, including health behaviours and health exposures. GATHER comprises a checklist of 18 items that are essential for best reporting practice. A more detailed explanation and elaboration document, describing the interpretation and rationale of each reporting item along with examples of good reporting, is available on the GATHER website (http://gather-statement.org).

Reporting of health estimates prior to GATHER: a scoping review

ABSTRACTBackground: Generating estimates of health indicators at the global, regional, and country levels is increasingly in demand in order to meet reporting requirements for global and country targets, such as the sustainable development goals (SDGs). However, such estimates are sensitive to availability of input data, underlying analytic assumptions, variability in statistical techniques, and often have important limitations. From a user perspective, there is often a lack of transparency and replicability. In order to define best practices in reporting data and methods used to calculate health estimates, the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) working group developed a minimum checklist of 18 items that must be reported within each study publishing health estimates, so that users may make an assessment of the quality of the estimate.Objective: We conducted a scoping review to assess the state of reporting amongst a cross-sectional sample of studies published prior to the publication of GATHER.Methods: We generated a sample of UN reports and journal articles through a combination of a Medline search and hand-searching published health estimates. From these studies we extracted the percentage of studies correctly reporting each item on the checklist, the proportion of items reported per study (the GATHER performance score), and how this score varied depending on study type.Results: The average proportion of items reported per study was 0.47, and the poorest-performing items related to documentation and availability of input data, availability of the statistical code used and the subsequent output data, and a complete detailed description of all the steps of the data analysis.Conclusions: Methods for health estimates are not currently fully reported, and the implementation of the GATHER guidelines will improve the availability of information required to make an assessment of study quality.

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time. Drawing from analytical approaches developed and refined in previous iterations of the GBD study, we generated updated estimates of child mortality by age group (neonatal, post-neonatal, ages 1-4 years, and under 5) for 195 countries and territories and selected subnational geographies, from 1980-2015. We also estimated numbers and rates of stillbirths for these geographies and years. Gaussian process regression with data source adjustments for sampling and non-sampling bias was applied to synthesise input data for under-5 mortality for each geography. Age-specific mortality estimates were generated through a two-stage age-sex splitting process, and stillbirth estimates were produced with a mixed-effects model, which accounted for variable stillbirth definitions and data source-specific biases. For GBD 2015, we did a series of novel analyses to systematically quantify the drivers of trends in child mortality across geographies. First, we assessed observed and expected levels and annualised rates of decrease for under-5 mortality and stillbirths as they related to the Soci-demographic Index (SDI). Second, we examined the ratio of recorded and expected levels of child mortality, on the basis of SDI, across geographies, as well as differences in recorded and expected annualised rates of change for under-5 mortality. Third, we analysed levels and cause compositions of under-5 mortality, across time and geographies, as they related to rising SDI. Finally, we decomposed the changes in under-5 mortality to changes in SDI at the global level, as well as changes in leading causes of under-5 deaths for countries and territories. We documented each step of the GBD 2015 child mortality estimation process, as well as data sources, in accordance with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Globally, 5·8 million (95% uncertainty interval [UI] 5·7-6·0) children younger than 5 years died in 2015, representing a 52·0% (95% UI 50·7-53·3) decrease in the number of under-5 deaths since 1990. Neonatal deaths and stillbirths fell at a slower pace since 1990, decreasing by 42·4% (41·3-43·6) to 2·6 million (2·6-2·7) neonatal deaths and 47·0% (35·1-57·0) to 2·1 million (1·8-2·5) stillbirths in 2015. Between 1990 and 2015, global under-5 mortality decreased at an annualised rate of decrease of 3·0% (2·6-3·3), falling short of the 4·4% annualised rate of decrease required to achieve MDG4. During this time, 58 countries met or exceeded the pace of progress required to meet MDG4. Between 2000, the year MDG4 was formally enacted, and 2015, 28 additional countries that did not achieve the 4·4% rate of decrease from 1990 met the MDG4 pace of decrease. However, absolute levels of under-5 mortality remained high in many countries, with 11 countries still recording rates exceeding 100 per 1000 livebirths in 2015. Marked decreases in under-5 deaths due to a number of communicable diseases, including lower respiratory infections, diarrhoeal diseases, measles, and malaria, accounted for much of the progress in lowering overall under-5 mortality in low-income countries. Compared with gains achieved for infectious diseases and nutritional deficiencies, the persisting toll of neonatal conditions and congenital anomalies on child survival became evident, especially in low-income and low-middle-income countries. We found sizeable heterogeneities in comparing observed and expected rates of under-5 mortality, as well as differences in observed and expected rates of change for under-5 mortality. At the global level, we recorded a divergence in observed and expected levels of under-5 mortality starting in 2000, with the observed trend falling much faster than what was expected based on SDI through 2015. Between 2000 and 2015, the world recorded 10·3 million fewer under-5 deaths than expected on the basis of improving SDI alone. Gains in child survival have been large, widespread, and in many places in the world, faster than what was anticipated based on improving levels of development. Yet some countries, particularly in sub-Saharan Africa, still had high rates of under-5 mortality in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-effective intervention packages to innovative financing mechanisms, is vital to charting the pathways for ultimately ending preventable child deaths by 2030. Bill & Melinda Gates Foundation.

Improving reporting of health estimates.

In May this year, the World Health Organization (WHO) published World health statistics 2016.1 This report presents the most recent monitoring data on health-related targets of the sustainable development goals (SDGs), and summarizes data availability and data gaps. For more than half of 35 health-related indicators considered in the report, data were available for less than 75% of countries, and for four indicators, data were available for less than 40% of countries. Yet for many of the indicators where there is incomplete data availability, WHO, other United Nations agencies and academic institutions publish global estimates that include country-specific estimates. The production of health estimates has increased tremendously in recent years. The increase is mainly driven by a growing demand to have recent health statistics for key indicators, such as those that were used to measure progress towards the Millennium Development Goals. For countries without data or with data of insufficient quality, estimates are calculated using statistical models. Modelling is done to make optimal use of lower-quality or incomparable data, and to fill data gaps. These estimates are primarily used for global monitoring and priority setting by global agencies including donors.2 Without information on the input data and methods used to calculate estimates, users may not know whether the estimates are fit for purpose. To facilitate the appropriate use and interpretation of health estimates, WHO convened a working group to develop the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).3,4 These guidelines aim to ensure that the documentation of input data and methods used to generate estimates are sufficient for users to evaluate the results and determine whether these may be used for a particular purpose. GATHER provides guidance on reporting quantitative population-level estimates of indicators of health status, health behaviours and health exposures. GATHER is a checklist of 18 items that are considered minimum essential documentation that should be reported every time a new set of health estimates are published. The checklist items are designed to communicate data and methods to a broad range of audiences, who may have varying levels of interest in the statistical methods used. Compliance with the checklist should assist users in understanding the input data used and any limitations of the data. For example, GATHER requires that authors provide information on all data sources that were used, such as the population represented, year of data collection and citation for the source. Using this information, a user can evaluate whether a particular estimate is based on a large quantity of high-quality data or a few low-quality studies. GATHER also provides guidance on reporting the limitations of an analysis. It requires that modelling assumptions or data gaps that affect interpretation of the results should be summarized in plain language. Other reporting items are meant to allow other researchers to scrutinize the data and methods. GATHER requires that authors make all data sets available. This requirement will maximize the benefits of assembled data sets by ensuring that data can be used for other research purposes. GATHER also requires that authors state how source code can be accessed. The requirement to make code available was considered essential to advance the science of health estimation by allowing researchers to build upon one another’s methods and to increase confidence in estimates by enabling external scrutiny. GATHER’s requirements on reporting input data and source code are ambitious in comparison to other leading guidelines in the medical field. Of the reporting guidelines for main study types found on the EQUATOR website – a clearinghouse for reporting guidelines – eight involve data analysis. Of these, only the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) requires reporting that would potentially allow reconstruction of the data used.5 None of the eight guidelines require that data or code be made available, though some encourage authors to do so.6 GATHER’s requirements are consistent with a growing movement among scientists, funding agencies and journals to improve reproducibility of research and reduce waste in research by making data and methods accessible.7–9 Sharing data and basic modelling assumptions will be an important step towards a greater understanding of estimates by a larger audience. This change will need to be supported by regular interaction and dialogue between UN agencies, academic institutions and technical staff of ministries of health to ensure the inclusion of all appropriate input data and greater understanding of methods, as is done through country consultations carried out by WHO for all its estimates.